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Kaplan Qbank USMLE



Author6 Posts
  #1

6 yr old girl has large swollen tender right axially LN. a week ago received scratches from a playful kitten. next step in management

aspirate node for gram stain and culture

biopsy node adn send for pathological assessment

place a PPD

CXR

treat wiht trimethoprim-sulfamethoxazole


___________________
It is not your aptitude but your attitude that determines your altitude in life

  #2

Trime - sulfa ?

  #3

ti-sulfa. looks like rochelimea henslea infection..

___________________
"Where there is a will there is a way!"
-Anonymous

  #4

no need to treat cat scratch. It usually goes by itself in 2 month. But in case pain is there or trouble with node, aspirate it.




  #5

observation isn't an option in the stem.

Ans is trimethoprim-sulfamethoxazole! way to go guys! For a typical case no need for diagnositic studies. and bartonella henslae cannot be cultured


___________________
It is not your aptitude but your attitude that determines your altitude in life

  #6

diagnosis is mainly on clinical grounds and to support the diagnosis you can go for B. Hensalae antibodies test, or Warthin- starry stain.

tender LN and systemic symptoms can be debiliatating, so a short course of ABx is recommended.

5 days of azitromycin or

7- 10 day course of clarithromycin, rifampin, tri-sulpa, cipro or doxyclycine (UW)


___________________
It is not your aptitude but your attitude that determines your altitude in life







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