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|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|Prompt=A 68 year old woman with past history of Parkinson's disease presents to the emergency department for 12 hours of high grade fever and several episodes of chills. On admission the patient's pulse is 121 bpm, her blood pressure is 98/66 mmHg, and temperature is 39.5 C (103 F). You draw 2 sets of blood cultures and initiate broad spectrum coverage with vancomycin and piperacillin/tazobactam. Two days later, the patient does not seem  be improving and blood culture results reveal gram negative rods resistant to piperacillin/tazobactam. You decide to switch the patient to another antibiotic that covers gram-negative rods. After less than 24 hours on the new medication, the patient experiences a tonic-clonic seizure lasting 4 minutes and requiring sedation. What is the mechanism of action of the drug used in this patient?
|Prompt=A 68 year old woman with past history of Parkinson's disease presents to the emergency department for 12 hours of high grade fever and several episodes of chills. On admission the patient's pulse is 121 bpm, her blood pressure is 98/66 mmHg, and temperature is 39.5 C (103 F). You draw 2 sets of blood cultures and initiate broad spectrum coverage with vancomycin and piperacillin/tazobactam. Two days later, the patient does not seem  be improving and blood culture results reveal gram negative rods resistant to piperacillin/tazobactam. You decide to switch the patient to another antibiotic that covers gram-negative rods. After less than 24 hours on the new medication, the patient experiences a tonic-clonic seizure lasting 4 minutes and requiring sedation. What is the mechanism of action of the drug used in this patient?
|AnswerA=Block peptide bond formation by inhibiting peptidyltransferase
|AnswerB=Inhibit protein synthesis by inhibiting translocation of growing peptide
|AnswerC=Inhibit tRNA binding to ribosome
|AnswerD=Interfere with cell wall synthesis by blocking cross-linking
|AnswerE=Interferes with cell membrane leading to postassium leak and depolarization.
|RightAnswer=D
|WBRKeyword=Carbapenems, Imipenem, Mechanism of Action
|Approved=No
|Approved=No
}}
}}

Revision as of 18:15, 23 October 2013

 
Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pharmacology
Sub Category SubCategory::Infectious Disease
Prompt [[Prompt::A 68 year old woman with past history of Parkinson's disease presents to the emergency department for 12 hours of high grade fever and several episodes of chills. On admission the patient's pulse is 121 bpm, her blood pressure is 98/66 mmHg, and temperature is 39.5 C (103 F). You draw 2 sets of blood cultures and initiate broad spectrum coverage with vancomycin and piperacillin/tazobactam. Two days later, the patient does not seem be improving and blood culture results reveal gram negative rods resistant to piperacillin/tazobactam. You decide to switch the patient to another antibiotic that covers gram-negative rods. After less than 24 hours on the new medication, the patient experiences a tonic-clonic seizure lasting 4 minutes and requiring sedation. What is the mechanism of action of the drug used in this patient?]]
Answer A AnswerA::Block peptide bond formation by inhibiting peptidyltransferase
Answer A Explanation AnswerAExp::
Answer B AnswerB::Inhibit protein synthesis by inhibiting translocation of growing peptide
Answer B Explanation AnswerBExp::
Answer C AnswerC::Inhibit tRNA binding to ribosome
Answer C Explanation AnswerCExp::
Answer D AnswerD::Interfere with cell wall synthesis by blocking cross-linking
Answer D Explanation AnswerDExp::
Answer E AnswerE::Interferes with cell membrane leading to postassium leak and depolarization.
Answer E Explanation AnswerEExp::
Right Answer RightAnswer::D
Explanation [[Explanation::

Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Carbapenems, WBRKeyword::Imipenem, WBRKeyword::Mechanism of Action
Linked Question Linked::
Order in Linked Questions LinkedOrder::