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
Fri Jun 12, 2009 11:44 am