USMLE Forum Archives - USMLE Step 2 CK - neuro
neuro
HIV - 07-01-08 22:32
12 days after cerebral infarct 70 y/o man has fever and cough .initial Sx included inability to move Rt arm & leg , swallow, speak ,respond to Q's. he is wearing false teeth .temp 101.8 bp 135/85 pulse 94 rr 28. exam shows moderate weakness of facial muscles and Rt extremity.gag refelx is absent .breath sounds dec...dullness to perc over Rt lung base posteriorly.CXR shows infiltrate in post basal segment of rt lung .which of the folloiwng is most likely to Prevent recurrence of this pts lung condition?
a removal of his false teeth
b suppression of gastric acid production
c chronic Ab prophylaxis
d metoclopramide to inc GIT motility
e insertion of feeding jejunostomy tube
HIV - 07-01-08 22:32
12 days after cerebral infarct 70 y/o man has fever and cough .initial Sx included inability to move Rt arm & leg , swallow, speak ,respond to Q's. he is wearing false teeth .temp 101.8 bp 135/85 pulse 94 rr 28. exam shows moderate weakness of facial muscles and Rt extremity.gag refelx is absent .breath sounds dec...dullness to perc over Rt lung base posteriorly.CXR shows infiltrate in post basal segment of rt lung .which of the folloiwng is most likely to Prevent recurrence of this pts lung condition?
a removal of his false teeth
b suppression of gastric acid production
c chronic Ab prophylaxis
d metoclopramide to inc GIT motility
e insertion of feeding jejunostomy tube
Page 1
#2
Re: neuro glacieres8401 - 08-03-08 08:42 E- GK tube
All the other mentioned options will not help him. It's only logical to have aGJ tube and feed him so that he woudn't have another aspiration , which he is prone to because of his absence gag.
#3
Re: neuro ammulufy - 06-26-10 22:56 Bcos of d long bedridden condition.....the ptnt has landed up in aspiration pneumonitis leading to pleural effusion.....hence d answer is betwn c or d......here d aspiration is not because of oropharyngeal contents but becos of gastric contents.....hence d answer can even be b.......but if we go according to d priority listing.....aspiration pneumonitis takes d lead necessitating attention.....therefore I go wid c i.e chronic antibiotic therapy.
#4
Re: neuro ammulufy - 06-26-10 22:58 I know feeding jejunostomy tube also requires mention.....but pleural effusion also needs to be taken care of......followed by placemnt of feeding jejunostomy tube.
Page 1