Febrile Neutropenia Quiz
Created by Chris Galbraith and Connor Bohlken
Edited by Dr. Paris Ingledew
You are a 3rd year medical student on call for the wards for Internal Medicine. Mrs. Actquick is one of your patients, she is a 67 year old female recently diagnosed with Acute Myeloid Leukemia (AML). She was admitted to hospital for Failure to Thrive likely secondary to her AML and was initiated on Chemotherapy (Cytarabine) with curative intent, she is on day 5 of her treatment. You are called by the nurse on the floor. She reports the following: Mrs. Actquick’s oral temperature is 38.4 Degrees Celsius and her most recent CBC demonstrated an absolute neutrophil count of 0.1 x 10^9 Cells/L. Which respect to diagnoses and treatment which of the following is correct?Untitled Question
No need for concern, Mrs. Actquick has a slight bump in her temp and this can be reassessed in the morning.
Mrs. Actquick is febrile, give Tylenol 325-650 mg PO Q6H PRN and reassess in 12 hours.
Mrs. Actquick has febrile neutropenia, she needs to be initiated on broad-spectrum antibiotics.
Mrs. Actquick has neutropenia, likely secondary to some remote inflammation. Give Ibuprofen 400 mg PO Q8H PRN and reassess in 24 hours.
Mrs. Actquick is experiencing side effects of her medication. Reassess in 24 hours.
Having made your decision plan for Mrs. Actquick, you call your attending at 0200 AM to present the case. Even though you woke up your attending, they are ecstatic that you caught febrile neutropenia, as it is an oncologic emergency. They ask what antibiotics you would like to start. You answer:
TMP-SMX Double Strength PO q12hr
Ceftriaxone 2g IV q24hr
Pip-Tazo 4.5g IV q8hr
Vancomycin 20mg/kg/dose q8hrs
Doxycycline 100mg q12hrs
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