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Prep4USMLE Forum » USMLE STEP 3 Forum » USMLE Step 3 CCS Forum

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4 Posts

sing
Forum Guru

Topics: 153
Posts: 370

10/14/06 - 08:23 AM

After a two day fever in a three yrs. old boy. examination in your office show some hyperemia in the pharynx and a genrealaized rash over the body.. tosills looks infected but no sheath. ther were few small palapabe mass in the front of neck no axilary or inguinal LN palpable. neck is supple. U satrt amoxill but the boy came back after five days with same fever.. he lost 2 pounds over 5 days with diarrhoea and dehydration. the fever now is 104F. you will

a: start third generation cephalosporin.
b: start Normal saline in D5W in your office and admit the patient in ward.
c: Start vancomycin as your first choice since he might have Cl. diff
d: Admit the patient in ICU
e) admit the patient in ward.

A&Y thanks

royalgeorge
Forum Elite

Topics: 10
Posts: 266

10/15/06 - 08:56 AM

Answer b: First step is to restore circulation, do it immediatly in a dehydrated child.

sing
Forum Guru

Topics: 153
Posts: 370

10/16/06 - 11:42 PM

but you think what's cause of his symptoms. is it severe form of tonsilitis or pseudomembrane colitis? fever getting high and there is diarrhea and dehydration. but only 5 days after amoxi treatment. is it too short for pseudomembrane colitis?

drvic
Forum Elite

Topics: 10
Posts: 181

01/01/07 - 02:12 AM

agree with choice b

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