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nbme form2 block4 - hipp
#1
A 2-year-old girl has had fever and bloody
diarrhea for 10 days.
A stool culture obtained 7 days ago grew Salmonella
species sensitive
to amoxicillin. A blood culture was negative.
Despite beginning oral
amoxicillin therapy 4 days ago, her diarrhea has
persisted. Current
examination shows no other abnormalities except for a
temperature of 38.6 C
(101.5 F). Which of the following is the most likely
explanation for
the failure of amoxicillin to improve her symptoms?

A
) Amoxicillin does not alter the course of
Salmonella enteritidis

B
) Amoxicillin has caused pseudomembranous colitis

C
) Amoxicillin is absorbed at the level of the
jejunum, leaving no
drug to be delivered to the colon

D
) Oral amoxicillin is not absorbed into the
systemic circulation in
the presence of diarrhea

E
) Salmonella has expressed an inducible ß-lactamase
that inactivates
amoxicillin


does anyone have answer to this question?
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