American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Which condition is associated with metabolic acidosis and is good against Pseudomonas?

Silvadene
Sulfamylon
Silver nitrate
G6PD deficiency

The correct answer is: Sulfamylon

The association of sulfamylon, also known as mafenide acetate, with metabolic acidosis as well as its effectiveness against Pseudomonas aeruginosa makes it the most suitable answer. Sulfamylon is a topical antibiotic used to prevent and treat infections in burn wounds. One of its distinctive features is that it penetrates eschar well, making it particularly effective in controlling Pseudomonas infections, which are known to be challenging to manage in burn patients. Additionally, the use of sulfamylon can lead to metabolic acidosis; this is primarily due to its ability to inhibit carbonic anhydrase, resulting in decreased bicarbonate in the blood. This condition is particularly relevant in the management of burn injuries, where the risk of Pseudomonas infections is high, and the potential for metabolic changes due to antibiotic therapies must be monitored closely. Therefore, the context of treating burns and preventing severe infections like those caused by Pseudomonas while also understanding the side effects of the treatment strongly supports why sulfamylon is the correct answer.