darkhorse
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You are the on-call physician practicing in a suburban community. You receive a call from a
28-year-old female with a past medical history significant for sarcoidosis who is currently on no
medications. She is complaining of the acute onset of crampy diffuse abdominal pain and
multiple episodes of emesis that are nonbloody. She has not had any light-headedness with
standing or loss of consciousness. When questioned further, the patient states that her last
meal was 5 hours previously, when she joined her friends for lunch at a local Chinese
restaurant. She ate from the buffet, which included multiple poultry dishes and fried rice. What
should you do for this patient?
A. Initiate antibiotic therapy with clindamycin.
B. Reassure the patient that her illness is self-limited and no further treatment is necessary if
she can maintain adequate hydration.
C. Ask the patient to go to the nearest emergency department for resuscitation with
intravenous fluids.
D. Refer the patient for CT to assess for appendicitis.
E. Refer the patient for admission for intravenous vancomycin because of her
immunocompromised state resulting from sarcoidosis.
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| cool doctor
Forum Junior
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B
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| drdg
Forum Senior
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CCC?
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| tamerbashir
Forum Elite
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DON'T KNOW
GOING WITH B
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| titly
Forum Elite
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B
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we spend our days waiting for the ideal path to appear in front of us, but, what we forget is paths are made by walking, not by waiting. keep walking................................
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| Kamsi
Forum Guru
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B Bacillus cereus infxn,it's self limiting within 24 hrs
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| darkhorse
Forum Elite
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The patient most likely has food poisoning because of contamination of the fried rice with
Bacillus cereus. This toxin-mediated disease occurs when heat-resistant spores germinate after
boiling. Frying before serving may not destroy the preformed toxin. The emetic form of illness
occurs within 6 hours of eating and is self-limited. No therapy is necessary unless the patient
develops severe dehydration. This patient currently has no symptoms consistent with volume
depletion; therefore, she does not need intravenous fluids at present. Sarcoidosis does not
predispose patients to infectious diseases.
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| Justice
Forum Fanatic
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And what is a tricky part of this Q?
B
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| darkhorse
Forum Elite
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those who know...easy for them...those who dont know....its tricky for them
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