03-04-2007, 08:01 AM
1
A patient with diabetes mellitus type 2 presents to your clinic complaining of fever, chills, and severe pain in his scrotal region. He went to his chiropractor 2 days ago when he only had pain and swelling and the chiropractor adjusted his. . .well, we won't go there. He denies instrumentation or injury. On exam the scrotum is mildly red and very tender with mild edema. There is no evidence of trauma or eschar.
At this point, you:
A) Initiate anti-Staphylococcal antibiotics (e.g., amoxicillin/clavulanate, cephalexin, dicloxacillin) as an outpatient.
B) Admit to the hospital for IV antibiotics, given that he is diabetic, and begin hot packs to the area.
C) Admit to the hospital for IV antibiotics and consult surgery about possible wide excision of the perineum.
D) Perform an ultrasound to rule out torsion.
E) Check a urinalysis to rule out nephrotic syndrome leading to scrotal edema.
2
You admit this patient and want to start IV antibiotics. The surgeon is called and, since this is a surgical emergency, comes in off the golf course (he had finished the front nine).
The proper antibiotic coverage for this patient is:
A) Ceftriaxone and nafcillin.
B) Levofloxacin and gentamicin.
C) Clindamycin and ampicillin/sulbactam.
D) Gentamicin and ceftriaxone.
E) Any of the above.
A patient with diabetes mellitus type 2 presents to your clinic complaining of fever, chills, and severe pain in his scrotal region. He went to his chiropractor 2 days ago when he only had pain and swelling and the chiropractor adjusted his. . .well, we won't go there. He denies instrumentation or injury. On exam the scrotum is mildly red and very tender with mild edema. There is no evidence of trauma or eschar.
At this point, you:
A) Initiate anti-Staphylococcal antibiotics (e.g., amoxicillin/clavulanate, cephalexin, dicloxacillin) as an outpatient.
B) Admit to the hospital for IV antibiotics, given that he is diabetic, and begin hot packs to the area.
C) Admit to the hospital for IV antibiotics and consult surgery about possible wide excision of the perineum.
D) Perform an ultrasound to rule out torsion.
E) Check a urinalysis to rule out nephrotic syndrome leading to scrotal edema.
2
You admit this patient and want to start IV antibiotics. The surgeon is called and, since this is a surgical emergency, comes in off the golf course (he had finished the front nine).
The proper antibiotic coverage for this patient is:
A) Ceftriaxone and nafcillin.
B) Levofloxacin and gentamicin.
C) Clindamycin and ampicillin/sulbactam.
D) Gentamicin and ceftriaxone.
E) Any of the above.