18 month old with diarrhea, fever, and seizure - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 06-22-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 112
Threads: 20
Thanked 128 Times in 39 Posts
Reputation: 143
Kids 18 month old with diarrhea, fever, and seizure

An 18-month-old child presents to the emergency center having had a brief, generalized tonic-clonic seizure. He is now postictal and has a temperature of 40°C (104°F). During the lumbar puncture (which ultimately proves to be normal), he has a large, watery stool that has both blood and mucus in it. Which of the following is the most likely diagnosis in this patient?

a. Salmonella
b. Enterovirus
c. Rota virus
d. Campylobacter
e. Shigella
Reply With Quote Quick reply to this message
The above post was thanked by:
bebix (06-24-2011)



  #2  
Old 06-22-2011
USMLE-Syndrome's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,203
Threads: 180
Thanked 1,254 Times in 441 Posts
Reputation: 1268
Default

c. Rota virus
watery diarrhea &fever
Reply With Quote Quick reply to this message
  #3  
Old 06-22-2011
USMLE Forums Addict
 
Steps History: Not yet
Posts: 192
Threads: 0
Thanked 47 Times in 40 Posts
Reputation: 57
Default

Quote:
Originally Posted by miss patho View Post
c. Rota virus
watery diarrhea &fever
But it says that has both blood and mucus in it. ..
Reply With Quote Quick reply to this message
 
  #4  
Old 06-22-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Default

Answer D. Campylobacter
Reply With Quote Quick reply to this message
  #5  
Old 06-22-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,268 Times in 881 Posts
Reputation: 3278
Default

Quote:
Originally Posted by aksyonez View Post
Answer D. Campylobacter
I also think is D)
Reply With Quote Quick reply to this message
  #6  
Old 06-23-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 112
Threads: 20
Thanked 128 Times in 39 Posts
Reputation: 143
Default

The correct answer is e; Shigella.

Clinical manifestations of shigellosis range from watery stools for several days to severe infection, with high fever, abdominal pain, and generalized seizures. In general, about 50% of these children have emesis, greater than two-thirds have fever, 10%to 35% have seizures, and 40% have blood in their stool. Often, the seizure precedes diarrhea and is the complaint that brings the family to the physician. Fever usually lasts about 72 h, and the diarrhea resolves within 1-to-2 weeks. Presumptive diagnosis can be made on the clinical history; confirmation is through stool culture. Supportive care, including adequate fluid and electrolyte support, is the mainstay of therapy. Antibiotic treatment is problematic; resistance to trimethoprim-sulfamethoxazole and ampicillin is common, necessitating therapy with third-generation cephalosporins in many cases.
Reply With Quote Quick reply to this message
  #7  
Old 06-24-2011
USMLE Forums Addict
 
Steps History: CK+CS
Posts: 145
Threads: 34
Thanked 82 Times in 37 Posts
Reputation: 92
Question

Quote:
Originally Posted by drmuh View Post
The correct answer is e; Shigella.

Clinical manifestations of shigellosis range from watery stools for several days to severe infection, with high fever, abdominal pain, and generalized seizures. In general, about 50% of these children have emesis, greater than two-thirds have fever, 10%to 35% have seizures, and 40% have blood in their stool. Often, the seizure precedes diarrhea and is the complaint that brings the family to the physician. Fever usually lasts about 72 h, and the diarrhea resolves within 1-to-2 weeks. Presumptive diagnosis can be made on the clinical history; confirmation is through stool culture. Supportive care, including adequate fluid and electrolyte support, is the mainstay of therapy. Antibiotic treatment is problematic; resistance to trimethoprim-sulfamethoxazole and ampicillin is common, necessitating therapy with third-generation cephalosporins in many cases.
good ...... but why NOT campylobacter or salmonella......
both can be C/P by bloody diarrhea.....?
may be 4 seizures........... but any febrile illness may be a cause of febrile seizures below age of 2.......?
__________________
“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning. ”
Albert Einstein

Last edited by cerebrum85; 06-24-2011 at 06:06 AM.
Reply With Quote Quick reply to this message



Reply

Tags
Gastroenterology-, Infectious-Diseases, Neurology-, Pediatrics-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Cause of diarrhea Peets USMLE Step 1 Forum 7 05-19-2016 01:31 PM
Diarrhea in AIDS docoftheworld USMLE Step 2 CK Forum 2 06-05-2011 04:26 AM
Starting anticonvulsants right after the first seizure? aghammoud85 USMLE Step 2 CK Forum 3 05-31-2011 02:16 PM
simple partial seizure marco USMLE Step 2 CK Forum 1 05-07-2010 07:09 AM
Why is Barbiturate the Rx of choice for seizure during pregnancy? lemontea88 USMLE Step 1 Forum 3 02-07-2010 08:50 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)