USMLE Forum Archives - USMLE Step 2 CK - next step
next step
bingousmle - 05-19-10 10:19
A 3-week-old white female who is being fed a formula with a cow's milk base is brought to your office with a 4-day history of dark blood flecks in otherwise normal appearing stools. Other history is unremarkable. A physical examination reveals yellow, curdy, guaiac-positive stool. Anal and rectal examinations are normal, as is the rest of the examination. The best course of action would be to
a.draw blood for CBC, BUN, and electrolytes, and start intravenous fluids
b.culture the stool for rotavirus
c.obtain upper and lower GI barium fluoroscopy studies
d.perform an alkali denaturation test on the stool to rule out a maternal source for the blood
e.suggest a change to a soy-based formula
bingousmle - 05-19-10 10:19
A 3-week-old white female who is being fed a formula with a cow's milk base is brought to your office with a 4-day history of dark blood flecks in otherwise normal appearing stools. Other history is unremarkable. A physical examination reveals yellow, curdy, guaiac-positive stool. Anal and rectal examinations are normal, as is the rest of the examination. The best course of action would be to
a.draw blood for CBC, BUN, and electrolytes, and start intravenous fluids
b.culture the stool for rotavirus
c.obtain upper and lower GI barium fluoroscopy studies
d.perform an alkali denaturation test on the stool to rule out a maternal source for the blood
e.suggest a change to a soy-based formula
The correct answer and explanation will be available after you answer.
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#2
Re: next step babbu5508 - 05-19-10 13:30 My answer is: b.
Symptoms of cow's milk protein allergy will generally appear within the first few months of life. An infant can experience symptoms either very quickly after feeding (rapid onset) or not until 7 to 10 days after consuming the cow's milk protein (slower onset).
The slower-onset reaction is more common. Symptoms may include loose stools (possibly containing blood), vomiting, gagging, refusing food, irritability or colic, and skin rashes.
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