 |  fever,cough,lobar infiltrate
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| Author | 6 Posts |
achilles
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A 71-year-old man presents to the emergency department with fever and cough. He has known hypercholesterolemia and is status post a right hemicolectomy for colon cancer. The patient states that he has had 3 days of fever to 102 F, cough productive of green sputum, as well as general malaise and weakness. His physical examination is remarkable for decreased breath sounds at the left base, left basilar egophony and dullness to percussion. A complete blood count reveals a leukocyte count of 15000/mm3. A chest radiograph reveals a left lower lobe infiltrate. Which of the following is the most important part of the history to ascertain prior to initiating therapy?
A. Influenza immunization status
B. Plasma lipid profile
C. Stage of the colon cancer
D. Social support structure for home therapy
E. Recent hospitalization
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| msyamp
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I go for Stage of the cancer. wether he is receivng any chemotherapy after that. or if splenectomy has been done. and if it can be a secondary that is in lung causing this infection etc
I go for C
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| yasmeen
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C IS MOST IMP TO SEE IF CA HAS METASTASIZED IN LUNG CAUSING SECONDARY PNEUMONIA
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| Jinx
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could this be e--n pseudomonas?
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| msyamp
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hey jinx you are right in saying it is Pseudomonas. but i doubt if confirming an obvious known fact of his hospitalisation again. well but thanks for the input.lets see for the answer
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| achilles
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good jinx. the answer is E.
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