WBR0704

Author	[[PageAuthor::Mohamed Moubarak, M.D. [1]]]
Exam Type	ExamType::USMLE Step 3
Main Category
Sub Category	SubCategory::Infectious Disease
Prompt	[[Prompt::19 year old boy present to the ER with generalized rash, he had fever and sore throat one week ago and got antibiotic prescription from his PCP 4 days ago. His past medical history is insignificant. He doesn’t smoke or consume recreational drugs or alcohol. He is sexually active with one partner and uses condoms regularly. Vital signs are normal except for temperature of 37.8 C(100 F). His physical examination reveals generalized maculopapular rash and posterior cervical lymphadenopathy. What is the best treatment for this patient?]]
Answer A	AnswerA::Discontinue the antibiotic
Answer A Explanation	[[AnswerAExp::Correct The best management for this case is to stop the antibiotic with supportive treatment and observation]]
Answer B	AnswerB::Discontinue the antibiotic and prescribe anti inflammatory
Answer B Explanation	[[AnswerBExp::Incorrect Anti inflammatory drugs are preserved for patients with severe complication such as liver failure, sever airway obstruction, or aplastic anemia]]
Answer C	AnswerC::Discontinue the antibiotic and prescribe antiviral drug
Answer C Explanation	[[AnswerCExp::Incorrect Antiretroviral drugs (e.g. acyclovir) doesn’t have clinical benefits in patients with infectious mononucleosis]]
Answer D	AnswerD::Prescribe another antibiotic
Answer D Explanation	[[AnswerDExp::Incorrect The cause of the rash is immune complexes, and there is no need to prescribe another antibiotic]]
Answer E	AnswerE::Continue the current antibiotic with reassurance
Answer E Explanation	[[AnswerEExp::Incorrect The antibiotic treatment should be stopped]]
Right Answer	RightAnswer::A
Explanation	[[Explanation::Supportive treatment and observation are the main lines of management for patients with infectious mononucleosis. Treatment should include nutrition, fluids, NSAIDS and acetaminophen for fever, malaise, and sore throat. Educational Objective: References: ]]
Approved	Approved::No
Keyword
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