USMLE Forum Archives - USMLE Step 3 - skin infection
skin infection
zkadhem - 07-24-09 17:41
A 14-year-old Caucasian boy is brought to the emergency department. He has a skin infection on the back of the chest which is moderately painful. He has had this infection for the past two days. His only other medical problem is diabetes mellitus-type 1. His medications include regular insulin, NPH insulin, cephalexin (for 2 days), and acetaminophen. He has no known drug allergies. His temperature is 37.8 C (100 F), blood pressure is 100/60 mmHg, pulse is 92/min, and respirations are 14/min. There is a red, hot, shiny and swollen lesion in the back of the neck. The area is very tender, slightly elevated, and has irregular borders. There are two vesicular lesions; one of them is open, draining yellowish secretions. If you decide to take care of the wound without referring him to a surgeon, why will you prefer to avoid the use of local anesthesia?
zkadhem - 07-24-09 17:41
A 14-year-old Caucasian boy is brought to the emergency department. He has a skin infection on the back of the chest which is moderately painful. He has had this infection for the past two days. His only other medical problem is diabetes mellitus-type 1. His medications include regular insulin, NPH insulin, cephalexin (for 2 days), and acetaminophen. He has no known drug allergies. His temperature is 37.8 C (100 F), blood pressure is 100/60 mmHg, pulse is 92/min, and respirations are 14/min. There is a red, hot, shiny and swollen lesion in the back of the neck. The area is very tender, slightly elevated, and has irregular borders. There are two vesicular lesions; one of them is open, draining yellowish secretions. If you decide to take care of the wound without referring him to a surgeon, why will you prefer to avoid the use of local anesthesia?
The correct answer and explanation will be available after you answer.
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#12
Re: skin infection conym5 - 04-14-10 13:38 This patient has cellulitis of the neck. Diabetes mellitus is an important risk factor for this condition. Since cellulitis is an infection located between the subcutaneous tissue and the fat, local anesthesia will not be useful.
#17
Re: skin infection babbu5508 - 08-31-10 00:18 My answer is: c.
The infection is located between the subcutaneous tissue and the fat...not likely to respond to the anaesthetic...
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