Am I going crazy?

[leviathan]

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Or is this another test question error from Kaplan. What would you describe this gram stain as and what would you empirically treat with? This is CSF in a patient with meningitis signs/symptoms.

http://imgur.com/FrwE3

 

[WilcoWorld]

Hmm, kind of a poor picture, because they look dark, but not quite Gram positive dark.

I'm going with gram negative cocci -->N. Meningitidis.

Treatment = Steroids + high dose rocephin +/- vancomycin.

 

[leviathan]

They're calling this pneumococcus. You're on my side, I also thought it was gram negative. I thought treatment was either penicillin or ceftriaxone if Neisseria has high resistance to penicillin in your region.

 

[WilcoWorld]

Well, I suppose that because those aren't intracellular it should've steered me away from N. Mening. But still, Gram staining questions should be darn clearly positive or negative. My experience has been that the actual USMLE and ABEM stimuli are much higher quality than the pretests' stimuli.

 

[CommunityED]

Who cares. If you think it is meningitis clinically give high dose (2g) rocephin. Le tthe lab worry about which specific bug it is.

 

[richse]

Or is this another test question error from Kaplan. What would you describe this gram stain as and what would you empirically treat with? This is CSF in a patient with meningitis signs/symptoms.

http://imgur.com/FrwE3

You're right and Kaplan messed up. This page should end all debate.