#june2020mccqe1
A 40-year-old man is admitted for chemotherapy for treatment of acute myelogenous leukemia. A central line through his subclavian vein is inserted to facilitate infusion of chemotherapeutic agents. Ten days after this procedure, he develops a temperature of 39.4 C (103.0 F). Physical examination is remarkable for tachycardia and tenderness around the central line insertion site. Blood cultures and a chest x-ray film are negative. Which of the following is the most appropriate next step in management?
(A) Repeat blood cultures and wait for culture results to guide therapy
(B) Administer amphotericin
(C) Administer vancomycin
(D) Remove the central line
(E) Remove the central line and insert a new one over a guide wire
A 40-year-old man is admitted for chemotherapy for treatment of acute myelogenous leukemia. A central line through his subclavian vein is inserted to facilitate infusion of chemotherapeutic agents. Ten days after this procedure, he develops a temperature of 39.4 C (103.0 F). Physical examination is remarkable for tachycardia and tenderness around the central line insertion site. Blood cultures and a chest x-ray film are negative. Which of the following is the most appropriate next step in management?
(A) Repeat blood cultures and wait for culture results to guide therapy
(B) Administer amphotericin
(C) Administer vancomycin
(D) Remove the central line
(E) Remove the central line and insert a new one over a guide wire
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