05-04-2007, 02:12 PM
A 28-year-old woman comes to the office because of a 3-hour history of severe nausea, vomiting, abdominal cramps, and diarrhea. She ate lettuce with salad dressing, custard, and pastries and drank stream water at a family picnic at a local park 2 hours before the onset of the symptoms. She is unsure whether anyone got sick. She was "absolutely fine" before she went to the picnic. She does not take any medications. Her temperature is 36.7 C (98.0 F), blood pressure is 110/70 mm Hg, pulse is 65/min, and respirations are 14/min. Physical examination shows mild abdominal tenderness. A stool sample shows large numbers of Gram-positive cocci in clusters. At this time the most correct statement about her condition is:
A. An antibiotic is indicated to treat her infection
B. Colonoscopy will show pseudomembranes and friable mucosa
C. Contaminated stream water at the picnic caused these symptoms
D. Her symptoms are due to an enterotoxin produced by the organism
E. It is unlikely that the organism was transmitted from an individual with purulent lesions on the hands, nose, and face
A. An antibiotic is indicated to treat her infection
B. Colonoscopy will show pseudomembranes and friable mucosa
C. Contaminated stream water at the picnic caused these symptoms
D. Her symptoms are due to an enterotoxin produced by the organism
E. It is unlikely that the organism was transmitted from an individual with purulent lesions on the hands, nose, and face