Chapter·SurgeryCardiothoracic Surgery

Empyema and pleural space infectionsDownloads

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1

Myeloperoxidase (MPO) is a heme-containing molecule that is found in the azurophilic granules of neutrophils. Upon release, the enzyme catalyzes hypochlorous acid production during the phagocytic response. In the setting of pneumonia, which of the following clinical findings is most directly associated with myeloperoxidase activity?

AShortness of breath

BGreen color of sputum

CRust-tinged sputum

DCough

EFever

2

A previously healthy 21-year-old man is brought to the emergency department 4 hours after the sudden onset of shortness of breath and pleuritic chest pain. He has smoked 1 pack of cigarettes daily for the past 3 years. He is 188 cm (6.2 ft) tall and weighs 70 kg (154 lb); BMI is 19.8 kg/m2. Physical examination shows decreased tactile fremitus and diminished breath sounds over the left lung. Which of the following is the most likely cause of this patient's symptoms?

AEmbolic occlusion of the pulmonary artery

BInflammation of the costal cartilage

CRupture of a subpleural bleb

DInfection with gram-positive diplococci

EHyperresponsiveness of the bronchial system

3

A 37-year-old man presents to the emergency department after he cut his hand while working on his car. The patient has a past medical history of antisocial personality disorder and has been incarcerated multiple times. His vitals are within normal limits. Physical exam is notable for a man covered in tattoos with many bruises over his face and torso. Inspection of the patient's right hand reveals 2 deep lacerations on the dorsal aspects of the second and third metacarpophalangeal (MCP) joints. The patient is given a tetanus vaccination, and the wound is irrigated. Which of the following is appropriate management for this patient?

AClosure of the wound with sutures

BClindamycin and topical erythromycin

CCiprofloxacin and topical erythromycin

DSurgical irrigation, debridement, and amoxicillin-clavulanic acid

ENo further management necessary

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