Physical Examination and Laboratory Tests general: Patient lying supine; WDWN yo
ID: 243824 • Letter: P
Question
Physical Examination and Laboratory Tests
general:
Patient lying supine; WDWN young female; Now crying with intermittent screaming
Vital signs:
BP= 105/65; RR= 35; WT= 20 lbs; HR= 145; T= 102 degrees F with ibuprofen; HT= 30 in
Head, eyes, ears, nose, and throat
pupils equal at 3 mm, round, responsive to light and accommodation; (+) tears; both TMs bulging with no mobility; left TM is yellow and opaque and there appears to be some purulent fluid behind it; right TM is erythematous; no otorrhea present; nares patent with no discharge; throat shows significant erythema
neck/lymph nodes
neck supple with no apparent pain or stiffness with movement; no lymphadenopathy
chest
clear to auscultation bilaterally without crackles or wheezes; chest wall rise is symmetric
cardiac
regular rate and rhythm with no murmurs, rubs, or gallops
abdomen
soft, non-tender, and non-distended; (+) bowl sounds; (-) hepatosplenomegaly and masses
genitalia
normal-appearing external genitalia
extremities
20 digits; no cyanosis, clubbing, or edema; brachial pulses palpable; capliiary refill WNL; moves all extremities well; skin is warm and pink with no rashes or lesions
neurologic
responsive to stimulation; depp tendon reflexes 2+ throughout; cranial nerves intact; hearing appears intact; motor exam shows normal muscle tone and bulk; facial strength appears symmetric and normal
lab blood test results
WBC= 12,100/mm^3; lymphs= 21%; Eos= 1%; Plt= 270,000/mm^3; Neutros= 75%; Monos= 3%; RBC= 5.0 million/mm^3; ESR= 18 mm/hr
Question: Describe a scenario in which it would be appropriate to use clarithromycin to treat this patient's AOM.
Explanation / Answer
TM(Tympanic Membrane) is present in the middle ear which is extremely thin, delicate and can be injured easily.Here this patient has acute otitis media which has lead to fever, tachycardia, tachypnea.
Clarithromycin is a macrolide antibiotic which is used to kill the bacteria most effective in treating skin infections.
Left TM appears some purulent fluidsome time happen in the recovery time of an ear infections.Right TM has otorrhea.throat show significant redness or erythema which is a sign of infection.
So administration of clarithromycin will be helpful in treating current infection and to prevent future infections.