Question of the Week # 331

331) A 16 year old girl is evaluated in the office for mild to moderate pain in her left ankle.  She reports that she heard a pop sound followed by the pain when she was about to walk briskly on her way to college. She is unable to walk normally and cannot lift up on to her toes while weight bearing. Her past medical history is significant for recurrent episodes of urinary tract infections. On examination, she is afebrile. There is no bruising or swelling in her left foot. There is tenderness at the back of her left foot about 2 cm above the posterior calcaneus.  Squeezing of the left calf muscle fails to result in passive plantar flexion at the ankle.  Which of the following element if obtained from the patient’s history would help in determining the cause of her presentation?

A) Eating habits

B) Menstrual History

C) Sexual History

D) Recent antibiotic use

E) Family history of Muscular Dystrophy

9 Responses

  1. d) Recent antibiotic use .- Fluoroquinolones incrise the risk for aquiles tendon rupture which is clear by PE in this patient.

  2. D

  3. d – assoc with quinolones

  4. answer is D , quinolones do this

  5. answer D

  6. ddd

  7. Recent antibiotic use , because is associated with the use of antibiotic (fluoroquinolones )

  8. D, antibiotics use

  9. D

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