A 49-year-old man presents to the Emergency Department complaining of fever and a productive cough for several weeks. He also endorses night sweats and perceived weight loss. The patient is homeless and is a known alcoholic. On examination, the patient's temperature is 38.3°C, blood pressure is 144/90 mmHg, heart rate is 94 beats per minute, and respiratory rate is 20 breaths per minute. He appears weak and disheveled with poor dentition. There are bronchial and amphoric breath sounds at the right lung base. His laboratory values are significant for a hemoglobin of 11.8 g/dL and a leukocyte count of 13,500/mm3. Blood and sputum cultures are collected and sent to the laboratory.What should be done next in the management of this patient?

A 32-year-old man comes to the physician complaining of fever, shortness of breath, and a productive cough that has developed slowly over the past week. He has no other medical history and does not take any medications. His temperature is 38.5°C, blood pressure is 122/78 mmHg, heart rate is 68 beats per minute, respiratory rate is 18 breaths per minute, and oxygen saturation is 98% on room air. There are decreased breath sounds and dullness to percussion over the right lung base. The rest of the physical examination, including cardiac auscultation, is normal. A chest x-ray confirms consolidation of the right lower lobe. What is the most appropriate course of action for this patient?

An 18-year-old girl is brought in to the hospital by her parents because of an asthma attack. She normally takes inhaled fluticasone and albuterol; however, she is not currently responding to the albuterol. On examination, she appears anxious and is moderately short of breath. There are loud bilateral wheezes on examination, with a prolonged inspiratory and expiratory phase and use of accessory muscles of respiration. Her temperature is 37.6°C, blood pressure is 118/78 mmHg, heart rate is 106 beats per minute, respiratory rate is 26 breaths per minute, and oxygen saturation is 93% on room air. She is placed on supplemental oxygen and bronchodilators and an arterial blood gas is drawn. Arterial Blood GaspH 7.40PaO2 60 mmHgPaCO2 40 mmHg Which of the following is the most appropriate next step in management?  Ask StudybuddyGroup of answer choicesIntubationIncrease supplemental oxygen flow rateAzithromycinIV corticosteroids

A 45-year-old man comes to the emergency department due to a 1-day history of constant upper abdominal pain, nausea, and several episodes of vomiting.  The pain is partially relieved by sitting up or bending forward.  He has also had mild shortness of breath.  The patient's other medical history includes hyperlipidemia and hypertension.  He uses tobacco and alcohol.  There is a family history of coronary artery disease and hypertension.  Temperature is 38.1 C (100.6 F), blood pressure is 110/70 mm Hg, pulse is 114/min, and respirations are 22/min.  There is dullness to percussion and decreased breath sounds at the left lung base.  Abdominal examination shows epigastric tenderness.  Laboratory results are as follows:Hematocrit 44%Leukocytes 16,000/mm3Calcium 7.8 mg/dLGlucose 250 mg/dLWhich of the following plays a principal role in initial management of this patient's current condition? A.Antiplatelet agents B.Broad-spectrum antibiotics C.Calcium gluconate D.Exploratory laparotomy E.Insulin infusion F.Isotonic crystalloids G.Proton pump inhibitors

A 36-year-old man comes to the office for a routine visit. He has not seen a doctor in over 15 years, but his wife insisted he go for a “checkup.” He has no medical problems or complaints. He has smoked half a pack of cigarettes for the last 10 years. His vitals show a temperature of 37.2°C, blood pressure of 148/82 mmHg, heart rate of 70 beats per minute, and respiratory rate of 12 breaths per minute. His BMI is 28 kg/m2. Repeat blood pressure measurement shows 152/88 mmHg. His physical examination is unremarkable.Hemoglobin 14.5 g/dLLeukocyte count 7,500/mm3Sodium 139 mEq/LPotassium 4.1 mEq/LCreatinine 0.9 mg/dLRandom blood glucose 98 mg/dL He is counseled on maintaining a healthy diet, exercise, and smoking cessation. What is the best next step in management?

A 59-year-old female presents to the office because she is “sick and tired” of this cough she has had for 5 years, and it is getting worse. The cough is often productive of watery mucus. She is also becoming increasingly short of breath and cannot climb a flight of stairs without taking a rest. She does not have chest pain, paroxysmal nocturnal dyspnea, fevers, chills, or weight loss. PMH is significant for HTN and a 35-pack-year history of cigarette smoking. Vital signs are as follows: Temperature = 99.0°F, HR 75, RR 21, BP 158/82 mm Hg. O2 saturation is 94% at rest and reaches a nadir of 90% with activity. Physical examination reveals an obese woman in no acute distress. On lung auscultation, there are coarse breath sounds bilaterally but no wheezes or crackles. Chest radiograph is significant for prominent lung markings at the bases. PFTs show FEV1/FVC ratio 0.60 and FEV1 65%.What is the most effective long-term intervention for this woman?Ask StudybuddyGroup of answer choicesAzithromycinSalmeterol inhalerSmoking cessationOxygen therapyTiotropium inhaler