04-08-2009, 11:06 AM
19. A 62-year-old woman with ovarian cancer comes
to the emergency
department because of fever for 2 days. Ten days ago,
she received
chemotherapy with paclitaxel and carboplatin. She
feels tired but has not
had nausea or vomiting. Her temperature is 39.5 C
(103.1 F), blood
pressure is 100/60 mm Hg, and pulse is 115/min. The
lungs are clear to
auscultation. Examination shows a soft, nontender
abdomen. Her
hematocrit is 32%, leukocyte count is 800/mm3, and
platelet count is
105,000/mm3. Serum electrolyte levels are within
normal limits. Which of the
following is the most appropriate next step in
treatment?
A
) Plasmapheresis
B
) Additional chemotherapy
C
) Intravenous antibiotic therapy
D
) Intravenous corticosteroid therapy
E
) Transfusion of 2 units of leukocytes
F
) Transfusion of 2 units of packed red blood cells
to the emergency
department because of fever for 2 days. Ten days ago,
she received
chemotherapy with paclitaxel and carboplatin. She
feels tired but has not
had nausea or vomiting. Her temperature is 39.5 C
(103.1 F), blood
pressure is 100/60 mm Hg, and pulse is 115/min. The
lungs are clear to
auscultation. Examination shows a soft, nontender
abdomen. Her
hematocrit is 32%, leukocyte count is 800/mm3, and
platelet count is
105,000/mm3. Serum electrolyte levels are within
normal limits. Which of the
following is the most appropriate next step in
treatment?
A
) Plasmapheresis
B
) Additional chemotherapy
C
) Intravenous antibiotic therapy
D
) Intravenous corticosteroid therapy
E
) Transfusion of 2 units of leukocytes
F
) Transfusion of 2 units of packed red blood cells