Respiratory Quiz #28, Pnuemonia, Lung Abscess and Empyema  

1. A 45-year-old male with a history of alcoholism presents to the emergency department with fever, cough, and foul-smelling sputum for the past week. He has been experiencing weight loss and night sweats. A chest X-ray reveals a cavitary lesion in the right upper lobe. Which of the following is the most likely diagnosis? 

Question 1 of 5

2. A 60-year-old female with a past medical history of rheumatoid arthritis treated with methotrexate presents with fever, pleuritic chest pain, and dyspnea. A chest CT scan shows a loculated pleural effusion with pleural thickening. Which of the following is the most appropriate next step in management? 

Question 2 of 5

3. A 30-year-old male presents with cough, fever, and pleuritic chest pain. He reports a history of intravenous drug use. A chest X-ray reveals a homogeneous opacity in the left lower lung field with a fluid level. Which of the following pathogens is most commonly associated with this condition? 

Question 3 of 5

4. A 55-year-old male with chronic obstructive pulmonary disease (COPD) presents with a two-week history of fever, productive cough, and left-sided chest pain. A diagnostic thoracentesis is performed, revealing purulent fluid with a pH of 7.20, glucose <40 mg/dL, and lactate dehydrogenase (LDH) >1000 U/L. Which of the following is the most likely diagnosis? 

Question 4 of 5

5. A 25-year-old female presents with a 3-week history of productive cough, night sweats, and a high-grade fever. She recently returned from a trip to a farm. A chest X-ray reveals a single cavitary lesion in the right lower lobe. Which of the following is the most appropriate initial step in the management of this patient? 

Question 5 of 5


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