A 58-Year-Old Man with a 45-Pack-Year Smoking History Comes to the Clinic

A 58-year-old man with a 45-pack-year smoking history comes to the clinic due to a persistent cough.  The cough started about 3 months ago and is distinctly worse than his usual smoker's cough.  During this period, he had episodes of hemoptysis and lost 9.1 kg (20 lb) .  He has had no nausea, vomiting, fever, chills, night sweats, pruritus, seizures, or gait abnormalities.  Temperature is 36.9 C (98.4 F) , blood pressure is 134/85 mm Hg without an orthostatic drop, and pulse is 76/min.  Temporal wasting is evident.  The mucous membranes are moist, and the neck is supple without lymphadenopathy.  Heart and breath sounds are normal.  The abdomen is soft and nontender.  No peripheral edema is present.  The patient is oriented to time, place, and person.  Pupils are equal and reactive, and no nystagmus is elicited.  Neurologic examination, including gait, is normal.  Laboratory results are as follows: Which of the following is the best initial treatment for this patient?

A) Albumin infusion
B) Demeclocycline
C) Fluid restriction
D) Hypertonic saline
E) Lactated Ringer solution
F) No additional intervention
G) Normal saline

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free