Question of the Week # 5

A 30 y/o pregnant woman has a one week history of a slowly enlarging red lesion on her right thigh. She reports having gone on a camping trip about 3 weeks ago and now recalls that she removed a tick from the site of the lesion. An ELISA test is negative for Lymes. Upon further questioning, she also reports contact with poison Ivy like  bushes during the same camping trip.

Archer USMLE Step 3 Qusetion Bank

What is the next step?
A. Re-assurance
B. Ampicillin
C. Doxycycline
D. Western blot testing
E. Topical Corticosteroid

Question of the Week – Wk#1

Archer will start  “Question of the Week” series starting today. Every week Archer Review will post most challenging questions that include close distractors in the choices that are often tested on USMLE Step 3.

Question of the Week – July 29th 2010

1. A 15 year old boy presents to emergency room with severe lower abdominal pain that awoke him from sleep about 5 hours ago. The pain is sharp and radiating to the left thigh. While in the emergency room, the patient has one episode of vomiting. He denied any fever, dysuria or chills. Physical examination reveals normal vitals with blood pressure 100/60 and temperature of 98.6F. Abdominal examination is relatively benign. Scrotal examination reveals an elevated left testis that is diffusely tender to palpation. Cremasteric reflex is present on the right but absent on the left. Most important next step in managing this patient :
a. CT scan Abdomen and Pevlis
b. Testicular Ultrasound
c. Surgical Exploration
d. Intravenos Antibiotics
e. Plain X-Ray KUB

Answer will be posted with in 3 days. You may submit your responses and analysis as a comment to this post.

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