🏥 USMLE Exam Prep

A 70-year-old female undergoes an elective total knee arthroplasty. On post-operative day 2, she develops fever (38.5°C), shortness of breath, and a productive cough. Chest X-ray shows new infiltrates in the right lower lobe. Her oxygen saturation is 90% on room air. What is the most likely diagnosis and initial management?

A Pulmonary embolism; start anticoagulation.
B Atelectasis; encourage incentive spirometry.
C Post-operative pneumonia; initiate broad-spectrum antibiotics.
D Acute respiratory distress syndrome; intubate for mechanical ventilation.

✓ Correct Answer: Option C

The combination of fever, dyspnea, productive cough, and new infiltrates in an elderly, post-surgical patient strongly suggests post-operative pneumonia. Initial management involves prompt initiation of broad-spectrum antibiotics, pending culture results.

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