A 78-Year-Old Woman Comes to the Urgent Care Center Due

question 571

Multiple Choice

A 78-year-old woman comes to the urgent care center due to the abrupt onset of fever, sore throat, a nonproductive cough, and muscle pain that began yesterday morning.  Several of her social friends have been sick, including one who was hospitalized with influenza.  The patient received an influenza vaccine 2 months ago and has no history of influenza infection.  Medical history includes hypertension, coronary artery disease, and ischemic cardiomyopathy with a left ventricular ejection fraction of 35%.  She is a lifetime nonsmoker.
Temperature is 38.3 C (100.9 F) , blood pressure is 122/76 mm Hg, pulse is 95/min, and respirations are 14/min.  Oxygen saturation is 98% on room air.  The patient appears uncomfortable but is in no acute distress.  No pharyngeal erythema or tonsillar exudates are present, and there is no cervical lymphadenopathy.  Auscultation of the lungs reveals no abnormalities.
Rapid influenza antigen test is negative, and chest x-ray reveals no infiltrates.  The patient asks to go home.
Which of the following is the most reasonable next step in management of this patient?

• A)Obtain viral cultures and discharge home
• B)Perform rapid streptococcal antigen testing
• C)Prescribe azithromycin
• D)Prescribe oseltamivir
• E)Provide symptomatic treatment and discharge home

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Definitions:

Chlorobenzene

A colorless organic compound consisting of a benzene ring substituted with a chlorine atom.

M/Z 70

A designation in mass spectrometry indicating a particle with a mass-to-charge ratio of 70, often associated with specific fragments in the spectra.

M/Z 127

The mass-to-charge ratio of an ion with a mass of 127 atomic mass units and a charge of one.

M/Z Fragments

In mass spectrometry, these fragments are pieces of a molecule resulting from ionization and fragmentation, described by their mass-to-charge ratio.