Differing answers?

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darkmansaad

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Hey guys I run into some differing answers between my study books and UsmleWorld. Usually I can resolve it by checking online or my medicine texts but sometimes I really cant figure it out. Heres one for ya = for Impetigo it says in Crush to use antistaphylococcal penicillins...but in UWorld it says to first use mupirocin first. Im not sure which answer I should go with first if both choices are on the USMLE...basically it boils down to do I go with UWorld or my Crush book (which does have a few mistakes I have caught/fixed). Responses appreciated!
 
Would go with UW for this one. Makes sense to use a topical for such a superficial infection. That's also what I see being used in practice for tx impetigo.

While we're on this topic... just want to say that I also ran into many instances where the answers differed depending on what source you're using.

The first example that comes to mind is...
"what is the most likely cause of osteomyelitis in a sickle cell patient?"
From multiple sources (books, professors), I remember learning the "answer" should be staph aureus. Even though salmonella is more common in a sickle cell pt than in the general population (and if you are given a patient with salmonella osteo, then more likely than not, they have sickle cell dz), staph aureus is still the most common cause of osteo, even in a sickler.
However, when I got this question in UW, the "answer" according to them was Salmonella. So then I was torn. Every other source I encountered said Staph aureus. Whereas I always respected the quality of answer explanations that UW provides... so yeah... I didn't really come to a conclusion on that one, and I was planning to just do "eenie meenie minee moe" if I ran across that question on the real thing.

(PS I didn't get asked that question on the real CK, thank goodness 🙂.
 
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It depends on the patient.. if the lesions are too big to cover with topical therapy (mupirocin), choose systemic/oral treatment.

Also, Kaplan says oral antistaph should be used if mupirocin is not effective.
 
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