sarika
Forum Guru
Topics: 195
Posts: 1,200
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A
) Chlamydia trachomatis
B
) Clostridium botulinum
C
) Clostridium tetani
D
) Group A streptococcus
E
) Group B streptococcus
F
) Listeria monocytogenes
G
) Neisseria gonorrhoeae
H
) Streptococcus pneumoniae
41/A premature 18-hour-old newborn is intubated and
mechanically
ventilated because of progressive respiratory
distress. Labor was complicated
by maternal fever and increased leukocyte count;
membranes ruptured 36
hours before delivery. His blood pressure and urine
output have
decreased since birth. The newborn appears acutely
ill, and peripheral pulses
are not palpable; the skin is pale, cool, and mottled.
The liver edge
is palpable 4 cm below the right costal margin. His
leukocyte count is
5000/mm3, platelet count is 48,000/mm3, and partial
thromboplastin time
is 60 sec. An x-ray film of the chest shows diffuse,
bilateral,
interstitial infiltrates.
42/43. A 6-year-old boy has been unable to walk for 2
days because of a
sore right knee. Three weeks ago he had a sore throat
and fever that
resolved within 2 days. He appears acutely ill. His
temperature is 39.2
C (102.5 F), and pulse is 120/min. A grade 2/6
pansystolic murmur is
heard at the apex. The right knee is red, tender, and
swollen; any
motion is painful. His leukocyte count is 15,000/mm3,
and erythrocyte
sedimentation rate is 120 mm
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| prathapdoctor
Forum Elite
Topics: 12
Posts: 406
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the answer for first question is Group B STREPTOCOCCUS
the answer for second on is Group A streptococcus
i put listeria in nbme exam and went wrong for first question.
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| sarika
Forum Guru
Topics: 195
Posts: 1,200
|
yeah "diffuse, bilateral,interstitial infiltrates. " this thing is confusing me too
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| CocaCola
Forum Guru
Topics: 35
Posts: 908
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1 - group B Strep; i think the bilateral pulmonary infiltrates are due to respiratory distress from septecemia.
2 - group A strep leading to septic arthritis
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| haduytu7
Forum Newbie
Topics: 2
Posts: 24
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Key word "membranes ruptured 36
hours before delivery" -> infection from vagina -> Streptococcus group B
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| fongch
Forum Elite
Topics: 71
Posts: 316
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So no one consider Listeria infection is a possibility in question #1?
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| coolmavs
Forum Elite
Topics: 21
Posts: 327
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The patient is septic in the 1st week with H/O PROM! GBS for sure
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