daira
Forum Senior
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Posts: 138
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1) 25yr old, IV drug abuser, presents with fever. Blood culture after 24hrs of presentation show gram+ve cocci in clusters. Sensitivity is pending. WOF is the most appropriate choice:
a. penicillin
b. nafcillin
c. vancomycin
d. TMP/SMX
e. Cipro
2) 38yr old HIV +ve. Presents with breathlessness. PO2 55mm Hg. Bronchoalveolar lavage positive for Pneumocystis Carinii. WOF statement is correct:
a. Steroids are contraindicated given the risk of other opportunistic inf. in Kaposi's sarcoma.
b. Pentamidine aerosoles should be given, if the pt has Sulfa drug allergy.
c. TMP/SMZ should be given alone.
d. TMP/SMZ should be given with Pentamidine.
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| usmleasr
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1-b
2-b :roll:
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| dimps
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1--b
2--c
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| daira
Forum Senior
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1- answer says vancomycin (though I opted for nafcillin too) and explanation says that the pt is in serious condition (which I cant see in the statement at all). Only thing is that the cultures came out positive pretty fast, so that might be significant.. but I am not sure.
2- C.
addition of Pentamidine hasnt shown any significant improvement in results, so it is an alternative Rx but not combo Rx. Aerosole form is only for prophylaxis not for treatment.
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| usmledoctor1
Forum Junior
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with po2 levels low steroids r to be given in such patient subsets
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| asmi
Forum Hero
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can't we give TMP-SMX and pentamidine both :roll: ?
I agree steroids can be given
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| daira
Forum Senior
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2- C.
addition of Pentamidine hasnt shown any significant improvement in results, so it is an alternative Rx but not combo Rx. Aerosole form is only for prophylaxis not for treatment.
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| mdwannabe
Forum Guru
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Posts: 1,133
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1... give Vanco...ocz of high resistance rate...and u know it is Staph!
2. Just TMP-SMZ can be given.. or Just Pentamidine.. or Clinda...but not in pair.
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