08-21-2014, 08:31 AM
13.
A 27-year-old African American woman is admitted to the hospital because of a temperature that has fluctuated between 37.0°C (98.6°F) and 40.6°C (105.0°F) during the past 3 days. During this time, she also has had severe chills and sweats, frontal headache, nausea, and body aches. She does not have a rash. She had received all recommended vaccines prior to traveling to Africa 2 months ago. She is 160 cm (5 ft 3 in) tall and weighs 63.5 kg (140 lb); BMI is 25 kg/m2. Vital signs are temperature 40.3°C (104.5°F), pulse 100/min, respirations 14/min, and blood pressure 100/60 mm Hg. Skin is dry with poor turgor. Sclerae are anicteric. The nose is patent. Examination of the throat discloses a slightly injected posterior pharynx. Neck is supple with no significant adenopathy. Lungs are clear to auscultation, and cardiac examination discloses no abnormalities. Abdomen is mildly tender in the right upper quadrant, but there is no rebound tenderness or organomegaly. Examination of the extremities shows full range of motion and no edema. Pulses are full bilaterally. Which of the following is the most appropriate diagnostic study?
A) Blood cultures
B) Blood smear
C) HIV antibody test
D) Hepatitis C antibody test
E) Stool culture
Ans) B
B) Blood smear
MALARIA
ESSENTIALS OF DIAGNOSIS
Residence or exposure in a malaria-endemic area.
Intermittent attacks of chills, fever, and sweating.
Headache, myalgia, vomiting, splenomegaly; anemia, thrombocytopenia.
Intraerythrocytic parasites identified in thick or thin blood smears.
Complications of falciparum malaria: cerebral malaria, severe anemia, hypotension, noncardiogenic pulmonary edema, acute kidney injury, hypoglycemia, acidosis, and hemolysis.
McPhee, Stephen (2013-09-13). CURRENT Medical Diagnosis and Treatment 2013,(p. 1448). McGraw-Hill. Kindle Edition.
A 27-year-old African American woman is admitted to the hospital because of a temperature that has fluctuated between 37.0°C (98.6°F) and 40.6°C (105.0°F) during the past 3 days. During this time, she also has had severe chills and sweats, frontal headache, nausea, and body aches. She does not have a rash. She had received all recommended vaccines prior to traveling to Africa 2 months ago. She is 160 cm (5 ft 3 in) tall and weighs 63.5 kg (140 lb); BMI is 25 kg/m2. Vital signs are temperature 40.3°C (104.5°F), pulse 100/min, respirations 14/min, and blood pressure 100/60 mm Hg. Skin is dry with poor turgor. Sclerae are anicteric. The nose is patent. Examination of the throat discloses a slightly injected posterior pharynx. Neck is supple with no significant adenopathy. Lungs are clear to auscultation, and cardiac examination discloses no abnormalities. Abdomen is mildly tender in the right upper quadrant, but there is no rebound tenderness or organomegaly. Examination of the extremities shows full range of motion and no edema. Pulses are full bilaterally. Which of the following is the most appropriate diagnostic study?
A) Blood cultures
B) Blood smear
C) HIV antibody test
D) Hepatitis C antibody test
E) Stool culture
Ans) B
B) Blood smear
MALARIA
ESSENTIALS OF DIAGNOSIS
Residence or exposure in a malaria-endemic area.
Intermittent attacks of chills, fever, and sweating.
Headache, myalgia, vomiting, splenomegaly; anemia, thrombocytopenia.
Intraerythrocytic parasites identified in thick or thin blood smears.
Complications of falciparum malaria: cerebral malaria, severe anemia, hypotension, noncardiogenic pulmonary edema, acute kidney injury, hypoglycemia, acidosis, and hemolysis.
McPhee, Stephen (2013-09-13). CURRENT Medical Diagnosis and Treatment 2013,(p. 1448). McGraw-Hill. Kindle Edition.