USMLE Forum Archives - USMLE Step 3 - int med
int med
bingousmle - 07-27-10 02:29
A 68-year-old woman seeks evaluation for an ulcerative lesion on her right hand. She reports the area on the back of her right hand was initially red and not painful. A biopsy of the edge
of the lesion shows ovoid and cigar-shaped yeasts. Sporotrichosis is diagnosed. What is the most appropriate therapy for this patient?
A. Amphotericin B intravenously
B. Caspofungin intravenously
C. Clotrimazole topically
D. Itraconazole orally
E. Selenium sulfide topically
bingousmle - 07-27-10 02:29
A 68-year-old woman seeks evaluation for an ulcerative lesion on her right hand. She reports the area on the back of her right hand was initially red and not painful. A biopsy of the edge
of the lesion shows ovoid and cigar-shaped yeasts. Sporotrichosis is diagnosed. What is the most appropriate therapy for this patient?
A. Amphotericin B intravenously
B. Caspofungin intravenously
C. Clotrimazole topically
D. Itraconazole orally
E. Selenium sulfide topically
The correct answer and explanation will be available after you answer.
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#1
Re: int med babbu5508 - 07-27-10 03:01 My answer is: d.
Itraconazole is currently the drug of choice and is significantly more effective than fluconazole. Fluconazole should be reserved for patients who cannot tolerate itraconazole.
#2
Re: int med
bingousmle - 07-27-10 07:19 My answer is: d.
itraconazole is a good choice in this case though it would be prudent to use amphoterecin B if systemic complications develop like pulmonary sporotrichosis
#6
Re: int med babbu5508 - 08-30-10 03:30 Sporotrichosis (also known as "Rose gardener's disease") is a disease caused by the infection of the fungus Sporothrix schenckii.This fungal disease usually affects the skin, although other rare forms can affect the lungs, joints, bones, and even the brain. Because roses can spread the disease, it is one of a few diseases referred to as rose-thorn or rose-gardeners' disease
#12
Re: int med babbu5508 - 02-22-11 10:39 Treatment of sporotrichosis depends on the severity and location of the disease. The following are treatment options for this condition:
Saturated potassium iodide solution
Although its mechanism is unknown, oral application of potassium iodide in droplet form can cure cutaneous sporotrichosis. This usually requires 3 to 6 months of treatment.
Itraconazole (Sporanox) and fluconazole
These are antifungal drugs. Itraconazole is currently the drug of choice and is significantly more effective than fluconazole. Fluconazole should be reserved for patients who cannot tolerate itraconazole.
Amphotericin B
#16
Re: int med ankit0503 - 06-26-11 13:26 My answer is: c.
it is acquired from Rose thorn's.. does not seem to be a concerning disease to me
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