#april2020mccqe1
A 20-year-old woman is evaluated in the emergency department for an acute episode of wheezing and dyspnea without cough or sputum production. She has had frequent evaluations in emergency departments for similar episodes. In between these episodes, findings on physical examination and pulmonary function testing, including methacholine challenge, have been normal. She is otherwise healthy and takes no medications. On physical examination, the patient has inspiratory and expiratory wheezing and is in moderate discomfort. The temperature is 37.1°C (98.8°F), pulse rate is 100/min, and respiration rate is 24/min; oxygen saturation on ambient air is 96%. After receiving albuterol and intravenous corticosteroids, she continues to wheeze and is in moderate respiratory distress. Oxygen saturation on ambient air remains at 96%. Chest radiograph shows decreased lung volumes. Which of the following is the most appropriate management for this patient?
(A) Chest CT scan
(B) Intravenous aminophylline
(C) Intravenous azithromycin
(D) Laryngoscopy
A 20-year-old woman is evaluated in the emergency department for an acute episode of wheezing and dyspnea without cough or sputum production. She has had frequent evaluations in emergency departments for similar episodes. In between these episodes, findings on physical examination and pulmonary function testing, including methacholine challenge, have been normal. She is otherwise healthy and takes no medications. On physical examination, the patient has inspiratory and expiratory wheezing and is in moderate discomfort. The temperature is 37.1°C (98.8°F), pulse rate is 100/min, and respiration rate is 24/min; oxygen saturation on ambient air is 96%. After receiving albuterol and intravenous corticosteroids, she continues to wheeze and is in moderate respiratory distress. Oxygen saturation on ambient air remains at 96%. Chest radiograph shows decreased lung volumes. Which of the following is the most appropriate management for this patient?
(A) Chest CT scan
(B) Intravenous aminophylline
(C) Intravenous azithromycin
(D) Laryngoscopy
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