A 67-year-old man is brought to the emergency department because of a 3-day history of fever and hea

Discussion in 'USMLE Step 2 CK' started by samuel, Dec 11, 2014.

  1. samuel

    samuel New Member

    A 67-year-old man is brought to the emergency department because of a 3-day history of fever and headache. Five years ago, he underwent placement of a mechanical aortic valve for treatment of sequelae of rheumatic fever. He appears ill. His temperature is 40 C (104 F), blood pressure is 110/65 mm Hg, pulse is 110/min, and respirations are 22/min. A grade 3/6, systolic ejection murmur is heard. Neurologic examination shows mild left hemiparesis. Babinski's sign is present on the left. There is no nuchal rigidity. This patient is at greatest risk for which of the following complications?

    A
    ) Brain abscess

    B
    ) Carotid artery occlusion

    C
    ) Encephalitis

    D
    ) Hydrocephalus

    E
    ) Venous sinus thrombosis

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