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nbme 1

Kaplan Test Prep and Admissions (Kaptest.com)

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what to do
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12/07/06 - 06:56 PM

49. A 35-year-old man who takes street drugs intravenously develops fever, cough, and hemoptysis. X-ray film of the chest shows bilateral infiltrates. Echocardiogram discloses a 1-cm mass that is attached to the tricuspid valve. Blood culture grows yeast. The most likely causal organism is

A ) Aspergillus flavus

B ) Candida albicans

C ) Cryptococcus neoformans

D ) Histoplasma capsulatum

E ) Mucor species

is this Cryptococcus or Histoplasmosis?

50. A 45-year-old man develops a fever 4 days after an abdominal operation. Blood cultures grow Staphylococcus aureus. Which of the following is the most likely site of infection from which the organism gained access to the blood stream?

A ) Anterior nares

B ) Sputum

C ) Stool

D ) Urine

E ) Wound

is it E (autoinfection) or 2ndary in fection from intubation and anaesthesia (A)?

PLZ PLZ PLZ someone plz answer me sad

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saif

macTT
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12/13/06 - 05:33 PM

What to do,
1st one is not Crypto or Histo....I would go with Candia (it is much more common). For # 2 is wound because that is the most likely place for staph to grow.

fruity
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12/13/06 - 06:23 PM

50. cud it be staph coz of stitch abcesses ................but thats like reading into the ques ..............what do u say??

fruity
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12/13/06 - 06:29 PM

check this out

www.emdicine.com/PED/topic2704.htm

so if all bacteremias come from ant. nares .........A shud be the ans

brutus25
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12/15/06 - 10:52 PM

Check FA2006 pg185 - topic about Candida
1st Q : Candida
2nd Q: probably A (anterior nares )

Ancylostoma
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12/16/06 - 10:08 PM

Brutus is right, candida form yeast when cultures in blood, 2nd the anterior nares are are where staph aureas lives naturally in our system. the most predominant flora in the nose is staph aureas. It was also a kaplan queston. Pick anterior nares.

sheena2005
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04/12/07 - 01:21 PM

i think answer to no2 should be wound, because the fever has developed after 4 days, if it was from intubation it would have developed right on the second day. wound infections are the later developing infections.

jaide
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04/14/07 - 09:28 AM

hmmm i think it should b e for q 2..

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lq2006
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05/25/07 - 11:50 AM

49.B
50.E

Addicudo
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05/26/07 - 12:48 AM

#10

49.B
50.E

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DRFP
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11/10/07 - 07:26 PM

#11

49. B
50. E, Staph lives on the skin thats why IV DA get staph infections so yea the wound.

nod

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SmokyWaters
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11/10/07 - 08:07 PM

#12

candida
true that bacteremia occurs from anterior nares if carrier and is most likely in pts with no other risk factor
but here there is a risk factor...thats abdominal surgery.. clearly wound be the most common cause here..
you cant rule out wound if u pick the anterior nares

DRFP
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11/11/07 - 09:41 AM

#13

I think the surgery is the key and that Wound is a choice, As pappy would say "They give you the answer" I think yo would pick Nares if wound was not a choice.

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DRFP
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11/12/07 - 04:40 PM

#14

19. A 27-year-old woman has a 1-week history of increased urinary frequency, dysuria, and intermittent suprapubic pain that have become worse over the past 3 days. Examination of her urine is most likely to show

A ) acid-fast organisms

B ) budding yeast forms

C ) fungal hyphae

D ) gram-negative bacilli

E ) gram-positive cocci

Why not E? Staph sarophyticus gram+ cocci and young women?

klebsiella are rods so that only leaves E Coli which are rods too.

Edited by DRFP on 11/12/07 - 05:08 PM

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cricket9014
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01/05/08 - 10:12 AM

#15

S saprophyticus is in "newly active", while this patient is 27 yo

maoudoody
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01/09/08 - 10:43 AM

#16

- candida
- wound

cause the most common cause of postoperative fever after the first day is wound infection

mytime
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01/09/08 - 12:43 PM

#17

brutus25 wrote:
Check FA2006 pg185 - topic about Candida
1st Q : Candida
2nd Q: probably A (anterior nares )

Coz wound is not 1 day but 7th day. after a week.

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new_n_lost
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01/09/08 - 08:29 PM

#18

mytime wrote:
nod

Coz wound is not 1 day but 7th day. after a week.

the question indicates wound infection not wound healing.

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