A 2-year-old boy is brought in by his parents to his pediatrician. The boy was born by spontaneous vaginal delivery at 39 weeks and 5 days after a normal pregnancy. The boy has received all age-appropriate vaccinations as of his last visit at 18 months of age. Of note, the boy has confirmed sickle cell disease and the only medication he takes is penicillin prophylaxis. The parents state that they plan on enrolling their son in a daycare, which requires documentation of up-to-date vaccinations. The pediatrician states that their son needs an additional vaccination at this visit, which is a polysaccharide vaccine that is not conjugated to protein. Which of the following matches this description?
APneumovax
BMenactra
CPrevnar
DHib vaccine
ELive attenuated influenza vaccine
A 72-year-old man is admitted to the hospital with productive cough and fever. A chest radiograph is obtained and shows lobar consolidation. The patient is diagnosed with pneumonia. He has a history of penicillin allergy. The attending physician orders IV levofloxacin as empiric therapy. On morning rounds the next day, the team discovers that the patient was administered ceftriaxone instead of levofloxacin. The patient has already received a full dose of ceftriaxone and had no signs of allergic reaction, and his pneumonia appears to be improving clinically. What is the most appropriate next step?
AAdminister diphenhydramine as prophylaxis against allergic reaction
BContinue with ceftriaxone as empiric therapy
CSwitch the patient to oral azithromycin in preparation for discharge and home therapy
DSwitch the patient back to levofloxacin and discuss the error with the patient
EContinue with ceftriaxone and add azithromycin as inpatient empiric pneumonia therapy
A patient is hospitalized for pneumonia. Gram-positive cocci in clusters are seen on sputum gram stain. Which of the following clinical scenarios is most commonly associated with this form of pneumonia?
AElderly patient who has trouble swallowing and poor dentition
BAn alcoholic with evidence of empyema and "currant jelly sputum"
CAn otherwise healthy young adult with a week of mild fatigue, chills, and cough
DHospitalized adult with development of pneumonia symptoms 2 weeks following a viral illness
EHIV positive adult with a CD4 count less than 150 and an impaired diffusion capacity
+ 7 more in the PDF
Browse all chapters