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+--- Thread: NBME FORM 4 / Section 2 / Question #22 - baby_doc (/showthread.php?tid=434057)
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NBME FORM 4 / Section 2 / Question #22 - baby_doc - ArchivalUser - 08-01-2009
A 32 year old woman comes to the physician because of a 4 day history of fever. She has had swelling and redness of her left leg during this period. She has a history of chronic lymphedema in both legs. She is 5 ft 5 in tall and weighs 235 lbs. BMI is 39. Her temp is 101.3 deg F. The left lower extremity is diffusely red and edematous from just below the knee to the ankle with a sharp demarcation separating the erythematous area from the normal skin and knee. The erythematous area is painful and hyperesthetic to touch. The left femoral nodes are enlarged and painful. Which of the following is the most likely cause of this patient's illness?
A) Deep vein thrombosis
B) Escherichia coli infection
C) Group A streptococcus infection
D) Necrotizing fasciitis
E) Superficial thrombophlebitis
Any explanation? thanks..
0 - ArchivalUser - 08-01-2009
C) GROUP A STREPTOCOCCUS, THIS IS AN ERYSIPELAS, WHY? OBESE, LYMPHODEMA, SHARP DEMARCATION, PAINFUL, HYPERSTHETIC, LYMPHADENOPATHY.
0 - ArchivalUser - 05-31-2011
isnt this necrotizing fascitis ?? plz guys, try to answer!
0 - ArchivalUser - 05-31-2011
this is Necrotizing Fascitis but the Question is that.. isnt Necro. Fascitis caused by Group A Strep i.e. Strep Pyogenis ... will ve asnwer D or C...??
0 - ArchivalUser - 06-01-2011
What is decribed is an Erysipela is true that at the beginning FN is similar to the Erysipela
But in this case I choose C bc that way you include both options
0 - ArchivalUser - 06-01-2011
ok..Ya now even I feel its
C) GRP A STREP, because that's the most common cause of Necrotizing Fasciitis !
0 - ArchivalUser - 02-06-2012
DD is wrong, I answered NF in extended feedback form... answer I think is CC
0 - ArchivalUser - 02-06-2012
if if it is DD they have to GIVE you ..crepitous on palpation and air bubbles in x-ray in Q
THAT IS WHY IT IS CCC.............this way you have to answer all other qq(always look for
missed link.....always look for missed link)
0 - ArchivalUser - 02-06-2012
A is correct. chronic lymphedema +femoral nodes enlarged and painful
0 - ArchivalUser - 02-06-2012
its classic erysipelas which is caused by Strep pyogenes