#april2020mccqe1
An 18-year-old woman is evaluated in the emergency department for a 3-day history of fever and rash accompanied by joint pain and swelling that initially involved only the left elbow before progressing to the left wrist. Medical history is unremarkable. She takes a depot medroxyprogesterone acetate injection every 12 weeks for contraception.
On physical examination, temperature is 38.1°C (100.6°C); other vital signs are normal. The left wrist is erythematous and swollen, and pain is induced with active range of motion. The left elbow is also swollen and painful. Scattered lesions are present on the left hand and both feet. Skin examination findings of the left hand are shown in the image.
Appropriate cultures are taken.
Which of the following is the most appropriate treatment?
(A) Acyclovir
(B) Ceftriaxone
(C) Ciprofloxacin
(D) Gentamicin
An 18-year-old woman is evaluated in the emergency department for a 3-day history of fever and rash accompanied by joint pain and swelling that initially involved only the left elbow before progressing to the left wrist. Medical history is unremarkable. She takes a depot medroxyprogesterone acetate injection every 12 weeks for contraception.
On physical examination, temperature is 38.1°C (100.6°C); other vital signs are normal. The left wrist is erythematous and swollen, and pain is induced with active range of motion. The left elbow is also swollen and painful. Scattered lesions are present on the left hand and both feet. Skin examination findings of the left hand are shown in the image.
Appropriate cultures are taken.
Which of the following is the most appropriate treatment?
(A) Acyclovir
(B) Ceftriaxone
(C) Ciprofloxacin
(D) Gentamicin
