Rosh Emergency Medicine Practice Test

What is a notable sign of potentially serious infection postpartum that necessitates immediate evaluation?

1. Creatinine level of 1.0 mg/dL

2. White blood cell count of 16,000/μL

3. Exquisite uterine tenderness

4. Tachycardia of 100 bpm

The correct answer is: Exquisite uterine tenderness

Exquisite uterine tenderness is a notable sign of potentially serious infection postpartum, often indicating conditions such as endometritis. This type of infection typically occurs following delivery, particularly in cases of cesarean sections or prolonged labor. When a patient exhibits significant uterine tenderness, it suggests that there may be an inflammatory process occurring in the uterus, which can lead to complications if not promptly addressed. Immediate evaluation is crucial to determine the extent of the infection and initiate the appropriate antibiotic treatment. Other options may reflect common physiological changes or mild infections but do not always require immediate intervention. For instance, a creatinine level of 1.0 mg/dL is generally considered normal, while a white blood cell count of 16,000/μL may represent a mild response to stress or infection but often does not denote an immediate crisis. Tachycardia at 100 bpm can occur in various situations, including anxiety or dehydration, and while it may indicate that a patient needs further assessment, it is not as specific for serious infection as exquisite uterine tenderness. Therefore, the presence of significant uterine tenderness warrants urgent medical attention to prevent complications associated with postpartum infections.