06-30-2012, 06:34 PM
Qs.2
Leukocytes count 30,000
Platelet count 928,000
ESR 110 A 17 year old boy with mental retardation is brought to the physician because of low grade fever and abdominal pain for 6 days. His temp. 37.8, pulse is 110/min, resp. 22/min, bp 120/70. Examination shows splinter hemorrhages under the nails. A grade 2/6 systolic murmur is heard best at the upper left sternal border. There is a systolic ejection click S1 and S2 are normal. Abdominal exam shows splenomegaly. Lab studies show:
Hemoglobin 9.1
Urine
Blood 2+
Protein 1+
Which of the following is the most appropriate next step in management?
1. 24 hr urine collection for measurement of protein and creatinine consetration
2. Blood cultures
3. ultrasound of the abdomen
4. CT scan of the abdomen
5. Broad spectrum antibiotic therapy
Leukocytes count 30,000
Platelet count 928,000
ESR 110 A 17 year old boy with mental retardation is brought to the physician because of low grade fever and abdominal pain for 6 days. His temp. 37.8, pulse is 110/min, resp. 22/min, bp 120/70. Examination shows splinter hemorrhages under the nails. A grade 2/6 systolic murmur is heard best at the upper left sternal border. There is a systolic ejection click S1 and S2 are normal. Abdominal exam shows splenomegaly. Lab studies show:
Hemoglobin 9.1
Urine
Blood 2+
Protein 1+
Which of the following is the most appropriate next step in management?
1. 24 hr urine collection for measurement of protein and creatinine consetration
2. Blood cultures
3. ultrasound of the abdomen
4. CT scan of the abdomen
5. Broad spectrum antibiotic therapy