03-18-2009, 03:25 PM
39. A previously healthy 6-month-old boy is brought to the emergency department because of a 12-hour history of intermittent episodes of in consolable crying associated with drawing up of the legs. Over the past 6 hours, he has had intermittent diarrhea that is reddish and mucoid, and for the past 3 hours he has been somnolent. On examination, he is sleepy but arousable. His temperature is 38.1 C(100.6 F), blood pressure is 90/55 mm Hg, pulse is 140/min, and respirations are 38/min. He cries when his abdomen is palpated; a mass is felt in the right lower quadrant. His leukocyte count is 12,400/mm3 (50%segmented neutrophils, 8% bands, 1% eosinophils, 40% lymphocytes, and 1%monocytes). Serum electrolyte levels are within normal limits. An x-ray film of the abdomen shows no free air.
A) Administration of parenteral antibiotics
B) Admission to the hospital for medical management
C) Admission to the hospital for operative management
D) Colon contrast studies
E) Discharge for follow-up by personal physician
F) Endoscopy
G) MRI of the abdomen
H) Observation in the emergency department
A) Administration of parenteral antibiotics
B) Admission to the hospital for medical management
C) Admission to the hospital for operative management
D) Colon contrast studies
E) Discharge for follow-up by personal physician
F) Endoscopy
G) MRI of the abdomen
H) Observation in the emergency department