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|QuestionAuthor={{MM}}
|QuestionAuthor={{MM}}
|ExamType=USMLE Step 3
|ExamType=USMLE Step 3
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|MainCategory=Emergency Room
|MainCategory=Emergency Room
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|Prompt=Regarding the previous question, what is the best treatment for this patient?
|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?
|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.  
|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.
|AnswerA=Discontinue the antibiotic  
|AnswerA=Discontinue the antibiotic
 
 
|AnswerAExp=Correct
|AnswerAExp=Correct


The best management for this case is to stop the antibiotic with supportive treatment and observation
The best management for this case is to stop the antibiotic with supportive treatment and observation
|AnswerB=Discontinue the antibiotic  and prescribe anti inflammatory  
|AnswerB=Discontinue the antibiotic  and prescribe anti inflammatory
|AnswerBExp=Incorrect
|AnswerBExp=Incorrect


Anti inflammatory drugs are preserved for patients with severe complication such as liver failure, sever airway obstruction, or aplastic anemia
Anti inflammatory drugs are preserved for patients with severe complication such as liver failure, sever airway obstruction, or aplastic anemia
|AnswerC=Discontinue the antibiotic  and prescribe antiviral drug
|AnswerC=Discontinue the antibiotic  and prescribe antiviral drug
|AnswerCExp=Incorrect
|AnswerCExp=Incorrect


Antiretroviral drugs (e.g. [[acyclovir]]) doesn’t have clinical benefits in patients with infectious mononucleosis
Antiretroviral drugs (e.g. [[acyclovir]]) doesn’t have clinical benefits in patients with infectious mononucleosis
|AnswerD=Prescribe another antibiotic
|AnswerD=Prescribe another antibiotic
|AnswerDExp=Incorrect
|AnswerDExp=Incorrect


The cause of the rash is immune complexes, and there is no need to prescribe another antibiotic
The cause of the rash is immune complexes, and there is no need to prescribe another antibiotic
|AnswerE=Continue the current antibiotic with reassurance
|AnswerE=Continue the current antibiotic with reassurance
|AnswerEExp=Incorrect
|AnswerEExp=Incorrect


The antibiotic treatment should be stopped
The antibiotic treatment should be stopped
|RightAnswer=A
|RightAnswer=A
|Approved=No
|Approved=No
}}
}}

Revision as of 13:35, 30 September 2013

 
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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