difficult nbme question

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difficult nbme question

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nadiabarati

05/29/07 - 04:17 PM

A 37 Y/O MAN WITH PAPAPLEGIA COMES TO THE PHYSICIAN FOR A FOLLOW UP EXAMINATION. HE HAS A DECUBITUS ULCER OVER THE SACRUM THAT HAS NOT HEALED DESPITE WOUND CARE AND REPEATED DEBRIDEMEN OVER THE PAST 3 MONTHS. OVER THE PAST 2 WEEKS HE HAS HAD A LOW GRADE FEVER AND A 3.6 KG WEIGHT LOSS. T: 38.1, BP: 120/80, EXAMINATION SHOWS A DEEP 4CM ULCER OVER THE SACRUM. LEUCOS: 14.000 (WHICH IS CONSISTENT WITH PREVIOUS LEUCOS COUNT OVER THE PAST MONTH. ESR: 98.
WHICH OF THE FOLLOWING IS THE MOST LIKELY DIAGNOSIS?

A) ANAEROBIC INFECTION.
B) MALNUTRITION.
C) OSTEOMYELITIS.
D) SQUAMOUS CELL CARCINOMA.
E) TYPE 2 DIABETES MELLITUS

vanshita
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05/29/07 - 04:21 PM

hanialkhadher
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05/29/07 - 05:00 PM

C too

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Justice
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05/29/07 - 08:46 PM

C) OSTEOMYELITIS

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doc_clotaire
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05/30/07 - 09:50 AM

agree with C

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gilbert
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05/30/07 - 12:34 PM

But according to FA, any ulcer unhealed within 3 months would be basal cell cancinoma?

ram3
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05/31/07 - 03:05 PM

its malnutrition

sailing boat
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05/31/07 - 07:05 PM

Akeen
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06/01/07 - 07:36 AM

Will malnutrition cause an elevated WBC count as in this vignette?
Thinks osteomyelitis.

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klimt
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06/01/07 - 03:44 PM

#10

C

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