Thank you for your suggestion! Can you post the note ID or Ankihub of the other card(s) please?
I believe she based this off of a card I previously updated because of this uworld question; QID: 2102. The note id is 1503605902487. Hope this helps !
Beautiful. Support
@somarimed I believe you copied the nid of this note, not the note that was previously updated based on the UW qid?
This needs more investigation with adequate sources. AMBOSS states that “Mixed infections with anaerobic organisms may occur (e.g., Fusobacterium, Peptostreptococcus, Bacteroides)”
hello! I think i know what happened - her suggestion is being made to the same card that i priorly edited! my edit effected two cards since there are two clozes in that card (note id: 1503605902487).
I think @sophwang was trying to update the front of that same card in order to match the updated information which i priorly added to the extras. The thing is, I did not want to change the front of the card because I don’t know if IV Amplicillin is used for aerobic aspiration pneumonia. I just wanted to mention in the extras that, technically, most aspiration pneumonia is aerobic (as opposed to anerobic). The uworld question was not about ampicillin, so I have no idea how the new evidence on aspiration pneumonia being aerobic affects the use of ampicillin for treatment of aspiration pneumonia. I hope that makes sense!
i went back to the question that prompted me to make the suggestion. The uworld qid was 2102. If you look in the answer description, it indicates that aspiration pneumonia is aerobic according to newer studies. It says that first line empiric treatment is for typical community acquired pneumonia pathogens and that anaerobic coverage is only needed if empyema or lung abcess is present! hope this helps!
I see-- @somarimed 's suggestion still open. Even though this cloze isn’t wrong, (anaerobic aspiration pneumonia is a thing, albeit less common than aerobic), I support changing it for the sake of avoiding confusion. Instead of deleting, could also change to “(e.g., Fusobacterium or Bacteroides)” with no cloze
If we approve this suggestion, then we don’t need to approve @somarimed’s open suggestion, since it would be out of context
@AnKing-Maintainers AMBOSS and UW show that aspiration pneumonia is more commonly caused by aerobes than anaerobes, so this example should be deleted to avoid confusion.
UWorld - Step 1 2102
agreed
@herstein.jacob I think it would be wise to push this suggestion but noticed your 
. Any thoughts on the matter? I think the TL;DR as I understand it is that aspiration pneumonia is more commonly caused by aerobes, so you would only treat aspiration pneumonia with ampicillin if there were a lung abscess or empyema. The card misleadingly gives the impression that aspiration pneumonia is typically treated with anaerobic coverage.
UW Step 2 - 2292:
Although early data showed that most cases of aspiration pneumonia were caused by anaerobes (eg, Peptostreptococcus, Fusobacterium), newer evidence indicates that the vast majority of infections are caused by aerobes (eg, gram-negative bacilli, Streptococcus pneumoniae, Staphylococcus aureus). Therefore, in the absence of lung abscess or empyema, empiric treatment for aspiration pneumonia is the same as for community-acquired pneumonia.
nid:1500499272778:
{{c1::Aspiration pneumonia}} occurs when oral {{c2::aerobic::aerobic or anaerobic}} bacteria enter the lungs
nid:1705683466861:
Aspiration pneumonia is treated with standard regimens in the absence of {{c1::empyema}} or {{c1::lung abscess}}
I don’t remember exactly what I was thinking when I initially reacted to the post, but this is one of those topics that I think is still classically tested (aspiration = anaerobic) even though it is wrong. For example, multiple instances in FA25 still say anaerobes are most common. If you read the UpToDate page on aspiration PNA in adults it goes into greater detail on this topic, but long-story-short is that they recommend anaerobic coverage even though American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) guidelines do not. It’s super complicated.
I can see the argument for removing but I am also not 1000% convinced
I see, fair point…personally I feel like it’s not super harmful to remove it-- it’s not serving a great purpose here since it’s just kinda just tacked onto the end of the sentence without any clarification. Meanwhile, it’s causing confusion for some users because it somewhat contradicts our other cards. UW and AMBOSS seem to be testing according to the ATS/IDSA guidelines, but I wonder what the NBME tests…