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+--- Thread: 2 and 1 q - target99 (/showthread.php?tid=284259)
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2 and 1 q - target99 - ArchivalUser - 03-21-2008
A 20-year-old woman with leukemia was undergoing chemotherapy with intravenous
antineoplastic drugs. During treatment she developed a systemic infection due to an opportunistic
pathogen. There was no erythema or edema at the catheter insertion site. A white vaginal discharge
was observed. After appropriate specimens were obtained for culture, empiric antibiotic therapy was
started with gentamicin, nafcillin, and ticarcillin intravenously. This regimen wa maintained for 72
hours, during which time the patient's condition did not improve significantly. Her throat was sore,
and white plaques had appeared in her pharynx. On day 4, none of the cultures had shown any bacte-
rial growth, but both the blood md urine cultures grew out Candida albicans.
1) At this point, the best course of action is to
(A) Continue current antibiotics and start flucytosine
(B) Stop current mtibiotics and start ketoconazole
© Continue current antibiotics and start amphotericin B
(121) Continue current mtibiotics md start griseofulvin
(E) Stop current tmtibiotics and start amphotericin B
2) If given amphotericin B, the patient should be premedicated with
(A) Diphenhydramine
(B) lbuprofen
© Prednisone
(D/ Any or all of the above
(E) None of the above
0 - ArchivalUser - 03-21-2008
e
e
0 - ArchivalUser - 03-21-2008
C & A...... C..... pt is having agranulocytosis so ABS should b continued
.....................A amphoterecin causes histamin release
0 - ArchivalUser - 03-21-2008
cici
0 - ArchivalUser - 03-21-2008
Ans: 1. E
2. A.
Histamine release causes hypotension; Sodium loading can help renal clearance as well as combat the hypotension also to some extent. Correct me if i m wrong
0 - ArchivalUser - 03-21-2008
ee
cc
0 - ArchivalUser - 03-21-2008
candida here due to lmmunosuppresion by antineoplastic drugs,stop empirical antibiotic put patient on ampho B if not localised candida lesion.
0 - ArchivalUser - 03-21-2008
i also go for e
0 - ArchivalUser - 03-21-2008
sorry E &A
0 - ArchivalUser - 03-21-2008
target so gaye kya????