doyoudig
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Hey guys I got this question from the USMLE 2008 online questions. I know the diagnosis, but was unsure of the treatment choice they had picked and wanted your input. Please help me out and I'll give the answer this afternoon.
A previously health 17 year old girl is brought to the ER because of 1 day h/o fever, vomitng, myalgias, and rash over her body, especially on her hands and feet. She takes no medications. She is sexually active with one partner and uses condoms inconsistently. Menses occur at regular 28 day intervals. Her last menstrual period began 4 days ago. She alternates between using tampons and sanitary pads. Her temperature is 38.9 (102), pulse 90/min, and BP 90/60 mmHg. PE shows diffuse, erythematous, macular rash over the body. Pelvic examination shows external genitatlia that are tender to touch and erythema of the vagina. There are ulcerations over the cervix. Which of the following is the most appropriate pharmacotherapy?
1. Acyclovir
2. Clindamyacin
3. Fluconazole
4. Metronidazole
5. Vancomyocin
6. Zidovudine (AZT)
pls explain ur reasoning
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| starcraftbw
Forum Senior
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please type NBME next time in the title
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| doyoudig
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its not nbme...
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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sorry maybe and nbme, got it from another forum and type of q's was not specified...
what's ur input??
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| Dr.D
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Clindamycin, staph aureus, anaerobic. Answer B
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| elitoki
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2. clindamycin for Toxic shock Syndrome.
Before having gram or culture result staph and strep should be considered.
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| doyoudig
Forum Guru
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answer is 5 guys Vancomycon
No Exlanation given, 2008 ecfmg cd question, maybe someone can explain ...
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| Justice
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5. Vancomyocin
I have chosen it before I read the answer by doyoudig... Why would you choose 2 vs 5 for a Gram(+) bug?
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| Justice
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Dr.D wrote:
Clindamycin, staph aureus, anaerobic. Answer B
Staph aureus is only facultatively anaerobic... It colonizes skin and mucous surfaces... In contrast to S. aureus anaerobius that is obligatively anaerobic
Edited by Justice on 09/21/07 - 12:04 PM
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| Justice
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Here is a cool pic of that bug...
Attached Files:
Staph aur.jpg (24 KB, 5 downloads)
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| doyoudig
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thx justice, from what I Know
pencillin doc, if CI or MRSS vanco next, and 3rd line clinda which is also effective for GAS
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| elitoki
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So, answer is vanco.
 Thanks guys
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| Justice
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doyoudig wrote:
thx justice, from what I Know
pencillin doc, if CI or MRSS vanco next, and 3rd line clinda which is also effective for GAS
So, this means that Vanco is the right answer, isn't it?
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| kpmle2
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5. Vancomyocin
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