A 31-year-old female with a history of injection drug use pr…

A 31-year-old female with a history of injection drug use presents with emergency department complaining of a 3-day history of fever, chills, loss of appetite and dyspnea on exertion. Transthoracic echocardiogram showed a vegetation present on the native tricuspid valve and blood culture reveal Staphylococcus aureus, susceptible to oxacillin.  She has her aortic valve replaced with prosthetic valve and she is successfully treated with nafcillinfor 6 weeks.  No however, 8 months later she presents again with these symptoms, and blood cultures confirm MSSA with a 4.5cm vegetation revealed on imaging confirming endocarditis.  How should you now treat this patient?

Answer all questions in the exam document embedded below. Af…

Answer all questions in the exam document embedded below. After you completed your exam, scan your pages into a single PDF, name it Midterm1_StudentName (example: Midterm1_JohnSmith).  Before uploading, verify your file has all the pages you need to submit. Upload it by clicking on “Choose a File” button in “Question 1” below. You are only allowed to upload one file to a question. Then click “Submit Quiz”. You may get a warning saying that you have some unanswered questions if you do not use optional file upload sections, click OK to submit anyway. View exam document here. Use double-sided arrow icon on the tool bar below to preview it in full screen mode. You can also download it by clicking on the download icon to the right of the document and open it on your computer. This is a link to the full pdf of the Midterm 1 exam: mid-term1.pdf