A 45 year old man comes to the physician because of a fever of 39.6o - ProProfs Discuss
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A 45-year-old man comes to the physician because of a fever of 39.6o C (103.2o F) that developed suddenly the previous night. On physical examination, the physician notes a new-onset murmur along with white spots on the retina. The appearance of his hands is shown in the image. Which agent, if used alone, is most likely to be used to treat this patient prior to the results of blood culture?



A. Ceftriaxone
B. Ciprofloxacin
C. Erythromycin
D. Gentamicin
E. Vancomycin
Asked by Halbert, Last updated: Dec 05, 2017

This question is part of

USMLE full length exam prt 14 the end

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1 Answer

John Smith

John Smith

Answered on Sep 09, 2016

Vancomycin -the correct answer is e. staphylococcus aureus causes acute bacterial endocarditis, which presents with an acute onset of high fever, other flu -like symptoms, new-onset murmur, petechiae, roths spots (white spots on the retina formed by microemboli), janeway lesions (painless macules on the palms or soles), oslers nodes (small, painful nodules on the pads of the fingers or toes), and nail bed (subungual) hemorrhages. the bacteria can attack healthy valves and result in vegetations that are much larger than those of subacute bacterial endocarditis. vancomycin is typically used to treat s. aureus endocarditis, and provides coverage in the case of methicillin-resistant s. aureusanswer a is incorrect. ceftriaxone is not used to treat s. aureus endocarditisanswer b is incorrect. ciprofloxacin is not used to treat s. aureus endocarditisanswer c is incorrect. erythromycin is not used to treat s. aureus endocarditisanswer d is incorrect. gentamicin may be used in combination with vancomycin to treat s. aureus endocarditis, but not alone.
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