dariush
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30 year old gravid female pt. treated for gonorrhea develops jaundice.
what is Correct about the drug causing the symptom ?
A. it covers both Gram + and Gram - organisms
B. it needs O2-dep. mechanism to get into the bacteria
C. it has a good Bone peneteration
D.it displaces Billirubin from Albumin
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| yakuzar
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there are two drugs commonly used for gonorrhoea--- ciprofloxacin and ceftriaxone.
I think both of them cover both g - and g+ bacteria
My answer is A
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| dariush
Forum Elite
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non of those cause jaundice i think.
keep going...
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| mazinger
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Well here goes a wild thought... C it has good bone penetration.. Eventhough its not first line for gonorrhea this drug might be use for chlamidial infections (gonorrhea and clam infections occurre both at the same time) which is tetracycline.. Tetracyclines are related with microvesicular fatty change and hepatic failure in pregnant women.. Tetracyclines are associated with bone and teeth penetration.. What do you think?
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| dariush
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so here goes the answer. this was a retired NBME q.
actually as mazinger correctly mentioned in almost 50% of gonorrhea cases we also have Clamydial infection concomitantly. so when treating Gonorrhea we should also cover Clamydia.
now there are 2 classes we can use : Tetracycline or Macrolides (Azithromycine) + Anti-gonococcal (3rd ceph/Quinolones/spectinomycine)
now they don`t use Tetracycline in pregnancy so what is left is Macrolides.
now options :
B- this is typical of Aminoglycosides
C-Many Antibiotics but specially Quinolones are well-known for their good penetration into Bone and other tissues. but Quinolones dont cause Cholestatic hepatitis in pregnancy
D-Sulfonamides do this not Macrolides
so the only option left is A. which i think is too non-specific!!
i didn`t like this Q. the buttomline here is only to know Clamydia Co-infection with Gonorrhea
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