65y M presents with sudden fever, chills, and rusty sputum. Vitals: T 39.5°C, HR 110, RR 24. Exam reveals RLL bronchial breathing. CXR shows RLL consolidation. Diagnosis is CAP requiring admission. What is the indicated initial antibiotic therapy?
Anonymous Quiz
30%
Amoxicillin PO
10%
Azithromycin IV monotherapy
50%
Ceftriaxone + Azithromycin
10%
Piperacillin-Tazobactam + Vancomycin
Maxemo EMREE 26-27
65y M presents with sudden fever, chills, and rusty sputum. Vitals: T 39.5°C, HR 110, RR 24. Exam reveals RLL bronchial breathing. CXR shows RLL consolidation. Diagnosis is CAP requiring admission. What is the indicated initial antibiotic therapy?
💡 EXPLANATION:
This patient has CAP requiring inpatient care (CURB-65 ≥2). Guidelines recommend combination therapy with a beta-lactam (e.g., Ceftriaxone) plus a macrolide (e.g., Azithromycin) for non-ICU inpatients to cover typical and atypical pathogens.
A 25-year-old male presents with sudden onset dyspnea and pleuritic chest pain. A chest X-ray is performed. Visualization of which specific line, representing the edge of the collapsed lung, confirms a pneumothorax?
Anonymous Quiz
30%
Parietal pleural line
40%
Kerley B line
10%
Mediastinal line
20%
Visceral pleural line
Maxemo EMREE 26-27
A 25-year-old male presents with sudden onset dyspnea and pleuritic chest pain. A chest X-ray is performed. Visualization of which specific line, representing the edge of the collapsed lung, confirms a pneumothorax?
💡 EXPLANATION:
A definitive diagnosis of pneumothorax on CXR is made by identifying the visceral pleural line. This thin white line represents the lung edge, separated from the chest wall by a radiolucent space devoid of lung markings (air).
A 45 y/o M presents with chronic sinusitis, nasal crusting, hemoptysis, and hematuria. Urinalysis shows RBC casts. Serum creatinine is elevated. Which diagnosis is most likely?
Anonymous Quiz
33%
Goodpasture syndrome
11%
Microscopic polyangiitis
22%
Granulomatosis with polyangiitis
33%
Churg-Strauss syndrome
Maxemo EMREE 26-27
A 45 y/o M presents with chronic sinusitis, nasal crusting, hemoptysis, and hematuria. Urinalysis shows RBC casts. Serum creatinine is elevated. Which diagnosis is most likely?
💡 EXPLANATION:
Granulomatosis with Polyangiitis (GPA/Wegener's) is defined by the triad of upper airway (sinusitis), lower airway (hemoptysis), and renal disease (glomerulonephritis). c-ANCA is typically positive. Goodpasture syndrome spares the upper airway.
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A patient presents with fever and cough. CXR demonstrates a dense opacity in the right lower zone that obscures the right heart border. What is the primary radiographic abnormality?
Anonymous Quiz
0%
Pleural effusion
75%
Lobar consolidation
25%
Pneumothorax
0%
Pulmonary edema
Maxemo EMREE 26-27
A patient presents with fever and cough. CXR demonstrates a dense opacity in the right lower zone that obscures the right heart border. What is the primary radiographic abnormality?
💡 EXPLANATION:
The finding of an opacity obscuring the heart border (positive Silhouette sign) is characteristic of lobar consolidation (pneumonia). This represents alveolar filling with fluid/pus. Pleural effusions typically show a meniscus, while pneumothorax appears hyperlucent.
A 32y F non-smoker presents with recurrent spontaneous pneumothorax. HRCT chest reveals diffuse, uniformly distributed thin-walled cysts. What is the most likely diagnosis?
Anonymous Quiz
42%
Pulmonary Langerhans cell histiocytosis
25%
Lymphangioleiomyomatosis
17%
Birt-Hogg-Dubé syndrome
17%
Lymphoid interstitial pneumonia
Maxemo EMREE 26-27
A 32y F non-smoker presents with recurrent spontaneous pneumothorax. HRCT chest reveals diffuse, uniformly distributed thin-walled cysts. What is the most likely diagnosis?
💡 EXPLANATION:
Lymphangioleiomyomatosis (LAM) affects women of childbearing age, presenting with recurrent pneumothorax and diffuse thin-walled cysts on HRCT. PLCH is associated with smoking and irregular cysts. Birt-Hogg-Dubé cysts are typically basal/subpleural.
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A patient presents with fever and cough. CXR demonstrates a dense opacity in the right lower zone that obscures the right heart border. What is the primary radiographic abnormality?
Anonymous Quiz
0%
Pleural effusion
67%
Lobar consolidation
17%
Pneumothorax
17%
Pulmonary edema
Maxemo EMREE 26-27
A patient presents with fever and cough. CXR demonstrates a dense opacity in the right lower zone that obscures the right heart border. What is the primary radiographic abnormality?
💡 EXPLANATION:
The finding of an opacity obscuring the heart border (positive Silhouette sign) is characteristic of lobar consolidation (pneumonia). This represents alveolar filling with fluid/pus. Pleural effusions typically show a meniscus, while pneumothorax appears hyperlucent.
A 32y F non-smoker presents with recurrent spontaneous pneumothorax. HRCT chest reveals diffuse, uniformly distributed thin-walled cysts. What is the most likely diagnosis?
Anonymous Quiz
33%
Pulmonary Langerhans cell histiocytosis
67%
Lymphangioleiomyomatosis
0%
Birt-Hogg-Dubé syndrome
0%
Lymphoid interstitial pneumonia
Maxemo EMREE 26-27
A 32y F non-smoker presents with recurrent spontaneous pneumothorax. HRCT chest reveals diffuse, uniformly distributed thin-walled cysts. What is the most likely diagnosis?
💡 EXPLANATION:
Lymphangioleiomyomatosis (LAM) affects women of childbearing age, presenting with recurrent pneumothorax and diffuse thin-walled cysts on HRCT. PLCH is associated with smoking and irregular cysts. Birt-Hogg-Dubé cysts are typically basal/subpleural.