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submitted by medstudied(1),

Why is it azithromycin not doxycycline? According to sketchy, you treat chlamydia with macrolides/doxy +ceftriaxone. You treat neisseria gonorrhea with ceftriaxone+azithromycin+doxycycline.

​Not sure what this question is testing -- is it wanting us to know that gonorrhea has to be treated as well? In that case, doxy would work for both according to sketchy ... Any other reasonings appreciated!

dr_salface  The patient in the stem is pregnant! The question wants to see if you know that doxy is a teratogen. Tetracyclines in general like to bind to fetal bone/teeth which can impair development. +5  
dr_salface  As a side note, treating chlamydia alone only requires macrolides or doxy. Treating gonorrhea alone only requires ceftriaxone or macrolides. The reason sketchy includes all three is because you usually treat one infection and co-treat the other. +  
yotsubato  Theres a crow in the chlamydia sketchy. You can use Macrolides, OR Ceftriaxone, OR Doxycycline. Most doctors in real life just give the azithromycin z pack (which kicks ass cause its one drug 5 doses thats it) +1  


submitted by medstudied(1),

Why is it azithromycin not doxycycline? According to sketchy, you treat chlamydia with macrolides/doxy +ceftriaxone. You treat neisseria gonorrhea with ceftriaxone+azithromycin+doxycycline.

​Not sure what this question is testing -- is it wanting us to know that gonorrhea has to be treated as well? In that case, doxy would work for both according to sketchy ... Any other reasonings appreciated!

dr_salface  The patient in the stem is pregnant! The question wants to see if you know that doxy is a teratogen. Tetracyclines in general like to bind to fetal bone/teeth which can impair development. +5  
dr_salface  As a side note, treating chlamydia alone only requires macrolides or doxy. Treating gonorrhea alone only requires ceftriaxone or macrolides. The reason sketchy includes all three is because you usually treat one infection and co-treat the other. +  
yotsubato  Theres a crow in the chlamydia sketchy. You can use Macrolides, OR Ceftriaxone, OR Doxycycline. Most doctors in real life just give the azithromycin z pack (which kicks ass cause its one drug 5 doses thats it) +1  


submitted by calcium196(7),

How is a synthetic opioid (dextromethorphan) that you can find with a 2 second google search as causing constipation the correct answer? Is it just because tiotropium wouldn’t treat the cough?

moneysacs  Tiotropium would cause constipation bc it’s an anticholinergic. Don’t have any insight into why dextromethorphan is the right answer though, other than process of elimination and diphenhydramine wouldn’t treat his symptoms. +  
upstairs_bumblebee  I thought it was dextromethorphan because it would bind NMDA receptors and have weaker opioid effect = less constipation? Idk though :/ +  
dr_salface  I agree. I mainly went by way of elimination but even DXM made me think of opiod-induced constipation. Though, all the other answer choices had obvious anticholinergic effects. At least, that was my reasoning for picking dxm. +