🏥 USMLE Exam Prep

A 60-year-old female undergoes an elective total knee arthroplasty. On post-operative day 3, she develops a fever of 101.5°F (38.6°C). Her physical exam is unremarkable except for mild incisional tenderness. She has no cough or dysuria. What is the most appropriate initial diagnostic step in evaluating her fever?

A Administer empiric broad-spectrum antibiotics.
B Order a CT scan of the abdomen and pelvis.
C Obtain a chest X-ray, urinalysis, and blood cultures.
D Reassure the patient, as this is a normal post-operative finding.

✓ Correct Answer: Option C

Post-operative fever on day 3 warrants investigation. Common causes include urinary tract infection, pneumonia, and wound infection. A chest X-ray, urinalysis, and blood cultures are appropriate initial steps to rule out these possibilities.

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