59.A 67-year-old man is brought to the ED in respiratory distress. His ini-
tial vitals include a HR of 112 beats per minute, a BP of 145/88 mm Hg,
and an RR of 18 breaths per minute with an oxygen saturation of 92% on
room air. He is also febrile at 102°F. After obtaining IV access, placing the
patient on a monitor, and administering oxygen via nasal cannula, a chest
radiograph is performed and shows patchy alveolar infiltrates with consol-
idation in the lower lobes. On review of systems, the patient tells you that
he had five to six watery bowel movements a day for the last 2 days with a
few bouts of emesis. Which of the following infectious etiologies is most
likely responsible for the patient’s presentation?
a. Streptococcus pneumoniae
b. Haemophilus influenzae
c. Mycoplasma pneumoniae
d. Chlamydophila pneumoniae
e. Legionella pneumophila
60.A 58-year-old man presents to the ED with progressive dyspnea over
the course of 1 week. Upon arrival, he is able to speak in full sentences and
states that he stopped taking all of his medications recently. Initial vitals
include a HR of 92 beats per minute, a BP of 180/100 mm Hg, and an RR
of 16 breaths per minute with an oxygen saturation of 94% on room air.
Upon physical examination, the patient has bibasilar crackles, jugular
venous distention, and pedal edema. Which of the following medication
regimens was the patient most likely on?
a. Loop diuretic only
b. Aspirin only
c. Loop diuretic and β-blocker
d. Calcium channel blocker
e. Loop diuretic, β-blocker, and angiotensin-converting enzyme (ACE) inhibitor
Shortness of Breath 55