USMLE-Rx Step 1 Qmax Challenge #1710

Check out today’s Step 1 Qmax Question Challenge.

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An 82-year-old woman with chronic obstructive pulmonary disease (COPD) is hospitalized for an acute COPD exacerbation. On admission the patient is found to have a pH of 7.25 and PaCO2 of 50. She is rapidly placed on ventilatory support and admitted to the ICU. After being on the ventilator for 72 hours, the patient is found to have a temperature of 102°F (38.9°C), pulse of 104/min, and BP of 115/20 mm Hg. Labs are significant for a white blood cell count of 15,000 cells/?L. A chest X-ray is taken and is shown. Sputum studies are significant for a gram-negative bacillus Acinetobacter baumannii. She is treated with intravenous antibiotics, but several hours later the patient has a seizure lasting 45 seconds. A subsequent lumbar puncture is normal. The physician suspects a pharmacologic cause for the seizure.

The patient’s adverse reaction was most likely caused by which of the following antibiotics?

A. Gentamicin
B. Imipenem
C. Levofloxacin
D. Linezolid
E. Rifampin

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