A patient presents to the emergency room reporting chest pain. They state their chest pain occurs with activity and that it subsided after taking nitroglycerin. In addition, the patient states the pain lasted for 8 minutes. Based on the patient's signs and symptoms, what type of angina may the patient be experiencing?

A. Chest pain: While chest pain can occur in various pulmonary diseases, it is not as universally common or characteristic as cough. Chest pain may be more indicative of specific conditions rather than a broad symptom associated with pulmonary disease.

B. Cough: Cough is one of the most common symptoms associated with pulmonary disease, often occurring in conditions such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia, and bronchitis. It serves as a protective reflex to clear airways and is frequently reported by patients with pulmonary issues.

C. Hemoptysis: Hemoptysis, or coughing up blood, can be a significant symptom in certain pulmonary conditions (e.g., lung cancer, pulmonary embolism), but it is not as common across all pulmonary diseases. It is typically more specific to particular conditions.

D. Digit clubbing: Digit clubbing is a physical finding associated with chronic pulmonary diseases, particularly those that cause long-term hypoxia (e.g., cystic fibrosis, interstitial lung disease). However, it is less common than cough and typically develops over time rather than being a frequent presenting symptom.

A. It does not remain dormant but some host defenses can kill the bacteria: While the immune system can kill some of the Mycobacterium tuberculosis bacilli, in many cases, the bacteria evade complete eradication and persist in a dormant state within the lungs. This does not mean the infection is fully eliminated, as it can reactivate later.

B. Virulence factors in the bacilli weaken over time, leading to apoptosis: Mycobacterium tuberculosis does not naturally lose its virulence over time. Instead, it can persist in a latent state due to immune containment, not because of a reduction in its ability to cause disease.

C. The bacilli can become isolated within tubercles in the lungs, possibly encapsulated: In latent tuberculosis, the immune system walls off the bacilli within granulomas (tubercles), preventing active disease. These granulomas may be encapsulated with fibrous tissue, restricting bacterial growth and spread. The bacteria remain dormant but can reactivate if the immune system weakens.

D. Macrophages attack and phagocytize new areas of infection: While macrophages do play a role in the immune response to tuberculosis, they are often unable to completely eradicate the bacilli. Instead, the bacteria can survive within macrophages and trigger the formation of granulomas, which help contain but not eliminate the infection.