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Old 09-18-2012
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Default help with question please

question : if i have a patient with a decubitus ulcer that do not heal with an elevated esr. patient is diabetic and lost weight recently. options are diabetes,squamous cell carcinoma, malnutrition,osteomyelitis
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Old 09-18-2012
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Must need more information, does the patient has a fever? has it been draining? the only 2 options are SCC aka Marjolin Ulcer or osteomyelitis... both are extremely more common in diabetic ulcers.

Put the whole question so that we can see and compare, they have to give a clue to be able to differentiate between SCC and Osteomyelitis.
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Old 09-18-2012
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He had low grade fever, leukocytes:14,000 no change for the past 3 months

Just one more question;
I have 68 yr woman, fatigue for 3 months, she takes digoxin, naproxen, HTZ, amoxicillin, enalapril. Previos hx of Coronary disease, osteoarthritis and chronic bronchitis. BUN:60 Cr:6. Which of the following medications is responsible for the renal failure.
Thank You very much for everything
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Old 09-18-2012
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For your first question I would then choose Squamous cell Carcinoma, as osteomyelitis fro 3 months in a diabetic patient either kills him/her or stomps him/her

For your second question I would say Naproxen, her BUN/CR is 10 which = to intrinsic renal failure, however amoxicillin and ACEi's can also damage the kidney.
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Old 09-18-2012
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Quote:
Originally Posted by XpaezX View Post
For your first question I would then choose Squamous cell Carcinoma, as osteomyelitis fro 3 months in a diabetic patient either kills him/her or stomps him/her

For your second question I would say Naproxen, her BUN/CR is 10 which = to intrinsic renal failure, however amoxicillin and ACEi's can also damage the kidney.
Thank you very much!!!
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Old 09-18-2012
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Quote:
Originally Posted by dianne1720 View Post
He had low grade fever, leukocytes:14,000 no change for the past 3 months
I think these are Nbme questions. If these are, Plz label the topic as question about Nbme concepts !!!!!!

Regarding ur first question.
The answer should be osteomyelitis.
Pt is immunocompromised..... D.M
Leucocytosis.... Infection
Duration... Decubitus ulcers start with the involvement of skin and later on might gradualy involve the bone.
3 months is still a short duration to cause squamous cell ca in a non- healing ulcer.
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