Antibiotics for Cellulitis? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 08-10-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 588 Times in 354 Posts
Reputation: 598
Drug Antibiotics for Cellulitis?

64-year-old man admitted for CABG. Prior to this he was well except for a 2-3-month Hx of tinea pedis. He does well in surgery but post-operatively on day 5 he develops progressive right leg swelling, pain and erythema; this occurs with
fever, chills, and difficulty walking.

PE: Tense edema of right leg, erythema, warmth. Within 6 hours, the cellulitis has spread to the groin, and the skin begins to slough from the leg distally with discoloration.

Lab shows W8C 1.9 wi 50% bands
Platelet 60,000 and prolonged PT/PTT
He develops renal failure and liver dysfunction.
No evidence of gas formation by x-rays
He develops hypothermia and hypotension.

Select the most appropriate antibiotic regimen

A. Ceftriaxone 1 gm IV q 12 hrs
8. Nafcillin 2 gm IV q 4 hrs
C. Vancomycin 1 g IV q 12 hrs and gentamicin at appropriate dose
D. Penicillin 4 million units IV q 4 hrs + clindamycin + IVIG
E. Chloramphenicol 1 g IV q 6 hrs
Reply With Quote Quick reply to this message



  #2  
Old 08-10-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 456 Times in 289 Posts
Reputation: 466
Default

C.......???just guessed
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
  #3  
Old 08-10-2012
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 64
Threads: 12
Thanked 34 Times in 20 Posts
Reputation: 44
Default

B ..Nafcillin IV

Quote:
Originally Posted by tyagee View Post
64-year-old man admitted for CABG. Prior to this he was well except for a 2-3-month Hx of tinea pedis. He does well in surgery but post-operatively on day 5 he develops progressive right leg swelling, pain and erythema; this occurs with
fever, chills, and difficulty walking.

PE: Tense edema of right leg, erythema, warmth. Within 6 hours, the cellulitis has spread to the groin, and the skin begins to slough from the leg distally with discoloration.

Lab shows W8C 1.9 wi 50% bands
Platelet 60,000 and prolonged PT/PTT
He develops renal failure and liver dysfunction.
No evidence of gas formation by x-rays
He develops hypothermia and hypotension.

Select the most appropriate antibiotic regimen

A. Ceftriaxone 1 gm IV q 12 hrs
8. Nafcillin 2 gm IV q 4 hrs
C. Vancomycin 1 g IV q 12 hrs and gentamicin at appropriate dose
D. Penicillin 4 million units IV q 4 hrs + clindamycin + IVIG
E. Chloramphenicol 1 g IV q 6 hrs
Reply With Quote Quick reply to this message
 
  #4  
Old 08-10-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,104 Times in 1,049 Posts
Reputation: 2124
Default

D. Penicillin 4 million units IV q 4 hrs + clindamycin + IVIG

Cant be

A. Ceftriaxone 1 gm IV q 12 hrs doesn't cover MRSA

8. Nafcillin 2 gm IV q 4 hrs does cover Strep & Staph but not MRSA

C. Vancomycin 1 g IV q 12 hrs and gentamicin at appropriate dose Vanc causes renal toxicity which is potentated by Genta. It also caused thrombocytopenia

E. Chloramphenicol 1 g IV q 6 hrs Duh?

Last edited by Novobiocin; 08-10-2012 at 03:46 PM.
Reply With Quote Quick reply to this message
The above post was thanked by:
aknz (02-03-2013), fadi551 (03-18-2013), Mondoshawan (08-10-2012)



Reply

Tags
Infectious-Diseases, Internal-Medicine-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Cavernous Sinsus Thrombosis Versus Orbital Cellulitis? tyagee USMLE Step 2 CK Forum 5 08-10-2012 08:47 PM
Severe Cellulitis with fever; Oral or IV Antibiotics! chienpolska USMLE Step 2 CK Forum 2 05-09-2012 01:33 PM
Cellulitis or Necrotizing Faciitis? tyagee USMLE Step 2 CK Forum 11 04-23-2012 05:28 PM
Question about Cellulitis (Erysipales) Dr_Kal_El USMLE Step 1 Forum 0 09-16-2010 12:00 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)