Correct!
5. More than one of the above
The chest CT findings are very unlikely to be related to COVID-19, and therefore Paxlovid (nirmatrelvir/ritonavir) therapy is not necessary. Surgical lung biopsy could certainly achieve a diagnosis for the lung parenchymal abnormalities but is needlessly invasive. Rather, bronchoscopy would provide the ability to determine if pulmonary alveolar proteinosis is present with risks substantially less than surgical lung biopsy. Similarly, given the suspicion for pulmonary alveolar proteinosis, granulocyte-monocyte – colony – stimulating factor [GM-CSF] titer assessment would be appropriate.
During the course of evaluation, the patient presented to the ER with complaints of worsening shortness of breath and non-neutropenic fever, with D-dimer again elevated at 6475 ng/mL (normal, <500 ng/mL), which prompted CT pulmonary angiography (Figure 6).
Figure 6. Left: static images in lung windows. Right: Video of CT scan in lung windows.
Which of the following represents an appropriate interpretationfor this examination? (Click on the correct answer to be directed to thirteenth of fourteen pages).