Residencias CABA Medicina Practice Questions - Buenos Aires City Health Residencies Contest (Concurso De Residencias Del Equipo De Salud Del GCABA - Medicina) Exam

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A 52-year-old male with a native bicuspid aortic valve presents with a 3-week history of low-grade fever, night sweats, fatigue, and weight loss. Physical examination reveals a new grade 3/6 regurgitant aortic murmur and subungual splinter hemorrhages. Blood cultures draw 3 separate sets positive for Streptococcus viridans sensitive to penicillin. Transthoracic echocardiogram confirms an 8 mm oscillating vegetation on the aortic valve. According to the modified Duke criteria, what is the diagnostic classification and the first-line targeted antimicrobial therapy?

Definite infective endocarditis; intravenous penicillin G (or ampicillin) plus gentamicina or ceftriaxone monotherapy Possible infective endocarditis; oral amoxicillin-clavulanate for 14 days Definite infective endocarditis; intravenous vancomycin plus rifampicin and ciprofloxacin Rejected infective endocarditis; oral clindamycin for 10 days

Correct Answer:

Definite infective endocarditis; intravenous penicillin G (or ampicillin) plus gentamicina or ceftriaxone monotherapy

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