By Anthony N.Glasr
Presents a concise evaluation for these getting ready for the USMLE Step 1. offers examples and includes overview workouts.
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ANSWER: E. Allergy consultation and admission for desensitization to penicillin in order to facilitate treatment with penicillin Syphilis infection during pregnancy can have serious consequences for both the mother and fetus if left untreated. Therefore, it is important to treat immediately with the most aggressive, data-supported effective treatment for syphilis, which is penicillin. Pregnant women who are diagnosed with syphilis should always be treated with penicillin, even if this requires hospitalization for desensitization to penicillin, in the case of penicillin allergy.
Treatment is with doxycycline or ciprofloxacin for mild disease, and with streptomycin or gentamicin for severe disease. Tropheryma whipplei is the etiologic agent in Whipple’s disease, which commonly presents with abdominal pain, diarrhea, weight loss, and joint pains. Babesia microti is a parasite that is transmitted by ticks primarily in New England and to some extent in the upper Midwest; babesiosis is characterized by fever, anemia, thromobocytopenia, and often respiratory distress, but this patient had no anemia or parasites visualized on initial labs.
On admission his oxygen saturation was 94% on room air, and he was not short of breath. 5). 5 L A B R ESULTS FOR QU ESTION 8 CBC ON ADMISSION White blood cell count 18,000/mm3 (4,000–10,000) Hematocrit 21% (36–48) Platelets 247,000/mm3 (150,000–450,000) One day later he complains of increasing shortness of breath and is found to have an oxygen saturation of 86% on room air. Chest radiograph reveals bilateral lower lobe opacities. Continue current antibiotic coverage and administer supplemental O2 .