USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 76-year-old man comes to the clinic with symptoms of fever, sore throat, shortness of breath, and central chest pain which is aggravated by lying down. His past medical history is significant for a recent myocardial infarction diagnosed in the emergency department eight weeks ago. He refused standard treatment and left the hospital against medical advice the next day. He says that his current symptoms began suddenly three days ago. His temperature is 37.8°C (100.2°F), pulse is 80/min, respirations are 22/min, and blood pressure is 118/75 mm Hg. Jugular venous pressure is 10 cm H2O. A positive friction rub is heard at all cardiac listening posts and there are no bruits or murmurs. Crackles are heard on the lower lung fields bilaterally on auscultation. Which of the following is the most appropriate next step in management of this patient?