A 60-Year-Old Woman Comes to the Emergency Department Due to Progressive

question 622

Multiple Choice

A 60-year-old woman comes to the emergency department due to progressive pain, swelling, and redness of her left leg for 4 days.  She has had no obvious trauma or insect bites to that area.  Two months ago, the patient had a hysterectomy for endometrial hyperplasia.  She also has a history of rheumatoid arthritis and gastroesophageal reflux disease.  She does not use tobacco, alcohol, or illicit drugs.  Temperature is 39.4 C (102.9 F) , blood pressure is 130/80 mm Hg, pulse is 106/min, and respirations are 18/min.  The patient appears well.  Her left anterior leg is swollen, erythematous, tender, and warm to the touch over a 10x5 cm region, as shown in the exhibit.  The erythema is present throughout the affected area and has a flat border.  There is no overlying crepitus or bullae.  The left thigh and right leg are normal in appearance.  The remainder of the examination is normal.  Laboratory results are as follows: Which of the following is the most likely diagnosis?

• A)Cellulitis
• B)Deep venous thrombosis
• C)Erysipelas
• D)Erythema nodosum
• E)Necrotizing fascitis
• F)Ruptured Baker cyst
• G)Toxic shock syndrome

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Definitions:

Margin of Safety

The difference between actual or expected sales and sales at the break-even point, indicating how much sales can fall before a business incurs a loss.

Break-even Point

The level of sales at which profit is zero.

Degree of Operating Leverage

A ratio that measures how a percentage change in sales will affect profits, highlighting the impact of fixed costs on earnings.

Break-even Point

The level of sales at which total revenues equal total costs, resulting in no profit or loss for the business.