Lucy is a 38 year-old woman with a cough.

Four days of 'hotness of body' (fever). Cough productive of dark colored sputum. Mild right-sided chest pain Indicates anorexa, fatigue, mild dsypnea. No orthopnea Treated for malaria two years ago, but otherwise healthy. Physical exam:

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• Vital signs: Temp = 38.8°C, Pulse = 130, BP = 130/80, Resp = 28.
• Neck supple with no adenopathy or JVD.
• Right upper lobe crackles and diminished breath sounds.
• Heart sounds normal apart from tachycardia.
• No abdominal masses, bowel sounds present.
• Neurological and extremity exam WNL.
• Blood smear is negative for parasites.

Lucy is admitted, a chest X-ray is ordered and she is started on IV penicillin.