Which condition can increase tactile fremitus?

• A. Pneumonia
• B. Pneumothorax
• C. Emphysema
• D. Pleural effusion

Answer: (A)

Tactile fremitus increases when the lung tissue becomes more solid or filled with fluid, because dense tissue transmits the vibrations from the voice more readily to the chest wall. In pneumonia, alveolar spaces are filled with inflammatory exudate and cells, creating a consolidation that conducts these vibrations well, so you feel a stronger vibration over the affected area.

The other conditions tend to reduce fremitus. A pneumothorax introduces air into the pleural space, which creates a barrier to vibration transmission. Pleural effusion adds fluid that layers and separates the lung from the chest wall, dampening the vibrations. Emphysema causes hyperinflation and destruction of alveolar walls, making the lung more air-filled and less able to transmit the vibrations.

So, pneumonia is the best answer because it creates the consolidated, more conductive tissue that amplifies tactile fremitus.