Approach to skin and soft tissue injury Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 66-year-old man was brought to the emergency department by ambulance after his partner found him obtunded in his living room. Three days ago, the patient had injured himself while working on their property in the woods. The patient has a history of uncontrolled diabetes, hypertension, hyperlipidemia and coronary artery disease. The patient takes insulin, metformin, lisinopril, atorvastatin, and aspirin. Temperature is 39°C (102°F), blood pressure is 99/60 mmHg, pulse is 106/min, respiratory rate is 22/min, and oxygen saturation is 94% on room air. The patient appears ill, is oriented only to self. Physical examination of the left lower leg reveals warmth and rapidly spreading diffuse significant erythema surrounding a 4 cm burn with exposed subcutaneous fat and foul smelling grayish discharge. There is significant tenderness over the areas of erythema. Initial blood work is shown below and a culture of the discharge is sent. Which of the following is the most likely diagnosis?  

Laboratory value
Result
Serum chemistry

Sodium
131 mEq/L
Potassium
4.2 mEq/L
Chloride
95 mEq/L
Creatinine
2.8 mg/dL
Albumin
3.2 g/dL
BUN/Cr
> 20
Glucose
> 500

Laboratory value
Result
Hemoglobin
12  g/dL
Hematocrit
40 %
Leukocyte count
19,100 /mm3
Platelet count
256,000/mm3
Lactic acid
3.6 mg/dL
Creatinine kinase
52 U/L

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