5.0 of 2 Ratings
A 5-year-old is brought into the emergency department for trouble breathing. He was at a family picnic playing when his symptoms began. The patient is currently struggling to breathe and has red, warm extremities. The patient has an unknown medical history and his only medications include herbs that his parents give him. His temperature is 99.5°F (37.5°C), pulse is 112/min, blood pressure is 70/40 mmHg, respirations are 18/min, and oxygen saturation is 82% on 100% O2. Which of the following is the best initial step in management?
Albuterol, ipratropium, and magnesium
Select Answer to see Preferred Response
A 3-year-old girl is brought to the emergency department by her father for acute-onset shortness of breath and wheezing. The rash shown in Figure A is found upon brief examination of the patient; the patient reports that the rash itches. While in the emergency department, the patient vomits and has an episode of diarrhea. Her vital signs are as follows: T 38.2, HR 155, BP 75/45, RR 38, and SpO2 99%. Examination is significant for the rash mentioned previously and rapid breathing, but there is no facial or oral swelling noted. On further discussion with the father, he relates that she has been otherwise healthy, except for an ear infection that developed a few days ago. She was seen by her pediatrician yesterday and started on her first dose of a course of amoxicillin this morning. The father relates that she took this medication for a previous ear infection without any issue. Which of the following best describes the pathophysiology of the skin lesions seen in this patient?
Histamine- and leukotriene-induced subscutaneous smooth muscle contraction
Type IV hypersensitivity reaction
Histamine-mediated vasodilation with increased vascular permeability resulting in dermal fluid accumulation
Acquired anti-desmoglein antibodies disrupt keratinocyte adherence, leading to epidermal bullae
Latent antibodies attack basement membrane, resulting in the formation of subepidermal blisters.
A 20-year-old woman presents to the emergency department after developing a widespread rash when she was playing in the park. She states she feels somewhat light-headed. She is otherwise healthy and has no significant past medical history. Her temperature is 97.0°F (36.1°C), blood pressure is 84/54 mmHg, pulse is 130/min, respirations are 22/min, and oxygen saturation is 95% on room air. Physical exam is notable for bilateral wheezing and a diffuse urticarial rash. Which of the following is the next best step in management?