Correct!
5. More than one of the above

All of the approaches are reasonable. Given that there has been some change on the chest radiograph and the patient reports some improvement in symptoms, a conservative approach with follow up chest radiography is appropriate. Given the persistence of symptoms and chest radiographic abnormalities, however, changing the antibiotic regimen to an agent with a broader activity is appropriate. Furthermore, given that a substantial fraction of community-acquired pneumonias in the desert Southwest are due to coccidioidomycosis, testing for this organism is appropriate.)

The patient was treated with a broad-spectrum antibiotic of a different class than the medication used initially and was seen in follow up one month later. Repeat frontal chest radiography (Figure 4) was performed.

Figure 4. Repeat frontal chest radiograph after 1 month of a second antibiotic.

Which of the following represents an appropriate interpretation of her frontal chest radiograph? (Click on the correct answer to be directed to page 5 of 10 pages)

1. Frontal chest radiography shows resolution of the previous left-sided abnormalities
2. Frontal chest radiograph shows worsening of the previous left-sided abnormalities
3. Frontal chest radiography shows no change since the prior chest radiograph
4. Frontal chest radiography shows worsening of opacities in some areas and improvement in findings in other areas
5. Frontal chest radiography shows new right-sided abnormalities

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