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Old 01-22-2012
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Drug Purpuric febrile rash in a pregnant woman!

A 27-year old primigravid woman at 18 weeks' gestation was recently on a camping trip.She comes to the physician complaining of a 5-day history of nausea, vomiting, fever and a rash. Physical examination shows diffuse petechiae and purpura over her arms and legs. Which of the following is the most appropriate agent for this patient?

A. Chloramphenicol
B. Doxycycline
C. Quinine
D. Rifampin
E. Valacyclovir
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Ans D....... rifampicin ....... seems like lyme disease and doxycycline is CI ...
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i donot know what the diagnosis is.. but by elimination

you cannot give A-B-C in pregnancy...

so left between D/E
dont think its viral.. more like Lymes or ricketsial... so will go with D rifampin
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The answer is A
Disease is lyme disease, but since she is pregnant Doxycycline (drug of choice) is contraindicated.
According to kaplan, Clindamycin would then be the best drug to give her.
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Quote:
Originally Posted by khushi.chahal View Post
The answer is A
Disease is lyme disease, but since she is pregnant Doxycycline (drug of choice) is contraindicated.
According to kaplan, Clindamycin would then be the best drug to give her.
but ur question states A is chloramphenicol ?
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may be she meant Choramphenicol .... but isnt it teratogenic ??? Gray baby syndrome ????? i think it should be rifampicin ...
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Quote:
Originally Posted by mbbs2010 View Post
but ur question states A is chloramphenicol ?
yes, according to Kaplan chloramphenicol is the drug of choice for lyme disease in a pregnant woman.
question ID: m200532
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eek, sorry i mean RSMF, not lyme disease.

chloramphenicol is the DOC for RSMF in a pregnant woman, as is the case in this question.
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Quote:
Originally Posted by Hitman View Post
may be she meant Choramphenicol .... but isnt it teratogenic ??? Gray baby syndrome ????? i think it should be rifampicin ...
"chloramphenicol is the DOC for RSMF in pregnant patients. It has a pregnancy category of C. Gray baby syndrome is a concern particularly if near term, but this patient is not near term and it is the DOC for pregnant patients with RMSF." - Kaplan's explanation to this question.
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oh i noticed i said Clindamycin earlier, my apologies. I meant Chloramphenicol, as it the option for A.
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Old 07-01-2012
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Default Answer is Q

Answer is A.

Although doxycycline is the recommended therapy for children and nonpregnant women with RMSF, chloramphenicol remains the recommended therapy for women during pregnancy.

Note that pregnant women with Lyme disease are treated mostly with amoxicillin. Women who are allergic to amoxicillin would most likely receive 500 mg cefuroxime axetil twice per day.
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can some tell me what they meant by RMSF?????????????

Thanks
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Old 07-01-2012
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Rocky mountain spotted fever........
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Old 07-02-2012
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oh, thanks
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