A 23-Year-Old Man Is Brought to the Emergency Department by His

question 1090

Multiple Choice

A 23-year-old man is brought to the emergency department by his family due to a severe sore throat, persistent elevated fevers, pain and difficulty with swallowing, and shortness of breath.  His symptoms worsened over the past day.  Three days ago, he was seen at an urgent care center for pharyngitis and was prescribed azithromycin.  The patient's past medical history is otherwise insignificant.  He does not use tobacco, alcohol, or illicit drugs.  His temperature is 40 C (104 F) , blood pressure is 90/58 mm Hg, pulse is 115/min, and respirations are 24/min.  Pulse oximetry shows 94% on room air.  Physical examination is notable for a well-built man in moderate distress due to pain.  There is mild swelling and erythema of the oropharynx and tonsils without exudate.  Dentition is intact and shows good hygiene.  The neck is swollen and tender along the left sternocleidomastoid muscle.  Lung examination reveals basilar crackles.  There are no heart murmurs.  Leukocyte count is 17,400/mm³ with 93% neutrophils.  A duplex ultrasound shows left internal jugular vein thrombosis.  Chest x-ray reveals multiple peripheral lung nodules, some with cavitation.  Which of the following is the most likely causative organism?

• A)Clostridium perfringens
• B)Fusobacterium necrophorum
• C)Haemophilus influenzae serotype b
• D)Klebsiella pneumoniae
• E)Streptococcus pyogenes

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Definitions:

Symbolic Meaning

The significance imbued in symbols, objects, or actions that go beyond their literal meaning and represent something more abstract.

Media Richness

Refers to the ability of information communication media to effectively convey complex messages in a timely and understandable manner.

Language Differences

Refer to variations in speech or writing that exist among individuals or groups, potentially leading to miscommunication or cultural misunderstandings in diverse settings.

Management by Walking Around

A leadership style where managers regularly walk around the workplace to interact with employees, observe operations, and encourage open communication.