A 16-Year-Old Boy Is Brought to the Emergency Department by His

question 257

Multiple Choice

A 16-year-old boy is brought to the emergency department by his mother due to a possible hand injury.  She noticed that the patient's right hand was swollen and that he was not using it despite being right-handed.  He has a history of oppositional defiant disorder and refuses to say how his hand was injured.  Temperature is 38 C (100.4 F) , blood pressure is 110/72 mm Hg, and pulse is 80/min.  The dorsum of the right hand is swollen.  There is erythema centered over the long finger metacarpophalangeal (MCP) joint, where there is a small, linear scab; the area is fluctuant on palpation, and passive movement of the joint elicits severe pain.  Right hand x-ray reveals soft tissue swelling, no retained foreign body, and no underlying fractures or dislocations.  Which of the following is the best next step in management of this patient?

• A)Intraarticular glucocorticoid injection
• B)Oral antibiotic therapy and outpatient follow-up
• C)Oral nonsteroidal anti-inflammatory drugs and outpatient follow-up
• D)Surgical irrigation and debridement of the MCP joint

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Definitions:

Market Price

The prevailing rate at which a service or asset is traded in the free market.

Standardized Product

Goods or services that are uniform in quality and performance, allowing them to be interchangeable among consumers.

Market Share

The segment of a market dominated by a specific company or product.

Perfect Competition

A market structure characterized by a large number of small firms, a homogeneous product, free entry and exit, and perfect information, leading to price takers.