1) You are a physician in a hospital in Hartford,
Connecticut. A 35-year-old, male patient with no underlying medical
conditions has had fever, chills, malaise and myalgias for 3 days.
Yesterday he developed a productive cough with watery mucoid sputum
and some chest pain.
What kinds of signs, symptoms and clues would you review to help
you rule out other diseases?
The best choice is E. Reviewing the state of the mediastinum on x-ray is an excellent way to rule out anthrax. You should also consider the progression of disease and the presence of influenza in the community to help rule out other community-acquired pneumonias.
The best choice is E. Reviewing the progression of the disease can help you rule out other pneumonias. Plague tends to be much more indolent than other pneumonias.
The
best choice is E. Looking for the presence of influenza in
the community is an excellent idea; especially between October and March
in the United States. The presence of bacteria in the lab specimens
can help rule out any viral pneumonias. Also, review the mediastinum
on x-ray to rule out anthrax and look at the progression of disease
to rule out community-acquired pneumonias.
The
best choice is E. Reviewing the state of the mediastinum on
x-ray is an excellent way to rule out anthrax. And looking for the presence
of influenza in the community can help you figure out if there is a
viral cause to the illness. However, looking at the progression of the
disease is also important, as other community-acquired pneumonias tend
to be less indolent.
Correct.
All three clues should be reviewed. Reviewing the state of the mediastinum
on x-ray is an excellent way to rule out anthrax. Looking for the presence
of influenza in the community can help you determine if the cause of
illness is viral. Determining, the progression of the disease is important,
as other community-acquired pneumonias tend to be less indolent.
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