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  1. #1
    tommyk is offline USMLE Advisor
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    Hy 2804 This borders on Step 2CK, but I know that anyone taking Step 1 will have...

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    to study step 2CK. So...

    q- 80 yo F, URI, has generalized weakness, headache, blurry vision. Her FP doctor diagnosed her w/ sinusitis. She then took antibiotics for 2 days. Then she had chills, lightheadedness, vomiting, blurry vision, aches and pains, headaches. PE: high temp. of 103 F, nuchal rigidity and sleepiness. What to do next???

    1- Get MRI, then lumbar puncture
    2- Oral Zithromax
    3- IV ceftriaxone w/ ampicillin
    4- IV acyclovir








































































    ans. is #3. Immediate concern is that pt. has bacterial meningitis. So go to it! Tell me why the other choices are wrong??

    (for example, lumbar puncture is a good answer, but NOT the BEST ANSWER. LP will take days to come back, maybe too late for the patient.)
    "All USMLE cases are original and are expressly not from questions seen, recalled, paraphraphrased from the real USMLE, the material is for the purpose of the education of future physicians and the safety of their patients."

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  2. #2
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    1- Get MRI, then lumbar puncture



    2- Oral Zithromax

    To long to start doing action, is bacteriostatic you will want bactericida.

    3- IV ceftriaxone w/ ampicillin

    Ceftriaxone crossed and intial tx and the ampicilin is because patients over 55 are prone to also get listeria and ampicillin will cover that.

    4- IV acyclovir

    For virus not bacteria

    There are MANY MANY Step2 questions in step1, so guys if you think is to clinical, THINK again.
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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