Mr Tan a 65 years old gentleman was admitted to the medical oncology unit for fever 3 days ago. He has a background of gastric cancer and is current receiving ongoing chemotherapy treatment. He was neutropenic on admission and hence was started on IV Piperacillin-Tazobactum with Vancomycin after blood cultures were taken. He has no known drug allergies. The aerobic blood culture results showed no bacterial growth and he is clinically well. What is the next appropriate management?

Medical Quiz

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Health Sciences
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University
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Hard
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37 questions
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1.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Stop all IV antibiotics and change to PO Augmentin
No action required as the anaerobic blood culture is not available yet
Stop IV Vancomycin while continue with IV Piperacillin-Tazobactum for at least 2 more days
Stop IV Piperacillin-Tazobactum while continue with IV Vancomycin for at least 2 more days
Stop all antibiotics and observe
2.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Which of the following are characteristics of Pulmonary Embolism?
Gradual onset, chest tightness, pain occurs in the substernal area and radiate to the left arm
Sudden onset, sharp and tearing pain, pain occurs in the chest and radiate to the back
Sudden onset, pain worsens with deep inspiration, pain located at the chest wall, associated with shortness of breath
Sudden onset, ipsilateral pleuritic chest pain, associate with shortness of breath
Sudden onset, generalised pain over chest area, associated with shortness of breath
3.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 30-year-old female came to the multidisciplinary clinic complaining of palpitations and unable to sleep well. She has intentional weight loss of 6kg over the past 2 months. On examination, her pulse rate is approximately 120/min and irregularly irregular. Her blood pressure is 140/90. There are no murmurs heard upon auscultation. The ECG confirms the diagnosis of atrial fibrillation. What would you suggest as the most useful next investigation?
Echocardiography
Chest x-ray
Fasting blood glucose
Thyroid function tests
Sleep study
4.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Which patient with asymptomatic bacteriuria no need treatment?
50 years old male with presence of struvite stones
60 years old MALE, prior to genitourinary tract procedures: TURP, cystoscopy
20 years old female prior to renal biopsy
30 years old female trying to conceive
Neonates and preschool children
5.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Which of the social history is not relevant for lower limb swelling?
Smoking
Alcohol consumption
Stress level
Recent long-haul flight
6.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
33 years old Malaysian female, married with no kids. Arrived in Singapore 3 weeks ago, now presented at emergency department for worsening abdominal pain for 2 days. Which test would you consider to order first?
Urine dipstick
US pelvis
CTAP
Urine pregnancy test
US kidneys
7.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 60-year-old male with chest pain. Interpret the following 12 leads ECG:
Anterior myocardial infarction
Lateral wall myocardial infarction
Inferior myocardial infarction
Posterior wall myocardial infarction
Septal myocardial infarction
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