12-12-2016, 12:49 PM
Like always u need to ans 72sec from the time I post Q
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A 38 y/o F is evaluated in the emergency department for fever, myalgia, and malaise 2 days after her pet dog bit her on the left lower extremity. Medical history is significant for a splenectomy 5 years ago following a motor vehicle accident. She has received tetanus, pneumococcal, meningococcal, and Haemophilus influenzae type B vaccines, and her dog’s immunizations are up-to-date. There are no allergies, and the remainder of the medical history is noncontributory.
On physical examination, temperature is 38.7 °C (101.7 °F), blood pressure is 90/60 mm Hg, pulse rate is 110/min, and respiration rate is 26/min; BMI is 26. There is erythema and tenderness at site of the puncture wound on the left thigh. An abdominal laparotomy scar is noted. There is no inguinal lymphadenopathy. The remainder of the physical examination is norm
Laboratory studies:
Hgb: 10.1 g/dL
Leukocyte count 16,600/µL with 56% neutrophils, 33% band forms, 10% lymphocytes, and 1% monocytes
Platelet count 17,500/µL
Peripheral blood smear Many https://upload.wikimedia.org/wikipedia/c...y_body.png
BUN 40 mg/dL
Cr: 2.4 mg/dL
Alanine aminotransferase: 499 U/L
Aspartate aminotransferase 449 U/L
Multiple blood cultures reveal growth of gram-negative rods/bacilli. The urinalysis is norm. Radiographs of the left femur show no gas or foreign body.
Which of the following is the most likely cause of this pat septic presentation?
a) Salmonella species
b) Escherichia coli
c) Streptococcus pyogenes
d) Capnocytophaga canimorsus
e) Staphylococcus aureus
_______________________________________________________________________________
A 38 y/o F is evaluated in the emergency department for fever, myalgia, and malaise 2 days after her pet dog bit her on the left lower extremity. Medical history is significant for a splenectomy 5 years ago following a motor vehicle accident. She has received tetanus, pneumococcal, meningococcal, and Haemophilus influenzae type B vaccines, and her dog’s immunizations are up-to-date. There are no allergies, and the remainder of the medical history is noncontributory.
On physical examination, temperature is 38.7 °C (101.7 °F), blood pressure is 90/60 mm Hg, pulse rate is 110/min, and respiration rate is 26/min; BMI is 26. There is erythema and tenderness at site of the puncture wound on the left thigh. An abdominal laparotomy scar is noted. There is no inguinal lymphadenopathy. The remainder of the physical examination is norm
Laboratory studies:
Hgb: 10.1 g/dL
Leukocyte count 16,600/µL with 56% neutrophils, 33% band forms, 10% lymphocytes, and 1% monocytes
Platelet count 17,500/µL
Peripheral blood smear Many https://upload.wikimedia.org/wikipedia/c...y_body.png
BUN 40 mg/dL
Cr: 2.4 mg/dL
Alanine aminotransferase: 499 U/L
Aspartate aminotransferase 449 U/L
Multiple blood cultures reveal growth of gram-negative rods/bacilli. The urinalysis is norm. Radiographs of the left femur show no gas or foreign body.
Which of the following is the most likely cause of this pat septic presentation?
a) Salmonella species
b) Escherichia coli
c) Streptococcus pyogenes
d) Capnocytophaga canimorsus
e) Staphylococcus aureus
