A 32-year-old man is evaluated in the office for a 2-month history of fever, night sweats, weight loss, and cough. He works as a pharmacy technician in an extended care facility for veterans. On examination, he has a prominent cough and appears ill. Temperature is 38 °C; other vital signs are normal. Fine crackles are auscultated over the right posterior thorax. The remainder of the physical examination is normal. A chest radiograph shows a right upper lobe infiltrate with a small cavity. A stained sputum specimen is positive for acid-fast organisms; sputum culture results are pending. HIV testing is negative. Which of the following is the most appropriate initial therapy for this patient?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Isoniazid, rifampin, pyrazinamide, and ethambutol.
Cavitary upper-lobe infiltrate with a positive acid-fast smear = presumed active pulmonary TB; treatment is started without waiting for culture. Active TB is treated with the four-drug RIPE regimen (rifampin, isoniazid, pyrazinamide, ethambutol) for 2 months, then isoniazid + rifampin for 4 months. Isoniazid alone is for latent TB, and a three-drug regimen without rifampin is inadequate.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Never treat TB with a single antibiotic: use multidrug therapy because resistance is a problem. Isoniazid alone is used for latent TB, not active cavitary disease.
✓ Step Up To Medicine 6th Edition 2024 (TB and its treatment).pdf · p. 6 -
B
ليش غلط
This regimen leaves out rifampin. Active TB needs all four RIPE drugs in the intensive phase.
✓ TB and Its TTx.pdf · p. 4 -
C
ليش صح
Active TB is treated with the four-drug RIPE regimen (rifampin, isoniazid, pyrazinamide, ethambutol) for 2 months, then rifampin plus isoniazid for 4 months.
✓ TB and Its TTx.pdf · p. 4
- المصدر
- TB and Its TTx.pdf · p. 4
Step Up To Medicine 6th Edition 2024 (TB and its treatment).pdf · p. 5 - المحاضرة
- Antimicrobials · Infectious Diseases · Module B
- ظهر في
- ID bank