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Old 04-28-2011
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Arrow High Yield Question #14

A 19-year-old previously healthy woman has had a mild pharyngitis followed by a high fever over the past 24 hours. When seen in the emergency room, her skin now shows extensive areas of purpura. Vital signs include T 39 C, P 105/minute, RR 22/minute, and BP 82/55 mm Hg. Laboratory studies show a serum sodium of 114 mmol/L, potassium 5.5 mmol/L, chloride 90 mmol/L, CO2 23 mmol/L, glucose 45 mg/dL, and creatinine 1.2 mg/dL. Which of the following is the most likely diagnosis?

A) Idiopathic adrenalitis
B) Disseminated tuberculosis
C) Reactive systemic amyloidosis
D) Sheehan syndrome
E) Meningococcemia
F) Hemochromatosis
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E. Meningococcemia
DIC and bilateral adrenal hemorrhage with resulting adrenal crisis may complicate N.meningitidis infection
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Old 04-28-2011
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yes, the answer is E)

Waterhouse-Friderichsen syndrome
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i think its E too
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The correct ans is E. Meningococcemia. Other than the lab values, high temperature and Skin involvement (purpura) are also important clues to look out for.
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Quote:
Originally Posted by TenderLovingDoc View Post
The correct ans is E. Meningococcemia. Other than the lab values, high temperature and Skin involvement (purpura) are also important clues to look out for.
Yes. Meningitis with purpura always think N. Meningitidis.


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I think meningococcemia.....
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CORRECT ANS IS (E) Meningococcemia

All of you are correct. Well Done guys...

This is acute adrenal insufficiency marked by hyponatremia, hyperkalemia, and hypoglycemia. Infection with Neisseria meningitidis can produce the Waterhouse-Friderischsen syndrome.
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