USMLE Forum Archives - USMLE Step 3 - FEVER
FEVER
zkadhem - 08-07-09 14:42
A 77-year-old male patient calls you in your office and complains of fever, chills, shortness of breath, and productive cough for the last two days. His symptoms have been getting progressively worse. His symptoms started with malaise, generalized body aches, nasal congestion, and a mild cough about a week ago. He has a history of coronary artery disease, congestive heart failure, diabetes, renal insufficiency, and chronic obstructive pulmonary disease. He lives by himself, and he says that he will not have any means of transportation until tomorrow, when his daughter will come to visit him. He has a 50-pack year history of smoking. The last time you saw him was a month ago, when he went to the office for a regular follow-up visit. He had refused to get an influenza vaccine at that visit. He received a pneumococcal vaccine six years ago. Which of the following is the most appropriate next step in the management of this patient?
zkadhem - 08-07-09 14:42
A 77-year-old male patient calls you in your office and complains of fever, chills, shortness of breath, and productive cough for the last two days. His symptoms have been getting progressively worse. His symptoms started with malaise, generalized body aches, nasal congestion, and a mild cough about a week ago. He has a history of coronary artery disease, congestive heart failure, diabetes, renal insufficiency, and chronic obstructive pulmonary disease. He lives by himself, and he says that he will not have any means of transportation until tomorrow, when his daughter will come to visit him. He has a 50-pack year history of smoking. The last time you saw him was a month ago, when he went to the office for a regular follow-up visit. He had refused to get an influenza vaccine at that visit. He received a pneumococcal vaccine six years ago. Which of the following is the most appropriate next step in the management of this patient?
The correct answer and explanation will be available after you answer.
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#16
Re: FEVER babbu5508 - 08-31-10 13:22 My answer is: d.
Ask him to call 911 and come to the hospital...with a bad past history regarding cardiac problems the symptoms should not be neglected.
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