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Points : 36335
Join date : 2014-04-06

PostSubject: Question-237   Sat Apr 12, 2014 11:41 am

A 50 year old heavy alcoholic man came with ascites, enlarged liver 4 cm below costal margin , his abdomen is tender and his temp. is 37.9 c his blood pressure is 100/60 which of the following is best treatment for current problem ?

a. IV metronindazole + amoxicillin
b. IV metronindazole + amoxicillin + gentamycin
c. Paracentesis
d. Oral amox. Clax.
e. IV albumin
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Points : 35953
Join date : 2014-04-11

PostSubject: Re: Question-237   Sun Apr 13, 2014 2:04 am

a)-IV metrondazole + amoxicillin ( Treatment of suspected Liver Abscess )
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Points : 34775
Join date : 2014-06-07
Age : 50
Location : WA

PostSubject: Re: Question-237   Tue Jun 10, 2014 7:21 am

The paitent is suspected to pyogenic liver Abcess.Thus broad spectrum antibiotics should be started before waiting for culture results. Use a penicillin, an aminoglycoside and metronidazole. A third-generation cephalosporin can be considered in the elderly or if renal function is impaired.[10] Antibiotic therapy can be modified once culture results are available. Treatment may be needed for up to 12 weeks and should be guided by the clinical picture and radiological monitoring
•Most patients with pyogenic liver abscess and those with very large amoebic abscesses, may not recover with antibiotics alone and need drainage guided by ultrasonography or CT.
•Percutaneous aspiration can be carried out for small abscesses although catheter drainage has become the standard of care. Larger abscesses may also need catheter drainage which is also CT- or ultrasound-guided. Drainage should also be carried out if there is impending rupture.
•Open surgery may be necessary if the abscess has ruptured and there are signs of peritonitis, if the abscess is larger than 5 cm or multiloculated, or if there is a known abdominal pathology such as appendicitis.
I think c. Paracentesis will help the patient first followedby Antibiotic therapy (B)
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PostSubject: Re: Question-237   Wed Nov 19, 2014 3:59 am

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