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You are seeing an 18-year-old male in the office in the office with runny nose and cough with temps of 101. He admits to intermittent

You are seeing an 18-year-old male in the office in the office with runny nose and cough with temps of 101. He admits to intermittent chest pain despite analgesia, worse with cough and deep breaths. The chest pain is worsening over time. He has sickle cell disease and chronic anemia with his latest H/H 6.1/17.5 (3 months ago). On physical examination, oxygen saturation is 91%, Pulse, 92, BP 110/60, RR 20, Temp 101.4. A few scattered wheezes are heard in posterior fields. His current medication profile is: Flovent 1 puff daily, albuterol 2 puffs q4 hours prn, Tylenol/Codeine #3 every 6 hours prn pain. He tells you he feels relatively well. What is your course of treatment? Group of answer choices Duoneb treatment in the office; increase the flovent to bid dosing or trial prednisone burst, add motrin for the chest discomfort, CXR and treat with antibiotics if + pneumonia, follow up in the office tomorrow Transfer to the ED via ambulance with oxygen for evaluation and possible admission for acute chest syndrome Albuterol treatment in the office and if improves, prednisone 50 mg daily for 5 days, zpack for possible community acquired pneumonia and FU in 1-2 days for

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