02-06-2012, 09:05 AM
17 yr old boy with MR brought to physician bc of low grade fever and abdominal pain for 6 days. His temp is 100.1F, pulse 110, resp. 22, and BP 120/70. Exam shows splinter hemorrhages under nails. A grade 2/6 systolic murmur head best at upper left sternal border. There is systolic ejection click. S1 and S2 norma. Abdominal exam shows splenomegaly. Labs show:
Hb 9.1
Leuckocyte 30,000
Platelet 928,000
ESR 110
Urine Blood 2+
Urine Protein 1+
What is next step in management?
A-24 hr urine collection for protein and creatinine
B-Blood cultures
C-Ultrasound of abdomen
D-CT scan of abdomen
E-Broad spectrum antibiotics
Hb 9.1
Leuckocyte 30,000
Platelet 928,000
ESR 110
Urine Blood 2+
Urine Protein 1+
What is next step in management?
A-24 hr urine collection for protein and creatinine
B-Blood cultures
C-Ultrasound of abdomen
D-CT scan of abdomen
E-Broad spectrum antibiotics