Property:AnswerBExp
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As a general rule, chest X-ray is the best initial radiographic test for any pulmonary complaint. In the case of gastric perforation, upright chest x-ray is a rapid diagnostic tool that will show free air under the diaphragm. +
Although this is highly unlikely. Hepatitis refers to liver injury characterized by presence of inflammatory cells in the liver tissue. The symptoms include: Abdominal pain or distention, breast development in males, dark urine and pale or clay-colored stools, fatigue, fever, itching, jaundice (yellowing of the skin or eyes), loss of appetite, nausea, vomiting, and weight loss.
Hepatitis typically causes a rise in liver function tests. In particular, there is often a disproportionate rise in transaminases relative to the alkaline phosphatase, but this is not universal and the pattern can be suggestive of cause. Hepatitis is usually diagnosed by serological tests, depending on the cause. +
This is usually used to treat syphilis in HIV-positive patients. It is not used as a prophylactic medication against PCP. +
Sensorineural hearing loss is a rare and transient complication. It responds promptly to intravenous immunoglobulin (IVIG) therapy. +
Reserve cell hyperplasia is characterized by small uniform cells observed in BAL. It is frequently included in the cytopathological differential diagnosis of small cell undifferentiated carcinoma. It are not typically observed in patients with aspiration pneumonia. +
'''Incorrect:'''Post-myocardial infarction pericarditis, much like Dressler's syndrome, is a pericarditis which occurs after a myocardial infarction. However Dressler's syndrome will occur 2-10 weeks after an MI, whereas post-myocardial infarction pericarditis typically occurs 2-4 days after a myocardial infarction. +
'''Correct:''' Pericardial resection is necessary for the treatment of constrictive pericarditis. However, diuretics should be administered first to acutely relieve the symptoms of heart failure. Because diuretic therapy was not an option in this question, pericardial resection is the next best answer. +
T wave inversion and poor R wave progression suggests ischemia, and is not specific for acute pericarditis. +
NSAIDs is the correct answer. NSAIDs, such as ibuprofen, naproxen or indomethacin, are the best initial therapy for acute pericarditis. +
The history of this patient is more consistent with Dressler's syndrome. There is nothing else in the patient history to suggest a different form of pericarditis, and no past medical history of tuberculosis. +