American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

The MKSAP Challenge

From the November ACP Observer, copyright 2005 by the American College of Physicians.

Clinical scenario

A 36-year-old woman is admitted to the intensive care unit with Guillain-Barre syndrome. She requires intubation and is placed on mechanical ventilation. On hospital day 11, she develops fever and purulent tracheobronchial secretions. A chest radiograph reveals a new infiltrate in the left lower lobe. On physical examination, temperature is 39 C (102.2 F). Coarse crackles are heard in the left posterior lung field. The leukocyte count is 15,000/L. An endotracheal aspirate is taken for culture and Gram stain.

Which of the following is the optimal management at this time?

A. Await Gram stain and culture results
B. Begin ceftriaxone
C. Begin vancomycin
D. Begin vancomycin, piperacillin and amikacin
E. Begin ceftriaxone and vancomycin

Answer

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Share

 
 

Internist Archives Quick Links

MKSAP 16 Holiday Special: Save 10%

MKSAP 16 Holiday Special:  Save 10%

Use MKSAP 16 to earn MOC points, prepare for ABIM exams and assess your clinical knowledge. For a limited time save 10% when you use priority code MKPROMO! Order now.

Maintenance of Certification:

What if I Still Don't Know Where to Start?

Maintenance of Certification: What if I Still Don't Know Where to Start?

Because the rules are complex and may apply differently depending on when you last certified, ACP has developed a MOC Navigator. This FREE tool can help you understand the impact of MOC, review requirements, guide you in selecting ways to meet the requirements, show you how to enroll, and more. Start navigating now.