bose
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A 64-year-old man presents to the physican's office complaining of fevers for the past 2 days. Over the past 24 hours, he has developed a productive cough. On physical examination, he does not appear chronically ill but appears moderately dyspneic. His temperature is 38.6 C (101.4 F), blood pressure is 136/94 mm Hg, and respirations are 26/min. There is no jugular venous distention. The lungs have coarse rhonchi at the right lung base with increased fremitus in the same area. He has a regular heart rhythm, with a 1/6 systolic murmur at the left sternal border. The remainder of the physical examination is unremarkable. Which of the following is the most appropriate next step in diagnosis?
A. Chest x-ray film
B. Sputum Gram's stain
C. Chest CT scan
D. Pulmonary function test
E. Peak expiratory flow rate measurement
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| mash
Forum Fanatic
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CX ray
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| dev
Forum Guru
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answer is A
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| bose
Forum Senior
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That's what I thought too and selected CXR (according to UW). But the correct answer was B..Sputum Gram Stain.
This Q is from IM Block 6 of Kaplan CD. The explanation they give is it takes one hour or so to get a CXR, so meanwhile collect sputum for gram stain.
So conficting answers between UW and Kaplan.
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