03-03-2008, 09:17 PM
A 28-year-old woman is evaluated in the emergency department for chest pain and shortness of breath. Her history is significant for hemoglobin SS.
On physical examination, the temperature is 39 °C (102.2 °F). She is tachypneic and has increased breath sounds with dullness to percussion at the right lung base. A chest radiograph confirms the presence of a right lower pulmonary lobe infiltrate. Oxygen saturation is 85% on room air. The hemoglobin is 7.2 g/dL (72 g/L), and the leukocyte count is 12,500/µL (12.5 x 109/L).
In addition to supplemental oxygen and antibiotics, which of the following is the most appropriate therapy for this patient at this time?
A Erythrocyte exchange transfusion
B Heparin
C Prednisone
D N-acetylcysteine
On physical examination, the temperature is 39 °C (102.2 °F). She is tachypneic and has increased breath sounds with dullness to percussion at the right lung base. A chest radiograph confirms the presence of a right lower pulmonary lobe infiltrate. Oxygen saturation is 85% on room air. The hemoglobin is 7.2 g/dL (72 g/L), and the leukocyte count is 12,500/µL (12.5 x 109/L).
In addition to supplemental oxygen and antibiotics, which of the following is the most appropriate therapy for this patient at this time?
A Erythrocyte exchange transfusion
B Heparin
C Prednisone
D N-acetylcysteine