09-01-2008, 04:45 PM
19. A 62-year-old woman with ovarian cancer comes to the emergency department because of fever for 2 days. Ten days ago, she received chemotherapy with paclitaxel and carboplatin. She feels tired but has not had nausea or vomiting. Her temperature is 39.5 C
(103.1 F), blood pressure is 100/60 mm Hg, and pulse is 115/min. The lungs are clear to
auscultation. Examination shows a soft, nontender abdomen. Her hematocrit is 32%, leukocyte count is 800/mm3, and platelet count is 105,000/mm3. Serum electrolyte levels are within normal limits. Which of the following is the most appropriate next step in
treatment?
A) Plasmapheresis
B) Additional chemotherapy
C) Intravenous antibiotic therapy
D) Intravenous corticosteroid therapy
E) Transfusion of 2 units of leukocytes
F) Transfusion of 2 units of packed red blood cells
(103.1 F), blood pressure is 100/60 mm Hg, and pulse is 115/min. The lungs are clear to
auscultation. Examination shows a soft, nontender abdomen. Her hematocrit is 32%, leukocyte count is 800/mm3, and platelet count is 105,000/mm3. Serum electrolyte levels are within normal limits. Which of the following is the most appropriate next step in
treatment?
A) Plasmapheresis
B) Additional chemotherapy
C) Intravenous antibiotic therapy
D) Intravenous corticosteroid therapy
E) Transfusion of 2 units of leukocytes
F) Transfusion of 2 units of packed red blood cells