Medicine : PreTest self-assessment and review by S L Berk; William R Davis; Robert S Urban

By S L Berk; William R Davis; Robert S Urban

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The tetracyclines are associated with photosensitization, and patients taking these antibiotics should be warned about exposure to the sun. Imipenem, a carbapenem, may cause central nervous system toxicity such as seizures, especially when administered at high dosages. The major toxicity of gentamicin, an aminoglycoside, is acute tubular necrosis; thus, drug levels should be closely monitored. The aminoglycosides may be ototoxic, with effects on vestibular or auditory function or both. This class of drugs can also produce neuromuscular blockade, especially when administered with Infectious Disease Answers 25 concomitant neuromuscular blocking agents or to patients with impairment of neuromuscular transmission, such as myasthenia gravis.

Patients with SLE have an unpredictable course. Few patients develop all signs or symptoms. Neuropsychiatric disease occurs at some time in about half of all SLE patients, and Raynaud’s phenomenon in about 25%. Pregnancy is relatively safe in women with SLE who have controlled disease and are on less than 10 mg of prednisone. 79. The answer is b. ) The symptoms of Raynaud’s phenomenon, arthralgia, and dysphagia point toward the diagnosis of scleroderma. Scleroderma or systemic sclerosis is characterized by a systemic vasculopathy of small and medium-sized vessels, excessive collagen deposition in tissues, and an abnormal immune system.

Oxacillin would be the drug of choice only if the incidence of methicillin-resistant staph is very low. Quinolones are often useful in the treatment of community-acquired pneumonia, but they would not be effective against methicillin-resistant staph. 27. The answer is b. ) The Infectious Disease Society of America’s guidelines on the treatment of community-acquired pneumonia still recommend the use of sputum gram stain and culture. This is particularly important in the era of multi-antibiotic-resistant S.

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