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MMLU-Pro / 6373 / A 38-year-old man with Down syndrome and severe mental retardation is brought to…

Problem

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question

A 38-year-old man with Down syndrome and severe mental retardation is brought to the emergency department by ambulance because of increasing lethargy for the past several hours. The patient is noncommunicative and you are unable to obtain an initial history of his present illness or a past medical history. You do not know if he takes any medications. Vital signs are temperature 38.3°C (100.9°F), pulse 90/min, respirations 19/min, and blood pressure 120/60 mm Hg. On physical examination the patient is awake but lethargic. Auscultation of the chest discloses clear lungs; cardiac examination discloses a systolic click. Neurologic examination shows decreased muscle tone. Serum electrolyte concentrations are normal. Complete blood count shows a leukocyte count of 18,000/mm3 with 23% band neutrophils. The patient's caregiver, who is also the patient's guardian, cannot be located and staff at the group home where the patient resides cannot be reached by telephone. The patient refuses lumbar puncture for examination of cerebrospinal fluid. Toxicologic screening of the urine is negative. Which of the following is the most appropriate next step?

category

health

options

  1. Obtain echocardiography
  2. Administer oral antibiotics
  3. Provide intravenous fluids and observe
  4. Order a chest X-ray
  5. Initiate seizure precautions
  6. Await contact with the caregiver before proceeding with management
  7. Wait for the patient's consent for a lumbar puncture
  8. Obtain CT scan of the head
  9. Administer intravenous antibiotics
  10. Perform a psychiatric evaluation

src

ori_mmlu-professional_medicine

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Source and history

upstream_id / Original problem ID
6373
task_id
4473c301-f80f-5103-8c13-33c98d3a145e
task_key
default--test--6373
task_revision_id
1
config / split
default / test

Official source

initial import