Challenging Question #9 - 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 09-16-2010
Official Advertiser Representative
 
Steps History: ---
Posts: 34
Threads: 12
Thanked 7 Times in 6 Posts
Reputation: 17
Drug Challenging Question #9

9) A 10 year-old male is brought to the urgent care clinic by his grandmother. She tells you that her cat bit the boy on the hand approximately 8 hours ago while he was teasing the animal. He just told his grandmother a few minutes ago because his hand started to hurt. The cat is up to date on all immunizations, as is the patient with his as their immunization records showed.

The child is otherwise healthy except for recurrent otitis media and mild season allergies. He is allergic to penicillins as he developed a rash the last time he took the antibiotic. On examination, vital signs are: BP 106/68 mmHg, Temp 99 F, Resp 17/min, Pulse 92/min. The physical exam is remarkable only for a deep pair of puncture wounds to the right thenar eminence, mild surrounding erythema, and localized tenderness to palpation.

After appropriate wound care in the urgent care clinic, what is the best antibiotic regimen for this patient?

A) cephalexin and trimethoprim-sulfamethoxazole
B) clindamycin and trimethoprim-sulfamethoxazole
C) azithromycin and cephalexin
D) azithromycin and trimethoprim-sulfamethoxazole
E) ciprofloxacin and clindamycin

Explanation will be posted soon....
__________________
_______________________
Try 60 Free Challenging questions with full explanations at:

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.


Join Us on
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
(4600+ Fans)
Reply With Quote Quick reply to this message



  #2  
Old 09-16-2010
Chessmatic's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 114
Threads: 5
Thanked 60 Times in 42 Posts
Reputation: 70
Default Don't know

This looks like pasteurell multocida infection rather than Bartonella hensellae
but I still don't know the answer
Reply With Quote Quick reply to this message
  #3  
Old 09-24-2010
Official Advertiser Representative
 
Steps History: ---
Posts: 34
Threads: 12
Thanked 7 Times in 6 Posts
Reputation: 17
Default

Quote:
Originally Posted by Chessmatic View Post
This looks like pasteurell multocida infection rather than Bartonella hensellae
but I still don't know the answer
The answer will be posted once we get some discussion on this post.

Care to give any reasoning for your answer?
__________________
_______________________
Try 60 Free Challenging questions with full explanations at:

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.


Join Us on
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
(4600+ Fans)
Reply With Quote Quick reply to this message
 
  #4  
Old 10-15-2010
atr88's Avatar
USMLE Forums Scout
 
Steps History: CK Only
Posts: 57
Threads: 20
Thanked 237 Times in 36 Posts
Reputation: 247
Post

causative agent is psteurella multocida that responds well to amoxicillin(augmentin) but the patient has allergy to penicillins so
we should use clindamycin+ciprofloxacin or trimethoprim-sulfamethoxazole or azithromycin
two choices ;E AND B
but we can't use ciprofloxacin at this age so choice B is correct
Reply With Quote Quick reply to this message
  #5  
Old 10-17-2010
USMLE Forums Veteran
 
Steps History: 1 + CS
Posts: 209
Threads: 34
Thanked 92 Times in 30 Posts
Reputation: 122
Default

@atr 88 agree with u r explanation but y dont u think its azithromycin and TMP SMX i think thats the answer
Reply With Quote Quick reply to this message
  #6  
Old 10-17-2010
atr88's Avatar
USMLE Forums Scout
 
Steps History: CK Only
Posts: 57
Threads: 20
Thanked 237 Times in 36 Posts
Reputation: 247
Default

although pasteurella multocida is the most causative of infection in cat bite and it's sensitive to azithromycin ,but we shouldn't forget that other bacterias like anaerobes can be present and we must cover them ;clindamycin will do it for us as it covers both gram positive cocci and anaerobes.
Reply With Quote Quick reply to this message



Reply

Tags
Infectious-Diseases, MedicalExams.com, Pharmacology-, 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
Challenging Question #6 MedicalExams USMLE Step 2 CK Forum 6 07-10-2012 02:41 PM
Challenging Question #4 MedicalExams USMLE Step 2 CK Forum 9 01-23-2011 11:25 PM
Challenging Question #5 MedicalExams USMLE Step 2 CK Forum 12 11-15-2010 03:37 AM
Challenging Question #3 MedicalExams USMLE Step 2 CK Forum 10 10-31-2010 05:19 AM
Challenging Question #7 MedicalExams USMLE Step 2 CK Forum 4 09-17-2010 03:26 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)