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Medical Emergencies · single question

A 9-year-old diagnosed with leukemia three months ago is currently receiving chemotherapy and needs an extraction. What is the FIRST step in management?

  1. Defer all care until chemotherapy is completed
  2. Contact the oncologist to review current blood counts and treatment timing
  3. Extract the tooth under antibiotic prophylaxis
  4. Take a panoramic radiograph and reappoint in one month
Show answer and explanation

Correct answer: B. Contact the oncologist to review current blood counts and treatment timing

  • A. ❌ Deferring everything is wrong in the other direction — an untreated dental infection during myelosuppression can be fatal. Acute infection is eliminated, ideally before or between cycles.
  • B. ✅ CORRECT — Consult the ONCOLOGIST first. You need the current absolute neutrophil count and platelet count, the chemotherapy cycle timing, and whether a central line is in place. Invasive care is ideally scheduled when counts recover between cycles — generally ANC above 1,000–1,500/µL and platelets above 50,000–75,000/µL.
  • C. ❌ Extracting without knowing the counts risks uncontrolled bleeding and life-threatening sepsis in a neutropenic child.
  • D. ❌ A radiograph without medical consultation and a month's delay does not address the immediate need.

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