Correct!
5. All of the above

Again, all of the above steps are appropriate measures for this patient. It is again conceivable that chest radiography could be deferred, given that normal oxygen saturation on room air, but obtaining a chest radiograph is certainly not inappropriate. In fact, given that the patient’s cough has subjectively worsened, a chest radiograph is a reasonable test to perform.

Basic laboratory data showed a normal white blood cell count = 5.3 x 109 / L (normal, 3.4 – 9.6 x 109 / L) with a mildly reduced platelet count of 116 x 109 / L (135- 317 x 109 / L), no evidence of anemia, normal serum chemistries and normal renal function parameters. The patient’s neutrophil count was normal, although the peripheral blood lymphocyte count was mildly reduced at 0.94 x 109 / L (normal, 0.95 – 3.07 x 109 / L). The patient’s ferritin was also increased at 578 mcg/L (normal, 24 – 337 mcg/L) and the procalcitonin-S level was mildly elevated at 0.09 ng/dL (normal, ≤0.08 ng/dL). The patient was referred for chest radiography (Figure 1).

Figure 1. Frontal chest radiography.

Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to be directed to the fourth of twelve pages)

  1. The chest radiograph shows focal rounded opacity at the left base
  2. The chest radiograph shows mediastinal and peribronchial lymph node enlargement
  3. The chest radiograph shows multifocal bilateral areas of consolidation
  4. The chest radiograph shows normal findings
  5. The chest radiograph shows numerous small nodules

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