USMLE Forum Archives - USMLE Step 2 CK - multiple myeloma+infection
multiple myeloma+infection
wow - 01-04-08 00:40
A 56-year-old man Jev Anand with multiple myeloma comes to the physician because of a 11-hour history of fever, sharp chest pain with deep inspiration, and cough productive of blood-tinged sputum. His temperature is 38.4 C (101 F), blood pressure is 119/78 mm Hg, pulse is 111/min, and respirations are 29/min. Crackles are heard at the right lung base. His hemoglobin level is 9.1 g/dL, leukocyte count is 2650/mm3, and platelet count is 96,500/mm3. Empiric antibiotics should be directed against which of the following organisms?
A ) Listeria monocytogenes
B ) Neisseria meningitidis
C ) Pseudomonas aeruginosa
D ) Streptococcus bovis
E ) Streptococcus pneumoniae
wow - 01-04-08 00:40
A 56-year-old man Jev Anand with multiple myeloma comes to the physician because of a 11-hour history of fever, sharp chest pain with deep inspiration, and cough productive of blood-tinged sputum. His temperature is 38.4 C (101 F), blood pressure is 119/78 mm Hg, pulse is 111/min, and respirations are 29/min. Crackles are heard at the right lung base. His hemoglobin level is 9.1 g/dL, leukocyte count is 2650/mm3, and platelet count is 96,500/mm3. Empiric antibiotics should be directed against which of the following organisms?
A ) Listeria monocytogenes
B ) Neisseria meningitidis
C ) Pseudomonas aeruginosa
D ) Streptococcus bovis
E ) Streptococcus pneumoniae
Page 1
#1
Re: multiple myeloma+infection TheOne - 01-04-08 01:58 This is a good question, I think the answer is E) S. pneumoniae.
#3
Re: multiple myeloma+infection abdelwhab - 01-04-08 13:44 anwer is strept.pneuminia asin all case of immunocopromized patient strept.pneumonia still the first organism other choice The manifestations of listeriosis include septicemia, meningitis (or meningoencephalitis), encephalitis, and intrauterine or cervical infections in pregnant women, which may result in spontaneous abortion which not present in this case
Neisseria meningitidis present with High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness.
Pseudomonas aeruginosa coomon with DM patients
Streptococcus bovis cause infective endocardities with CHF symptom & associated with high risk of lower GIT cancers it need immediat endoscopy if it present with blood culture
#4
Re: multiple myeloma+infection wello939 - 01-06-08 05:23 
posted by wow on 01-04-08 00:40
A 56-year-old man Jev Anand with multiple myeloma comes to the physician because of a 11-hour history of fever, sharp chest pain with deep inspiration, and cough productive of blood-tinged sputum. His temperature is 38.4 C (101 F), blood pressure is 119/78 mm Hg, pulse is 111/min, and respirations are 29/min. Crackles are heard at the right lung base. His hemoglobin level is 9.1 g/dL, leukocyte count is 2650/mm3, and platelet count is 96,500/mm3. Empiric antibiotics should be directed against which of the following organisms?
A ) Listeria monocytogenes
B ) Neisseria meningitidis
C ) Pseudomonas aeruginosa
D ) Streptococcus bovis
E ) Streptococcus pneumoniae
A 56-year-old man Jev Anand with multiple myeloma comes to the physician because of a 11-hour history of fever, sharp chest pain with deep inspiration, and cough productive of blood-tinged sputum. His temperature is 38.4 C (101 F), blood pressure is 119/78 mm Hg, pulse is 111/min, and respirations are 29/min. Crackles are heard at the right lung base. His hemoglobin level is 9.1 g/dL, leukocyte count is 2650/mm3, and platelet count is 96,500/mm3. Empiric antibiotics should be directed against which of the following organisms?
A ) Listeria monocytogenes
B ) Neisseria meningitidis
C ) Pseudomonas aeruginosa
D ) Streptococcus bovis
E ) Streptococcus pneumoniae
strept pneumoniae
#6
Re: multiple myeloma+infection 8401glacieres - 01-06-08 13:11 It's STREP PNEUMONIAE, even though Herpes & Haemophilus are common.
#7
Re: multiple myeloma+infection radhamesramos - 01-29-08 13:50 Either E or B. E seems better for a patient in ths condition
#11
Re: multiple myeloma+infection bingousmle - 06-30-10 12:15 i think the causative organism is probably listeria monocytogenes because given the history of multiple myeloma and looking at the labs its more likely
Page 1