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Problem
You receive the Your new patient is a 12-month old child who has not been seen by any outpatient provider since her 1 week well visit. She is unimmunized. Her parents are concerned because she has had a high fever, irritability, decreased appetite and voiding and a rash that looks like she is bleeding under her skin. On exam, you notice a diffuse petechial rash and the child screams when you try to move her neck (consistent with nuchal rigidity). The most critical diagnostic step in the child is: Group of answer choices Evaluation of the CSF to evaluate for meningitis The physical examination to further explore hydrations Blood culture to evaluate for septicemia The history to evaluate for exposures to infectious diseasesresults of newborn screening that indicates possible hypothyroidism just before seeing Di for her 2-week-old well visit. Her parents report that she does not seem to be feeding too well, having hard stools every 3 days and seems tired. Her growth shows that she has only gained 2 ounces in the past 7 days. A stat TSH done at today is 96 mIU/L. What is the best choice for care?
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