A 23-year-old black woman fell while snowboarding and hurt her ribs. She denies having had any symptoms before her fall. Her examination reveals chest wall tenderness but no adenopathy, skin lesions, or organomegaly. An x-ray done to look for a rib fracture reveals bilateral hilar adenopathy.
Which of the following would be appropriate as initial therapy for this patient?
❑ A. Isoniazid
❑ B. Itraconazole
❑ C. Prednisone
❑ D. Chloroquine
❑ E. Observation
RESP5
A 43-year-old African-American woman who has had asthma for 16 years presents to your walk-in clinic with progressive dyspnea, chills, and productive cough. Physical examination reveals a thin woman in moderate distress. She is afebrile but has mild tachypnea and tachycardia. Lung examination reveals moderate air movement, diffuse wheezes, and egophony in the left upper lung zone without change in tactile fremitus. Chest radiography shows a segmental infiltrate of the left upper lobe with fingerlike
shadows and dilated central bronchi.
Which of the following diagnoses best explains the constellation of clinical findings and radiologic changes?
❑ A. Allergic bronchopulmonary aspergillosis
❑ B. Alvelolar cell carcinoma with endobronchial invasion
❑ C. Bronchiolitis obliterans organizing pneumonia (BOOP)
❑ D. Caplan syndrome
Ans: E for fracture, for hilar adenopathy further investigation!
Respi5: A