A 59-year-old woman on ramipril, a fibrate and an antiepileptic was admitted for chronic fatigue. On day 3 she has fever 39°C for 2 hours not relieved by paracetamol. What is the most likely diagnosis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: B. Nosocomial infection
- إجابة ثانية: C. Drug-induced fever
Fever starting more than 48 hours after admission (day 3) is by definition hospital-acquired, so a nosocomial infection is the usual intended answer (old bank B). However, the sources list drug fever among the key causes of fever in hospitalised patients, and anticonvulsants (e.g. phenytoin) and antihypertensives (e.g. captopril) are named culprits – so C is also defensible. Drug fever is more likely when the fever coincides with starting a drug; the stem does not say whether these drugs are new, which leaves the question ambiguous.
ليش كل خيار صح أو غلط
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A
ليش غلط
The pulmonology notes classify pneumonia as community-acquired or hospital-acquired, with hospital-acquired defined by onset more than 48 hours after admission. Her fever starts on day 3 of the stay, past that point, so a community-acquired illness fits poorly.
✓ Pulmonology 🫁.pdf · p. 14 -
B
ليش صح
Source support: the pulmonology notes define hospital-acquired pneumonia by onset more than 48 hours after admission, and her fever begins on day 3. The definition is written for pneumonia, so it supports the timing only.
✓ Pulmonology 🫁.pdf · p. 14 -
C
ليش صح
Source support: the fever-of-unknown-origin station notes list drug-induced fever from anticonvulsants and antihypertensives, and she takes an antiepileptic and ramipril. The stem does not say if the drugs are new.
✓ view-material.pdf · p. 170
- المصدر
- Pulmonology 🫁.pdf · p. 14
Pyrexia of unknown origin (PUO).pdf · p. 3
view-material.pdf · p. 170 - المحاضرة
- Pyrexia of Unknown Origin · Infectious Diseases · Module B
- ظهر في
- MED41 ♂ EOM B