springbird
Forum Newbie
Topics: 6
Posts: 33
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26. A 57-year-old man with multiple myeloma comes
to the physician
because of a 12-hour history of fever, sharp chest
pain with deep
inspiration, and cough productive of blood-tinged
sputum. His temperature is
38.3 C (101 F), blood pressure is 120/78 mm Hg, pulse
is 112/min, and
respirations are 28/min. Crackles are heard at the
right lung base.
His hemoglobin level is 9.2 g/dL, leukocyte count is
2600/mm3, and
platelet count is 96,000/mm3. Empiric antibiotics
should be directed against
which of the following organisms?
A
) Listeria monocytogenes
B
) Neisseria meningitidis
C
) Pseudomonas aeruginosa
D
) Streptococcus bovis
E
) Streptococcus pneumoniae
Is the answer A or E, the platelets number is down and WBC is down, anyone? 
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| gr8doc
Forum Senior
Topics: 8
Posts: 210
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I would go for the community acquired, Strep Pneumonia.
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| radonc
Forum Senior
Topics: 6
Posts: 175
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I thought E too.
Listeria rarely causes community-acquired pneumonia.
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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In multiple myeloma, capsulated organisms are responsible for frequent infections----So, Strep Pneumoniae looks good.
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| tamerbashir
Forum Elite
Topics: 20
Posts: 284
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strep. pneumonia
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| chemamr
Moderator and PGY1
Topics: 703
Posts: 4,441
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E should be the answer.
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| darkhorse
Forum Elite
Topics: 56
Posts: 275
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| sherry39
Forum Junior
Topics: 3
Posts: 105
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strep pneumonie
Edited by sherry39 on 03/15/08 - 07:39 AM
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| Miradautas Vras
Forum Senior
Topics: 8
Posts: 154
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E. Listeria is not that common at all.
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| Adam
Forum Senior
Topics: 6
Posts: 136
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patients with MM get infections with encapsulated organisms >>>> i'll go with E
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