Rosh Review EM Scholar Monthly Question

A 51-year-old woman presents for evaluation of increasing right lower extremity swelling for the last 3 hours. She was hiking with her dog in the southwest US when she heard a rattling noise in a nearby bush. She bent over to examine where the sound was coming from when she felt a sharp pain in her right lower leg. She subsequently noticed a single puncture wound. Her exam is shown below, with pain radiating up to her inguinal region. Which of the following is recommended?

  1. 4-factor prothrombin complex concentrate
  2. Crotalidae polyvalent immune fragment-antigen binding antivenom
  3. Latrodectus antivenom
  4. Observation

FOR THE RIGHT ANSWER CLICK ON THE ROSH REVIEW LOGO BELOW

 

References:

  1. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th annual report. Clin Toxicol. 2017;55(10):1072–1252. https://www.tandfonline.com/doi/abs/10.1080/15563650.2017.1388087
  2. Norris RL, Bush SP, Cardwell MD. Bites by venomous reptiles in Canada, the United States, and Mexico. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach’s Wilderness Medicine. 7th ed. Elsevier; 2017:(Ch) 35.
  3. Rokyta DR, Wray KP, Margres MJ. The genesis of an exceptionally lethal venom in the timber rattlesnake (Crotalus horridus) revealed through comparative venom-gland transcriptomics. BMC Genomics. 2013;14:394. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3701607/
  4. Warrell DA. Bites by venomous and nonvenomous reptiles worldwide. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach’s Wilderness Medicine. 7th ed. Elsevier; 2017:(Ch) 36.

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)

Cite this article as: Rosh Review Author Team, "Rosh Review EM Scholar Monthly Question", REBEL EM blog, July 13, 2023. Available at: https://rebelem.com/rosh-review-em-scholar-monthly-question-3/.

Like this article?

Share on Facebook
Share on Twitter
Share on Linkdin
Share via Email

Want to support rebelem?

Sponsored