USMLE Forum Archives - USMLE Step 2 CK - IV drug use
IV drug use
bingousmle - 05-23-10 14:31
A 42-year-old IV drug user presents to the ED with fever, chills, pleuriticchest pain, myalgias, and general malaise. The patient’s vitals include a HR of 110 beats per minute, BP of 110/65 mm Hg, RR of 18 breaths per minute, and temperature of 103°F. Physical examination is notable for retinal hemorrhages, petechiae on the conjunctivae and mucus membranes, a faint systolic ejection murmur, and splenomegaly. Which of the following is the most likely diagnosis?
a. Sick sinus syndrome
b. Myocarditis
c. Pericarditis
d. Cardiac tamponade
e. Endocarditis
bingousmle - 05-23-10 14:31
A 42-year-old IV drug user presents to the ED with fever, chills, pleuriticchest pain, myalgias, and general malaise. The patient’s vitals include a HR of 110 beats per minute, BP of 110/65 mm Hg, RR of 18 breaths per minute, and temperature of 103°F. Physical examination is notable for retinal hemorrhages, petechiae on the conjunctivae and mucus membranes, a faint systolic ejection murmur, and splenomegaly. Which of the following is the most likely diagnosis?
a. Sick sinus syndrome
b. Myocarditis
c. Pericarditis
d. Cardiac tamponade
e. Endocarditis
The correct answer and explanation will be available after you answer.
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#1
Re: IV drug use babbu5508 - 05-24-10 01:09 My answer is: e.
Patients who inject narcotics or other drugs intravenously may introduce infection which will travel to the right side of the heart classically affecting the tricuspid valve, and most often caused by S. aureus.
#4
Re: IV drug use babbu5508 - 05-24-10 02:23 treatment:: intravenous cloxacillin 2 g every four hours for two weeks together with gentamicin 1 mg/kg every eight hours for tricuspid endocarditis caused by methicillin sensitive staphylococcal species along with drug withdrawal measures..
#5
Re: IV drug use
bingousmle - 05-24-10 02:31 
posted by babbu5508 on 05-24-10 02:23
treatment:: intravenous cloxacillin 2 g every four hours for two weeks together with gentamicin 1 mg/kg every eight hours for tricuspid endocarditis caused by methicillin sensitive staphylococcal species along with drug withdrawal measures..
treatment:: intravenous cloxacillin 2 g every four hours for two weeks together with gentamicin 1 mg/kg every eight hours for tricuspid endocarditis caused by methicillin sensitive staphylococcal species along with drug withdrawal measures..
well it can be commented upon only after one initiates a thorough work up including blood cultures... the early antibiotic therapy includes vancomycin/ceftriaxone + gentamycin...
#8
Re: IV drug use babbu5508 - 05-24-10 15:08 posted by bingousmle on 05-24-10 02:31
well it can be commented upon only after one initiates a thorough work up including blood cultures... the early antibiotic therapy includes vancomycin/ceftriaxone + gentamycin...
well it can be commented upon only after one initiates a thorough work up including blood cultures... the early antibiotic therapy includes vancomycin/ceftriaxone + gentamycin...
yeah i agree....but it is a well known treatment for right sided endocarditis in intravenous drug abusers......
#10
Re: IV drug use bingousmle - 05-25-10 00:29 posted by babbu5508 on 05-24-10 15:08
yeah i agree....but it is a well known treatment for right sided endocarditis in intravenous drug abusers......
yeah i agree....but it is a well known treatment for right sided endocarditis in intravenous drug abusers......
can you site a reference? i think this is an important concept tested frequently so a correct and most reliable answer should be known...
#11
Re: IV drug use mtniharika - 05-25-10 16:08 My answer is: e.
Right-sided endocarditis is common in intravenous drug abusers (IVDAs) because of nonsterile injection into the venous system. The presentation tends to differ from that of classic IE, in that these patients are more likely to develop pneumonia or septic pulmonary emboli
#14
Re: IV drug use babbu5508 - 06-30-11 19:14 There are multiple ways to classify endocarditis. The simplest classification is based on etiology: either infective or non-infective, depending on whether a microorganism is the source of the inflammation or not.
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