NBME CBSE USMLE STEP 2 EXAM 2024 LATEST VERSION WITH 200+ QUESTIONS AND CORRECT ANSWERS (100% CORRECT VERIFIED ANSWERS) WITH EXPLANATIONS/ STEP 2 NBME CK ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS GRADED A+ (BRAND NEW!!)
37yo M with 3-day history of diarrhea. Six to eight watery stools daily that
occasionally contain streaks of blood. Family does not have similar symptoms. No
travel. Two weeks ago, he completed course of oral ciprofloxacin for acute
prostatitis. CBC normal. Stool for leukocytes and clostridium difficile toxin is
positive. Next step?
-Metronidazole
-Vancomycin - ANSWER-Metronidazole!
-In cases when the WBC is <15k, oral metronidazole is the correct answer.
Remember that in patient's with WBC >20k, lactacte >2.2, toxic megacolon and/or
severe ileus, the patient will need emergent surgery
-Oral vancomycin is reserved for more severe cases, particularly when WBC > 15k
and creatinine is >1.5x the patient's baseline.
A 15 year old girl is brought to the physician because of a 1 week history of
vaginal discharge and 2 day history of sore throat and recurrent candidal infections
of the skin and mucous membranes since childhood. She has a 2 year history of
type 1 diabetes mellitus and thyroiditis. Medications include insulin and
levothyroxine. Exam shows oral candidiasis. Pelvic exam shows to have thick
white and budding yeasts. Which of the following is the most likely mechanism of
her recurrent candidal infections?
A) Autoimmune destruction of thymus
B) Blunting of inflammatory response from complement deficiency
C) Deficiency of anticandidal antibodies
D) Impaired cell-mediated immunity
E) Inability of macrophage to present candidal infection - ANSWER-Chronic
mucocutaneous candidiasis?
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