Which description matches coarse rhonchi that clear with coughing?

• A. Turbulence due to mucus in the larger airways
• B. Fluid in the alveoli
• C. Pleural crackles
• D. Air leaks in the pleural space

Answer: (A)

Coarse rhonchi describe low-pitched, snoring-type sounds in the large airways caused by mucus or secretions creating turbulent flow. They clear with coughing because the act of coughing moves and expels the mucus, temporarily reopening the airway and reducing the obstruction. This pattern distinguishes them from crackles, which come from fluid in the smaller airways or alveoli and do not typically clear with coughing. Fluid in the alveoli produces crackles that persist or change with breathing, not a mucus-driven sound that disappears after a cough. Pleural crackles or rubs arise from friction between pleural surfaces and aren’t described as mucus-driven airflow sounds. Air leaks in the pleural space lead to different findings like decreased breath sounds or hyperresonance, not rhonchi. Therefore, turbulence due to mucus in the larger airways best matches coarse rhonchi that clear with coughing.