1.3.3: Assess and modify individualized treatment plans, considering efficacy of therapy
Which of the following antineoplastic agents would not be effective as adjuvant therapy for postmenopausal patients with breast cancer that is ER negative and does not overexpress HER-2?
Letrozole (D) would not be effective in treating breast cancer that is ER negative.
Cyclophosphamide (A), epirubicin (B), and doxorubicin (C) are effective in treating ER negative, HER-2 negative breast cancer.
When the 15-day-old, former 36-week gestational age baby is examined at the pediatric hospital, she is also noted to have some lesions. The team will be sending cultures of the lesions as well as HSV PCR of the CSF. Which of the following is an appropriate pharmacologic approach in this patient?
(A) Wait for the cultures and PCR results to come back, then modify therapy if needed.
(B) Change antibiotic therapy to ceftriaxone and daptomycin.
(C) Add IV acyclovir to the current antibiotic regimen.
(D) Add oral posaconazole therapy to the current antibiotic regimen.
Adding IV acyclovir to the current antibiotic regimen provides immediate therapy and adequate concentrations of the drug.
Therapy against possible HSV encephalitis should not be delayed (A), because the delay could result in devastating consequences.
Changing antibiotic therapy to ceftriaxone and daptomycin (B) is not recommended, because therapy against possible HSV encephalitis would be delayed, which could result in devastating consequences, and ceftriaxone should not be used in infants less than 1 month old. Daptomycin is not indicated in neonatal meningitis. Antifungal therapy (D) is not indicated and therapy against possible HSV encephalitis would be delayed, which could result in devastating consequences.
Topic: Central Nervous System Infections
OU is a 63-year-old woman with HF (NYHA class I) receiving furosemide 20 mg twice daily, lisinopril 10 mg daily, metoprolol succinate 50 mg daily, digoxin 0.125 mg daily, and spironolactone 25 mg daily. During her routine clinic visit today, pertinent findings include: BP 125/77 mm Hg, HR 70 bpm, RR 13 rpm, K + 5.1 mmol/L, BUN 32 mg/dL, creatinine 1.1 mg/dL (baseline), and serum digoxin concentration of 0.8 ng/mL. Which of the following is the most appropriate change to optimize OU's medical regimen?
(A) Increase ACE inhibitor dose