aspiration pneumonia q

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

aspiration pneumonia q

Author

14 Posts

virgola82
Forum Guru
avatar

Topics: 85
Posts: 348

06/20/07 - 06:13 AM

An 82 yo woman is admitted from the nursing home for aspiration pneumonia. She has periodontal disease and dementia. She also has a history of penicillin allergy. What would be the most appropriate treatment for this patient?

A. Tazobactam

B. Imipenem Cilastin

C. Levofloxacin

D. Ciprofloxacin + gentamicin

E. Moxifloxacin

F. Ciprofloxacin + metronidazole

tanmaynator
Forum Senior
avatar

Topics: 12
Posts: 153

06/20/07 - 06:39 AM

i am not sure but is it F. Ciprofloxacin and Metronidazole??

prathapdoctor
Forum Elite

Topics: 12
Posts: 406

06/20/07 - 07:16 AM

yes, I go for F.

arlete
Attending in 2012!!!!!

Topics: 42
Posts: 2,970

06/20/07 - 07:34 AM

___________________
Que sera sera, whatever will be will be.

sprint123
Forum Guru

Topics: 129
Posts: 870

06/20/07 - 08:36 AM

We should cover for Gram negative and anaerobes mainly-----Best drug of the options is IMPENEM+CILASTIN ....

I am not sure whether we can give this drug in penicillin allergy but still the asnwer is IMIPENEM!

Ivonne
Find a way or make one
avatar

Topics: 58
Posts: 1,611

06/20/07 - 10:48 AM

F (Why not it covers anaerobics, gram-, and even Pseudomonas)

imipenem should not be given to patients with proven penicillin hypersensitivity(pub med).

___________________
"I must, I can and I will"

prathapdoctor
Forum Elite

Topics: 12
Posts: 406

06/20/07 - 11:09 AM

penicillin group of drugs do not cover organisms causing atypical pneumonia.

virgola82
Forum Guru
avatar

Topics: 85
Posts: 348

06/20/07 - 11:32 AM

The right answer is F

sprint123
Forum Guru

Topics: 129
Posts: 870

06/20/07 - 11:55 AM

Thanks for the info---Ivonne..

To prathap : Can you explain what are the organisms to suspect is aspiration pneumonia..
I thought of anaerobes in the oral cavity and gram negatives which might be hospital acquired..

Should we have to consider atypicals also in aspiration pneumonia?
I thought CIPRO will not cover atypicals and newer quinolones will cover...Any inputs on this are welcomed!

Justice
Forum Fanatic
avatar

Topics: 117
Posts: 2,324

06/20/07 - 12:20 PM

#10

F. Ciprofloxacin + metronidazole

___________________
Don't live in a town where there are no doctors

prathapdoctor
Forum Elite

Topics: 12
Posts: 406

06/20/07 - 01:17 PM

#11

yes, we need to think of anerobes and gram negativebacilli while treating aspiration pneumonia. But inadditon to that, we need to look for common organisms in community like Mycoplasma,Legionella(ofcourse the drug must be active aginst str pneumoniae) against which penicllins are ineffective.

thats why we go for Azithro or Cipro for community acquired pneumonia rather than penicillins.

dr in trouble
Forum Guru
avatar

Topics: 62
Posts: 608

06/20/07 - 10:44 PM

#12

Isnt Clindamycin for anaerobic inf above diaphragm and metronidazole for inf below diaphragm??????

___________________
If u want to do something, do it today as there is no tomorrow.

prathapdoctor
Forum Elite

Topics: 12
Posts: 406

06/21/07 - 12:07 AM

#13

yes, Dr in trouble, you are correct.

elitoki
Forum Guru
avatar

Topics: 54
Posts: 508

08/23/07 - 05:41 PM

#14

You don't have permission to post.