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  #1  
Old 05-25-2011
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Drug Woman with Recent Hx of South Asia Travel

My 3rd Attempt at making a question!

A 24 Year old woman presents to the Emergency Room with complaints of fatigue, malaise, anorexia and night sweats. Physical examination reveals presence of splinter hemorrhages. Vitals include: 120 / 80 mm Hg, Pulse: 95, Temp: 100 Degrees. Family history is insignificant. When asked about recent travel history, the patient reports traveling to South Asia for a period of 3 months, for visiting family where she also had her wisdom teeth removed.

Treatment of the above should be done with:

A) Penicillin G & Gentamicin
B) Isoniazid & Ethambutol
C) Ceftriaxone & Nafcillin
D) Isoniazid & Rifampin
E) Isoniazid & Streptomycin
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  #2  
Old 05-25-2011
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Default

D.............................
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Old 05-25-2011
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A
Thinking she has a bacterial endocarditis because of the splinter hemorrhage and wisdom tooth removed.
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Old 05-25-2011
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i think its D...
regarding endocarditis y the focus of q. is on south asia i guess its TB thts the prevalent disease but cn it be transmitted thru tooth xtraction .??????
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Old 05-25-2011
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Quote:
Originally Posted by heights View Post
A
Thinking she has a bacterial endocarditis because of the splinter hemorrhage and wisdom tooth removed.
yeap, me too
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Old 05-25-2011
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I get the TB association because of SE Asia and night sweats etc, but M. TB is still less common than Staph / Strep isn't it?
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Old 05-25-2011
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Default

A?
I think for TB too fast, or may be association of SLE with something?
__________________
Instead of saying “we don’t know why,” though, say “idiopathic.” It sounds so much smarter.
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Old 05-25-2011
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Default HRZE

Ans:
D

1st choice treatment is HRZE
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Old 05-25-2011
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ans is c
its srepto mutans
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Old 05-25-2011
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Correct Answer Corrent Answer Is: A) Penicillin G & Aminoglycoside

The answer is A),

Don't let the recent travel to south asia and night sweats throw you off, it clearly states this person has petechial haemorrhages and she had dental surgery.

Caustative Organism: S. Viridans

Tx: Penicillin G & Aminoglycoside!
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  #11  
Old 05-25-2011
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yup its d .... but what about night sweats ...
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Old 05-25-2011
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Quote:
Originally Posted by amritdhillon257 View Post
yup its d .... but what about night sweats ...
Its not D), look at the answer I posted above!
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  #13  
Old 05-26-2011
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Quote:
Originally Posted by patelMD View Post
Its not D), look at the answer I posted above!
the low grade fever 100,night sweat and H/O tvle to s asia are all indicative of TB,for SBE they have only given splinter hemorrhage and H/O tooth extraction,for SAB to occur after tooth extraction you need damaged heart..and in young women of 24 splinter hemorrhage can occur by estrogen- Oral contraceptives...its fair assumption to make.
lets go through vitals again.. they do not go along with SBE..

Last edited by moonjane11; 05-26-2011 at 02:36 AM.
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Old 05-26-2011
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Quote:
Originally Posted by moonjane11 View Post
the low grade fever 100,night sweat and H/O tvle to s asia are all indicative of TB,for SBE they have only given splinter hemorrhage and H/O tooth extraction,for SAB to occur after tooth extraction you need damaged heart..and in young women of 24 splinter hemorrhage can occur by estrogen- Oral contraceptives...its fair assumption to make.
lets go through vitals again.. they do not go along with SBE..
Actually, the symptoms of SABE are also:

- Low Grade Fever
- Night Sweats
- Splinter Haemorrhages

Differential would be:

- Lack of splinter haemorrhages in TB patients

There are no symptoms that would lock down TB, Ex:

- Thick Red Productive Sputum

No Labs:

- No AFB Bacilli
- No PPD Test

There was no history of OCP's (I'm not sure why you stated that).

I haven't taken anything personal, Im just trying to make you realize that you have your mind geared towards one thing when the question has differential diagnostic features!
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