Today's Clinical Vignette is a series of 7's. It involves a 7 year old with 7 days of fever and vomiting and it happens to be Case number 7 from our Laughing Your Way to Passing the Pediatric Boards : Clinical Vignettes book.
In addition to lethargy she has developed a specific rash that you should be able to identify, and will be able to identify with ease once you complete the quiz. The question provides lab results and a red herring in the form of treatment that did not work .
Read the vignette and answer the questions first. Then we provide you with a proven systematic approach to analyzing and breaking down the question so the answers become obvious or when you are tested with this presentation on the exam or the Peds MOCA module.
Good Luck !
It is important to put the abnormal lab results and vital signs into words. When you study it is the words that stick out not the numbers. In the case of this questions you have
Take Home Message :
The important parts in unpacking this question include 7 Facts About the 7 year old girl with 7 days of Vomiting
1) A specific Rash
2) Recent Travel
3) Decreased bowel sounds / Bloody Stools
6) Tachycardia / Hypotension / or even better note " low blood pressure"
This tells you that you are dealing with Rocky Mountain Spotted and that should open the key to the questions on diagnosis and treatment. All of that is explained below