American Board of Internal Medicine (ABIM) Certification Practice Exam

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What white blood cell count is associated with fulfilling fulminant C. diff criteria?

Greater than 10,000
Greater than 15,000
Greater than 20,000
Greater than 25,000

The correct answer is: Greater than 15,000

Fulminant Clostridium difficile infection (CDI), which is a severe and potentially life-threatening manifestation of C. difficile colitis, is characterized by specific clinical and laboratory criteria. A crucial component of the diagnostic criteria for fulminant CDI includes an elevated white blood cell (WBC) count, reflecting significant inflammation and the body's response to infection. In this context, a WBC count greater than 15,000 cells per microliter is specifically associated with fulfilling the criteria for fulminant CDI. This threshold is indicative of a severe infection and helps distinguish fulminant cases from less severe forms of CDI. Additionally, patients presenting with such high WBC counts often have more severe symptoms, including profuse diarrhea and abdominal pain, and may require more aggressive management. Establishing this elevated WBC count as a criterion is critical because it informs clinicians about the severity and potential complications of the infection, guiding timely treatment decisions that can improve patient outcomes. Therefore, the identification of a WBC count greater than 15,000 serves as a key indicator in the vigilance for fulminant C. difficile colitis.