A patient comes to your office for a hospital follow-up. You had sent him to the hospital three weeks earlier for persistent fevers but no other symptoms; he was diagnosed with infective endocarditis and is currently being treated appropriately. Advice to this family should now include which of the following?
- Restrict the child from all strenuous activities
- Give the child a no-salt-added diet
- Provide the child with antibiotic prophylaxis for dental procedures
- Test all family members in the home with repeated blood cultures
- Avoid allowing the child to get upset or agitated
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The answer is c, Provide the child with antibiotic prophylaxis for dental procedures.[2-4]
Treatment of infective endocarditis usually consists of 4 to 6 weeks of appropriate antimicrobial therapy. Activity is not usually limited unless there is extensive destruction of heart muscle or the conducting system leading to failure. Minimizing salt intake is generally a good idea, but not any more so in an individual who has endocarditis. Bed rest should be instituted only in the case of heart failure. Family members are not typically at risk. Antimicrobial prophylaxis prior to and after dental cleaning is indicated.