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MMLU / A 43-year-old man with a history of self-mutilation comes to the emergency…

Problem

Answer published by the source. Consult the official source to check your work against its answer.

question

A 43-year-old man with a history of self-mutilation comes to the emergency department because of pain in his right thigh and shaking chills during the past 3 days. He says he intentionally burned his right thigh several times with a cigarette lighter 6 days ago. This morning he soaked his thigh in a tub of hot water and massaged it, after which a large amount of "greenish fluid" drained from the wound sites. The patient normally takes lithium carbonate but stopped 3 months ago after he lost his job. Medical history is otherwise unremarkable. Vital signs are temperature 39.2°C (102.5°F), pulse 170/min, respirations 18/min, and blood pressure 120/60 mm Hg. Physical examination shows an edematous right lateral thigh with multiple burn sites with a white exudative appearance. There is erythema surrounding the burn areas with red streaks extending up the thigh. Palpation of the burn sites discloses fluctuance. Results of laboratory studies show a hemoglobin concentration of 14 g/dL and a leukocyte count of 19,000/mm3 . In addition to beginning antibiotic therapy, which of the following is the most appropriate next step?

choices

  1. Incision and drainage
  2. Psychiatric consultation
  3. Topical silver sulfadiazine
  4. Transfer to a burn center

subject

professional_medicine

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Source and history

task_id
18f46098-a41f-5e79-939f-b700f539d0e8
task_key
all--test--18f46098-a41f-5e79-939f-b700f539d0e8
task_revision_id
1
config / split
all / test

Official source

initial import