A 65-year-old man admitted with CAP on ceftriaxone and azithromycin. On day 3 he has high fever with reduced breath sounds and tactile fremitus at the left base. What is the best course of action?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. CXR
Still febrile on day 3 of CAP treatment = non-resolving pneumonia; the new left-base signs (reduced breath sounds and reduced tactile fremitus) point to a complication such as a parapneumonic effusion/empyema. Chest X-ray is the standard initial imaging to detect it. Blood/sputum cultures or procalcitonin do not identify the complication.
ليش كل خيار صح أو غلط
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A
ليش صح
Reduced tactile fremitus and breath sounds suggest pleural effusion, and chest X-ray is the standard initial imaging for it (blunted costophrenic angle).
✓ Pleural effusion.pdf · p. 3 -
B
ليش غلط
Blood cultures only identify bacteremia; they do not look for the pleural complication suggested by the new signs.
✓ Pulmonology 🫁.pdf · p. 16 -
C
ليش غلط
Gram stain identifies the class of the bacteria; it does not detect a pleural effusion or empyema, the likely cause of non-response here.
✓ Pulmonology 🫁.pdf · p. 16 -
D
ليش غلط
Procalcitonin is an inflammatory marker; a low level after 2-3 days helps decide when to stop antibiotics. It does not identify a complication.
✓ Pneumonia (1).pdf · p. 3
- المصدر
- Pulmonology 🫁.pdf · p. 17
Pleural effusion.pdf · p. 3 - المحاضرة
- Pneumonia · Pulmonology · Module B
- ظهر في
- MED41 ♀ EOM B