USMLE-Rx Step 2 CK Qmax Challenge #21283

Check out today’s Step 2 CK Qmax Question Challenge.

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A 32-year-old woman is brought to the emergency department by her husband because of increased lethargy along with a headache, high fever, and new purpuric lesions. One year ago she underwent splenectomy for idiopathic thrombocytopenic purpura (ITP) that failed prednisone therapy. The patient is allergic to ?-lactam agents. Her temperature is 39.6°C (103.2°F), blood pressure is 102/64 mm Hg, pulse is 124/min, and respiratory rate is 19/min. The patient’s husband recalls she had a minor upper respiratory tract infection the previous week that seemed to resolve on its own. On examination the patient is ill appearing, in respiratory distress, and confused. Blood culture reveals gram-positive cocci in chains (see image).

Which of the following therapies is most appropriate to treat this patient’s underlying infection?

A. Cefepime
B. Gentamicin
C. Levofloxacin
D. Nafcillin
E. Penicillin

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