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A young, previously healthy adult clinic patient reports symptoms of pneumonia including high fever and cough. Auscultation reveals rales in the left lower lobe. A chest radiograph is normal. The patient is unable to expectorate sputum. Which treatment is recommended for this patient?


A) A B-lactam antibiotic plus a fluoroquinolone
B) A respiratory fluoroquinolone antibiotic
C) Empirical treatment with a macrolide antibiotic
D) Hospitalization for intravenous antibiotics

E) All of the above
F) C) and D)

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C

A patient presents with a cough and fever. The provider auscultates rales in both lungs that do not clear with cough. The patient reports having a headache and sore throat prior to the onset of coughing. A chest radiograph shows patchy, nonhomogeneous infiltrates. Based on these findings, which organism is the most likely cause of this patient's pneumonia?


A) A virus
B) Mycoplasma
C) S. pneumoniae
D) Tuberculosis

E) All of the above
F) B) and C)

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B

A patient was initially treated as an outpatient for pneumonia and then after 2 weeks was hospitalized after no improvement was evident. The patient continues to show no improvement after several antibiotic regimens have been attempted. What is the next step in managing this patient?


A) Administration of the pneumonia vaccine
B) Increasing the dose of the antibiotics
C) Open lung biopsy
D) Performing diagnostic bronchoscopy

E) A) and C)
F) A) and B)

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D

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