In 2010, indigenous transmission of which of the following diseases had been eliminated in the United States? One goal of immunization programs is to eliminate a specific disease. Which type of bite represents a potential medical emergency in a febrile asplenic patient?

Discontinue oxacillin and add vancomycin and gentamicin. Discontinue oxacillin and add piperacillin/tazobactam and vancomycin.Į. Discontinue oxacillin and add clindamycin, vancomycin, and gentamicin.ĭ. Continue oxacillin and add clindamycin and gentamicin.Ĭ. Continue oxacillin and add clindamycin.ī. What changes to the patient’s antibiotic therapy would be recommended?Ī. A CT scan of her right leg demonstrates a collection of fluid with gas in the deep fascia of her right leg. Over the course of the next 24 hours, the patient develops profound septic shock complicated by hypotension, acute renal failure, and evidence of disseminated intravascular coagulation. The admitting physician notes that the degree of pain appears to be disproportionate to the amount of overlying cellulitis. She is treated empirically with oxacillin intravenously for a cellulitis. A 32-year-old woman is admitted to the hospital complaining of right thigh pain. Ceftriaxone, vancomycin, and amphotericin Bĭ. Ceftriaxone, ampicillin, and vancomycinĬ. What are the most appropriate empiric antibiotics for the treatment of this patient?ī. Blood, sputum, and urine cultures are obtained. His only other history is an automobile accident at age 20 years, requiring exploratory laparotomy and splenectomy. He takes amlodipine 10 mg daily and atorvastatin 20 mg daily. The patient has a history of hypertension and hyperlipidemia. Ongoing volume resuscitation is ordered, and the patient is initiated on norepinephrine to maintain adequate blood pressure. The patient received 1 L of normal saline before arrival in the emergency department but continues to have hypotension (blood pressure, 75/40 mmHg). He was intubated and placed on mechanical ventilation. He was tachypneic with a respiratory rate of 32 breaths/min with an oxygen saturation of 75% on room air, and his initial temperature was 104.9☏ (40.5☌). Upon arrival of emergency medical services, his initial blood pressure was 60/40 mmHg with a heart rate of 142 beats/min. He was brought to the hospital by ambulance this morning when he was lethargic and unresponsive at home. He had no other specific complaints but reportedly had decreased oral intake and generalized malaise. His family reports that he developed myalgias and fevers at that time. He was well until 1 day before admission. A 48-year-old man is admitted to the intensive care unit for treatment of septic shock for an uncertain cause. Deficits in the complement membrane attack complex (C5-8) are associated with infections of what variety? SECTION IV. Infectious DiseasesĭIRECTIONS: Choose the one best response to each question. Harrisons Principles of Internal Medicine Self-Assessment and Board Review 18th Ed.

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