12-16-2004, 04:18 AM
qq
5. 37 yrs woman, itchy rash over trunk for 2 wks. No fever, chills, shortness of breath, chest pain, or GI symptoms. History of recurrent urinary tract infection, taking trimethoprim-sulfamethoxazole prophylaxis for past year. Mild distress. Temp 37.5, BP 96/62, pulse 78, resp 14. PE: maculopapular erythematous rash over trunk. Lab: WBC 10,500, seg. Neutrophils 72%, bands 1%, eosinophils 15%, lymphocytes 4%, mono 8%.Serum: BUN 12, creatinine 0.9. Urine: WBC 2/hpf, RBC 2/hpf. Most likely cause?
A. Eczema
B. Medication adverse effect
C. Staphylococcal skin infection
D. Streptococcal skin infection
E. Urinary tract infection
6. 14 yrs girl w/ 14 hrs of irritability and episodes of drawing her knees toward chest. Vomited nonbilious fluid twice, bowel movement containing small amount of blood. Upper respiratory tract infection 2 wks ago. Listless except for intermittent episodes of discomfort. Temp 38. PE: right-sided tenderness w/o guarding or rebound. Bowel sounds present. Rectal exam: bright red blood and mucus. Xray: (-). Next step?
A. Xray of upper GI with contrast
B. Water-soluble contrast enema
C. Corticosteroid enemas
D. Admission to hospital for total parenteral nutrition
E. Immediate laparotomy
5. 37 yrs woman, itchy rash over trunk for 2 wks. No fever, chills, shortness of breath, chest pain, or GI symptoms. History of recurrent urinary tract infection, taking trimethoprim-sulfamethoxazole prophylaxis for past year. Mild distress. Temp 37.5, BP 96/62, pulse 78, resp 14. PE: maculopapular erythematous rash over trunk. Lab: WBC 10,500, seg. Neutrophils 72%, bands 1%, eosinophils 15%, lymphocytes 4%, mono 8%.Serum: BUN 12, creatinine 0.9. Urine: WBC 2/hpf, RBC 2/hpf. Most likely cause?
A. Eczema
B. Medication adverse effect
C. Staphylococcal skin infection
D. Streptococcal skin infection
E. Urinary tract infection
6. 14 yrs girl w/ 14 hrs of irritability and episodes of drawing her knees toward chest. Vomited nonbilious fluid twice, bowel movement containing small amount of blood. Upper respiratory tract infection 2 wks ago. Listless except for intermittent episodes of discomfort. Temp 38. PE: right-sided tenderness w/o guarding or rebound. Bowel sounds present. Rectal exam: bright red blood and mucus. Xray: (-). Next step?
A. Xray of upper GI with contrast
B. Water-soluble contrast enema
C. Corticosteroid enemas
D. Admission to hospital for total parenteral nutrition
E. Immediate laparotomy