USMLE STEP 3 : Q 4 : ANSWER

 

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Correct Answer: E

Explanation:

Colony growth with a zone of inhibition around the disk indicates a presumptive identification of Group A beta Strep. Gram staining produces Gram positive cocci in chains. These features are suggestive of beta-hemolytic streptococcal pharyngitis. Symptoms of acute pharyngitis most commonly are caused by viruses.However, in order to prevent rheumatic fever and its complications, group A beta-hemolytic streptococcal (GABHS) pharyngitis should be recognized and treated. For compliance reasons, single-dose benzathine penicillin G is recommended for GABHS pharyngitis or tonsillitis. The recommended dosage is 600,000 units intramuscularly for patients weighing 27 kg or less, and 1,200,000 units for patients weighing more than 27 kg. If oral penicillin must be used, twice-daily dosing has been found as effective as 4-time daily dosing (500 mg bid for 10 days). A full 10-day course is necessary for eradication


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