Organisms Causing Infection In A Patient With COPD.

Which of the following infections is least likely in a patient with COPD?

A) Streptococcus pneumoniae
B) Haemophilus influenzae
C) Moraxella catarrhalis
D) Mycoplasma pneumoniae

Answer and Discussion

Cause For Shivering And Cyanosis Following recovery From Anaesthesia

A 24-year-old man undergoes an uncomplicated appendectomy for acute appendicitis. Shortly after the end of surgery, in the recovery room, he develops violent shivering and becomes cyanotic.
Which of the following is most likely to have caused this condition?

A Depression of the reflex control of blood oxygen saturation
B Exaggeration of the reflex control of body temperature
C Low temperature in the recovery room
D Septicaemia related to the appendicitis
E Undiagnosed cyanotic heart disease

Answer And Discussion:

Roseola Infantum

An 18-month-old is discharged from the hospital after having a febrile seizure secondary to exanthem subitum (roseola , also known as sixth disease and roseola infantum). On discharge, the mother asks the nurse if her 6-year-old twins will get sick. Which teaching about the transmission of roseola
would be most accurate?

1. The child should be isolated in the home until the vesicles have dried.
2. The child does not need to be isolated from the older siblings.
3. Administer acetaminophen to the older siblings to prevent seizures.
4. Monitor older children for seizure development.

Answer And Discussion:

Normal Weight For A 6 Month Old Baby?

A 6-month-old male is at his well-child checkup. The nurse weighs him, and his mother asks if his weight is normal for his age. The nurse’s best response is:

1. “At 6 months his weight should be approximately three times his birth weight.”
2. “Each child gains weight at his or her own pace.”
3. “At 6 months his weight should be approximately twice his birth weight.”
4. “At 6 months a child should weigh about 10 lb more than his or her birth weight.”

Answer And Discussion:

Best Management Steps For Patient Presenting With Acute Stroke.

A 71-year-old woman is brought to the emergency room by her daughter because of sudden onset of right-sided weakness and slurred speech. The patient, a recent immigrant from Southeast Asia, has not seen a doctor in 2 decades. Her symptoms began 75 minutes ago while she was eating breakfast. A stat non contrast CT scan of the head is normal. Labs are normal.
Physical examination reveals an anxious appearing woman with dense hemiplegia of the Right upper and lower extremities. Deep tendon reflexes are not discernible on the Right side and 2+ on the left. Aspirin has been given.

What is the best next step in management of this patient?
a. Immediate intravenous unfractionated heparin
b. Immediate thrombolytic therapy
c. Immediate administration of interferon-beta
d. Emergent MRI/MRA of head
e. Emergent cardiac catheterization

Answer And Discussion:

Role of Sputum Gram Stain And Culture In A Patient With Pneumonia

A 30-year-old male with sickle cell anemia is admitted with cough, rusty sputum, and a single shaking chill. Physical examination reveals increased tactile fremitus and bronchial breath sounds in the left posterior chest. The patient is able to expectorate a purulent sample.
Which of the following best describes the role of sputum Gram stain and culture?

a. Sputum Gram stain and culture lack the sensitivity and specificity to be of value in this setting.
b. If the sample is a good one, sputum culture is useful in determining the antibiotic sensitivity pattern of the organism, particularly Streptococcus pneumoniae.
c. Empirical use of antibiotics for pneumonia has made specific diagnosis unnecessary.
d. There is no characteristic Gram stain in a patient with pneumococcal pneumonia.
e. Gram-positive cocci in clusters suggest pneumococcal infection.

Answer And Discussion: