Question

A 31 year old female presents to her physician in January with several days of fever, malaise, and a cough productive of yellow-green sputum. She had been feeling well until four days ago when she developed a sore throat and rhinorrhea; this was soon followed by fever, malaise, and myalgias. Two days ago she began experiencing a hacking cough that has been occasionally productive of purulent sputum. Vital signs include temperature 37.2 C (99.0 F), pulse 80, blood pressure 118/78, respirations 14/min, oxygen saturation 98% on room air. No crackles or rhonchi are appreciated on auscultation of the lungs. Which of the following is the most appropriate initial step in the management of this patient?

A. Azithromycin
B. Ceftriaxone and levofloxacin
C. Salmeterol
D. Amantadine
E. Pseudophedrine and acetaminophen

Answer 1

The most appropriate initial step in the management of this patient is to administer antibiotic therapy, specifically azithromycin.

Step-by-step explanation:

The most appropriate initial step in the management of this patient is to administer antibiotic therapy. Based on the patient's symptoms and physical examination findings, it is likely that she has a bacterial respiratory infection such as pneumonia. Antibiotics are the mainstay of treatment for bacterial respiratory infections. The choice of antibiotic should be guided by the likely pathogens involved, which are typically Streptococcus pneumoniae, Haemophilus influenzae, or atypical pathogens such as Mycoplasma pneumoniae or Chlamydophila pneumoniae. In this case, based on the patient's age and symptoms, a good initial choice would be azithromycin, as it covers both typical and atypical pathogens.