A patient-Oriented Problem-Solving (pops) System Elderly Man With Fever and Cough




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Revised 10/6/12

An Elderly Man With Fever and Cough


Gabriel Virella, M.D., Ph.D.

Department of Microbiology and Immunology

Medical University of South Carolina, Charleston, SC

Gene Burges, MD, PhD

Department of Microbiology and Immunology

Medical University of South Carolina, Charleston, SC

Renee Meyer, MD

Medical University of South Carolina;

Geriatrics and Extended Care, VAMC; Charleston, SC

Ming Tan, MD

Departments of Microbiology and Molecular Genetics, and of Medicine

University of California, Irvine

Caroline Thiedcke, MD

Department of Family Medicine,

Medical University of South Carolina, Charleston, SC

Sally Webb, MD

Department of Pediatrics

Medical University of South Carolina, Charleston, SC





The reason the POPS system works so well is that they have been revised many times based on feedback from students and faculty.

Please send suggestions and/or comments to: mcuchens@microbio.umsmed.edu

Note to Instructors


This workbook is divided into five sections:

1. Introduction to the POPS System, introduction to and objectives of the clinical simulation, and a pretest

  1. Four booklets with pretest answers and the clinical problem(s)

  2. Group question and answer sheets

  3. Posttest

  4. Posttest answers

Each student should receive a copy of section 1 to study and answer questions before the group problem-solving session. If you wish, section 2 also may be distributed for the students to review prior to the group session.

A Patient-Oriented Problem-Solving (POPS) System

Elderly Man With Fever and Cough



Pretest


Instructions: Please mark your answers to the following questions on this exam to facilitate later discussion and review. If your instructor has provided a separate answer form, please be sure to fill in the identification section; then answer the questions both on the form and on this exam.

Choose the one correct or most appropriate answer. If you do not know an answer, leave it blank. Do not guess. Health professionals who think they know something, but don't, can do real harm. Those who know they don't know something can get help.

Don't be upset if you don't know all the answers. The purpose of the pretest and objectives is to alert you to important concepts. The posttest will be similar to the pretest.


  1. The slide reproduces a nutrient agar plate seeded with an aerobic Gram negative rod recovered from the urine of a 78 year old man with advanced prostatic carcinoma in whom a Foley catheter was placed to relieve obstruction. Of the following antibiotics, which one would be more likely effective in this patient?




  1. Doxycycline

  2. Ceftriaxone

  3. Sulfamethoxazole-trimethoprim

  4. Metronidazole

  5. Piperacillin/Tazobactam


2. Which of the following steps has been successfully used to increase the immunogenicity of the Streptococcus pneumoniae vaccine in humans?

  1. Use of complete killed bacteria instead of polysaccharides

  2. Conjugation of the bacterial polysaccharides with an immunogenic protein

  3. Emulsion in Complete Freund’s Adjuvant (CFA)

  4. Increase the diversity of polysaccharides in the vaccine

  5. Simultaneous injection with the Diphtheria-Tetanus-Pertussis (DTaP) vaccine



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