By Ajay K. Singh, Joseph Loscalzo
This question-and-answer better half to The Brigham extensive evaluate of inner medication, that is dependent upon the preferred overview path from Harvard clinical tuition, is a examine consultant for the yank Board of inner drugs certification or upkeep of certification exam, in addition to for common perform evaluate by way of physicians and citizens. Editors Ajay okay. Singh and Joseph Loscalzo recruited major specialists from Harvard in addition to former leader citizens at Brigham and Women's clinic to give a contribution to this publication. This thorough source beneficial properties 500 board evaluation questions and solutions on inner medication specialties together with: Infectious disorder, Hematology and Oncology, Rheumatology, Pulmonary and significant Care drugs, Endocrinology, Nephrology and high blood pressure, Digestive illnesses and problems of the Pancreas and Liver, heart problems, Neurology, and basic inner medication. because the required content material for the yank Board of inner drugs maintains to adapt, learning can turn out difficult. The Brigham in depth evaluation of inner drugs query and resolution better half is the suitable learn consultant for somebody getting ready for certification or recertification.
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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 .