| |
* nbme 4 bl3 q24 |
| #413948 |
|
|
|
|
24 A hospitalized 37-year-old woman has the sudden onset of fever 7 days after undergoing splenectomy for immune thrombocvtopenic purpura. She has had moderate
abdominal pain and mild left shoulder pain for 2 days Her hemoglobin concentration has ranged from 9.5 g”dL to 10 g/dL since the operation Current medications include
hydrocodonie and docusate Her temperature is 39 1°C (102 4°F) Abdominal examination shows mild distention and diffuse tenderness without rebound, rigidity, or guarding
Bowel sounds are absent Laboratory studies show:
Hemoglobin 98 g/dL
Leukocyte count 21,3oo1mm3
Segmented neutrophils 50%
Bands 17%
Eosinophils 3%
Lymphocytes 25%
Monocytes 5%
Platelet count 105,000/mm3
Serum amylase 124 U/L
A chest x-ray shows a left pleural effusion. Which of the following is the most likely cause of these findings?
O A) Aspiration
O B) Gastric perforation
O C) Pancreatitis
O D) Pneumonia
0 E) Subphrenic abscess |
|
Report Abuse |
|
* Re:nbme 4 bl3 q24 |
#3081386 |
|
|
Guys the answer is Pancreatitis. Amylase is normal in up to 10% of cases and the value is upper limit of normal. There is a reason why the lipase value was not provided. Don't over think it. |
|
Report Abuse |
|
|
|