Tricky Q's - What will YOU Choose

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Tricky Q's - What will YOU Choose

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14 Posts

doyoudig
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Topics: 144
Posts: 613

05/17/07 - 11:21 AM

a 7yr girl with sickle comes after scraping her leg while climbing over a barbed fence.Her mom applied mercurochrome at the time of injury but brought her 2 u today after discussing with a friend.She says tar the child recieved her last DPT at 4yrs.On exam there is a red crusted incision approx 3cm long on Lt lat gastonemius.Appropriate management,

a.tetanus boost,incision and drain of wound
b.tetanus immunoglob 250U
c.oxacillin and nafficillin
d.intramuscularly irrigation with 1lt of N saline,followes by topical antibio

2months later u get a call from ER tat this pt has presented with periostal pain above the site of wound.Appropriate action includes all except

a.drawing blood cultures and emperic antibio coverage
b.hydration,oral acetominophen and codein
c.radiologic long bone films
d.Tc bone scan
e.needle bone biopsy at the site of wound

The childs 4yr sis also has sickle,scrapes herself
following yr.She develops osteomyelitis and treated.The lab report on pathogen is most likely

a.gm -ve intracellular diplococci
b.gm -ve motile,nonsporulating gas producing rods
c.gm -ve rods producing bluish green pigment
d.gm +ve beta hemolytic cocci in pairs
e.gm+,coagulase + cocci in clusters

Justice
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05/17/07 - 03:33 PM

b.tetanus immunoglob 250U
e.needle bone biopsy at the site of wound
b.gm -ve motile,nonsporulating gas producing rods (Salmonella)

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sandra
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Topics: 201
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07/17/07 - 02:30 PM

i think 2 is c. xrays r not useful in diagnosing osteomyelitis as findings are found only after 2 wks.

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robin082006
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07/17/07 - 05:25 PM

a.tetanus boost,incision and drain of wound

d.Tc bone scan: diagnostic test for osteomyelitis

e.gm+,coagulase + cocci in clusters: Samonella is most seen in SSD but here there is a wound so S.Aureus is likely the cause.

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khorshid
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Topics: 32
Posts: 591

07/17/07 - 07:26 PM

1.a(booster, incision and drain)
2.e(needle bone bx)
3.e(S.aureus)

Robin q2 is "all needed except" smiling face

Justice
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07/17/07 - 07:33 PM

Hey guys,
why to choose strep or staf when we know that the most frequent pathogen involved in osteomyelitis in SCD is salmonella?

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khorshid
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07/17/07 - 08:47 PM

I chose it because of the route of infection, underlying a wound. salmonella is the mcc, but I think here it should not be the one. But I'm not positive.

dr in trouble
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07/17/07 - 10:48 PM

For 2 isn't it should be second option as there are no signs of dehydration and morphine for osteomyelitis????and for 3 i am in favour of staph aureus.

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robin082006
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07/17/07 - 10:52 PM

khorshid wrote:
1.a(booster, incision and drain)
2.e(needle bone bx)
3.e(S.aureus)

Robin q2 is "all needed except" smiling face

Yeah I did not read it carefully, thanks

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dr_arc
Forum Senior

Topics: 5
Posts: 156

07/18/07 - 02:17 AM

#10

for the first part of the question since it is a minor wound, and she has recd DPT within the last 4years wouldnt antibiotics be more appropriate here?

deardoc007
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Topics: 18
Posts: 139

07/18/07 - 11:13 AM

#11

for q 2 i will go with a. xary , bone scan and needle bone biopsy all helpful in diagnosis of osteomyelitis. Blood cultures dont guide treatment in osteomyelitis..........what do u think guys?

usmleck2007
Forum Newbie

Topics: 0
Posts: 3

07/26/07 - 01:18 PM

#12

so what is the correct answer doyoudig? raised eyebrow

usmleck2007
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07/26/07 - 04:17 PM

#13

adb?

khorshid
Forum Guru

Topics: 32
Posts: 591

07/30/07 - 03:49 PM

#14

now per uw: the second one is tc bone scan

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