ATI TEAS (Test of Essential Academic Skills) Version 7ReadingHard
A medical record entry states: 'Patient reports 3-day history of malaise, myalgia, and a low-grade fever (100.8°F). Denies cough or sore throat. Physical exam reveals clear lung sounds bilaterally. Rapid influenza test negative. Differential diagnoses include viral syndrome, early bacterial infection.' What information from this entry most strongly supports the conclusion that the patient's condition is likely a viral syndrome rather than a bacterial infection?
- AMalaise and myalgia
- BClear lung sounds bilaterally
- CLow-grade fever (100.8°F)
- DDenial of cough or sore throat
Show answer & explanationAnswer & explanation
Correct answer: B. Clear lung sounds bilaterally
While malaise, myalgia, and low-grade fever can occur in both viral and bacterial infections, clear lung sounds bilaterally (meaning no abnormal sounds in either lung) are a strong indicator against a respiratory bacterial infection like pneumonia or bronchitis, which would typically present with abnormal lung sounds. This helps narrow down the differential toward a viral syndrome.
Why the other options are wrong
- A. Malaise and myalgia are non-specific symptoms common to both viral and bacterial infections.
- C. A low-grade fever can be present in both viral and bacterial infections, so it's not a strong differentiator.
- D. While denying cough/sore throat might lean away from *some* respiratory infections, it doesn't rule out all bacterial infections and can also be seen in viral syndromes.
Differentiating Viral vs. Bacterial Infections
Distinguishing between viral and bacterial infections often relies on specific clinical signs, lab results, and the absence of indicators for one type of pathogen.
- Symptoms can overlap (fever, malaise).
- Specific findings (e.g., lung sounds, WBC count) are key.
- Lack of expected bacterial signs points to viral.
Memory trick: Viral = less specific, Bacterial = more focused signs.