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The most appropriate first-line therapy for this patient's tachycardia is
A. atenolol 0%
0 0%
B. intravenous imipenem 0%
0 0%
C. normal saline and broad spectrum antibiotics 80%
egomez2001, hanwin, starcraftbw, dr_singh246, useless, medicus_81, drxyz, jvo_md, cuadrado_g, agars, carmen77, mojedo		 12 80%
D. metoprolol 13%
numita, webjeee		 2 13%
E. packed red blood cell transfusion 0%
0 0%
15 votes



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Author8 Posts
skinyballs
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Topics: 14
Posts: 26
08/27/07 - 09:20 PM       #1

A 31-year-old alcoholic homeless man with a history of type 1 diabetes comes to the urgent care clinic with a left foot ulcer. The ulcer has been present for 4 months, but has been sore for the past 2 weeks. There is no other medical history. His blood pressure is 92/54 mm Hg and pulse is 170/min. Physical examination shows an eschar extending to the bone with necrotic sides on the dorsal aspect of the hallux just distal to the interphalangeal joint. Laboratory studies reveal a leukocyte count of 33,000/mm3. Fingerstick glucose is 210 mg/dL. Urinalysis, complete blood count, chest radiograph, and blood cultures are pending. An electrocardiogram shows a sinus tachycardia at a rate of 180/min. The most appropriate first-line therapy for this patient's tachycardia is

A. atenolol

B. intravenous imipenem

C. intravenous 0.9% normal saline and broad spectrum antibiotics

D. metoprolol

E. packed red blood cell transfusion

Edited by new_n_lost on 09/03/07 - 11:13 AM. Reason: Ads Not Allowed in Posts

smal
Forum Guru
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Topics: 140
Posts: 727
08/30/07 - 03:52 PM       #2

D?

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robin082006
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08/30/07 - 05:25 PM       #3

C. intravenous 0.9% normal saline and broad spectrum antibiotics



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skinyballs
Forum Junior

Topics: 14
Posts: 26
08/31/07 - 07:49 AM       #4

mmmm...
make your votes.

skinyballs
Forum Junior

Topics: 14
Posts: 26
08/31/07 - 02:25 PM       #5

Are you sure?

starcraftbw
Forum Senior

Topics: 13
Posts: 166
09/10/07 - 05:47 PM       #6

pt has septic shock so he needs fluid. beside wbc > 33k = antibiotic (imipenem not cover much staph/strep for DM foot ulcersmiling face). if you give him b-blocker, he may die

arlete
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Topics: 50
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10/02/07 - 11:37 AM       #7

C

nod


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jvo_md
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Topics: 22
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11/27/07 - 12:21 PM       #8

C is the answer

Not b-block...Call your lawyer











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