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* Please help with this Free 150 Question
 #848815  
  defeatthebeast - 03/08/18 18:14
 
  A 3-week-old male infant is brought to the office by his mother because of a 2-day history of white lesions in the mouth. The infant was born at term via uncomplicated spontaneous vaginal delivery; he has been breast-feeding well and is urinating and having bowel movements normally. At birth, he weighed 3289 g (7 lb 4 oz; 30th percentile). Today, he weighs 3629 kg (8 lb; 25th percentile). He appears adequately hydrated. Vital signs are normal. Physical examination discloses white patches on the tongue and buccal mucosa that do not come off when gently scraped with a tongue blade. Which of the following is the most appropriate pharmacotherapy?
(A) Acyclovir
(B) Fluconazole
(C) Nystatin
(D) Valacyclovir
(E) No pharmacotherapy is necessary
 
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* Re:Please help with this Free 150 Question
#3362326
  cardio69 - 03/08/18 19:17
 
  Nonadherent patches usually -> milk dep.

Early/onset candida/or congenital candidiasis arises from expo of the kido to organisms colonizing the mom genital tract.

Adherent patches (read PE stem Q classic pic) -> candidiasis/thrush Oral is common in
infants-> nystatin
 
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* Re:Please help with this Free 150 Question
#3362328
  defeatthebeast - 03/08/18 19:24
 
  thanks for the explanation, I guess it makes sense hows a kid gonna have leukoplakia lol but just been hammered with removable = candida, non removable lesion = viral  
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* Re:Please help with this Free 150 Question
#3362334
  cardio69 - 03/08/18 20:03
 
  NP.

In 48hrs:)? in 3ks/o kido, unlikely. Leukoplakia assoc with underlying multistep/& 2/3 risk factors & those that unlucky to fall in 1/3 idiopathic that not gone match with that weight been given in Q.
 
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* Re:Please help with this Free 150 Question
#3362335
  cardio69 - 03/08/18 20:09
 
  May I ask what ans u pick?  
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* Re:Please help with this Free 150 Question
#3362345
  defeatthebeast - 03/08/18 23:59
 
  Well I actually went with fluconazole because I thought it said that the lesions scrape off (read it incorrectly) forgetting completely about nystatin swish and swallow...but then when I re read it thought it was leukoplakia so went with valacyclovir....had a major brain fart on this q, happens lol

Got 76% right on the whole free 150, exam in 2 weeks
 
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* Re:Please help with this Free 150 Question
#3362362
  acestep2ck - 03/09/18 12:22
 
  hey where did u get these free qs from fred?  
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* Re:Please help with this Free 150 Question
#3362398
  cardio69 - 03/09/18 18:18
 
  @defe, it happens. Just learn ans more to next
Good luck on your exam.
 
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* Re:Please help with this Free 150 Question
#3362435
  defeatthebeast - 03/10/18 12:30
 
  Yeah its from the fred

thanks cardio, appreciate it :)
 
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