A 59-Year-Old Man Comes to the Emergency Department Due to a Sore

question 485

Multiple Choice

A 59-year-old man comes to the emergency department due to a sore throat.  He says that he was assaulted during an altercation in a bar 7 days ago.  The following day, the patient noticed some neck pain and stiffness, followed by a sore throat.  Today, he has severe throat pain, which has spread to his left shoulder and radiates down his left arm.  The patient drinks 6-12 beers daily and has a 50-pack-year smoking history.  Medical history includes type 2 diabetes mellitus and hypertension.  Temperature is 38.6 C (101.5 F) , blood pressure is 108/70 mm Hg, pulse is 106/min, and respirations are 16/min.  On examination, the patient is awake and alert.  Abrasions are present on the head, neck, and face.  Mild swelling and ecchymosis are noted on the forehead and around the right eye.  The posterior pharynx is normal; there is no trismus or drooling.  Right upper extremity strength is 5/5, and left upper extremity strength is 4/5.  Cervical spine tenderness is present at the C5 and C6 level.  Laboratory results are as follows: What is the best next step in management of this patient?

• A)Contrast esophagography
• B)CT scan of the head
• C)Direct laryngoscopy
• D)MR angiography of the neck vessels
• E)MRI of the cervical spine with contrast

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Definitions:

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Costs that vary directly with the level of production or sales volume, such as raw materials or sales commissions.

Margin of Safety

The difference between actual sales and the break-even point, indicating the extent to which sales can decline before losses begin.

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The profit a company generates from its core business operations, excluding expenses and revenues from non-operating activities.

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A company that specializes in the production and sale of one specific product or type of product.