Mrs. Jones has a serious case of conjunctivitis and the doctor orders chloramphenicol and penicllin. Why would the administration of both of these antibiotics be contraindicated? Explain in detail why.

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Nelly StrackeLv2

28 Sep 2019

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A doctor who regularly worked with an immunocompromised population went in for a routine biopsy. Standard prophylactic antibiotics were used to prevent infection (ciprofloxin). The day after the biopsy, the patient returned to the hospital with the following symptoms: â¢ Confusion â¢ Fever (~40C) â¢ Malaise â¢ Increased heart rate â¢ Very low blood pressure At the hospital, these symptoms continued despite the administration of ampicillin and gentamicin. A blood culture was taken and the Kirby-Bauer test was conducted to determine sensitivity/resistance to various antibiotics. Following this test, the antibiotics being used were changed and the patient recovered.

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A pregnant 23 year old female arrives at her doctor's office complaining of fever, headache, abdominal pain on her left side radiating to her back, dysuria, and hematuria. The doctor ordered a urinalysis with a urine culture and a CBC.

The results of the urinalysis are as follows:

Specific gravity: 1.017

pH: 6.4

Protein: Positive

Glucose: Negative

Ketone: Negative

Bilirubin: Negative

Blood: Positive

Nitrites: Positive

Leukocytes: Positive

White Blood cells casts: Positive

Urobilinogen: .2-10. Her U/dL

All values obtained in the CBC were normal witht the exception of white blood cell values which showed leukocytosis. Once these results were reviewed, the doctor admitted the patient to the hospital for IV antibiotic treatment and fluid hydration. The antibiotics chose for the treatment ar ampicillin and gentamicin. The diagnosis was pyelonephritis

Questions:

1. Why did not the doctor order an x-ray of the patient's urinary system? If an X ray would have been ordered what would it be potentially showing?

2. Why did the doctor order a urinalysis witha urine culture?

3. Why are pregnant women are more at risk for developing urinary tract infections and pyelonephritis?

4. Why did the doctor admit the patient to the hospital instead of sending her home with antiobiotics? Why did he order the use of ampicillin and gentamicin instead of the preffered ciprofloxacin route?

5. Should there be protein in the patient's urine?

6. explain the following urinalysis results:

a. presence of nitrites

b.positive leukocytes

c. white blood cell casts