USMLE Forum Archives - USMLE Step 3 - int med
int med
bingousmle - 07-27-10 02:40
A 50-year-old man is admitted to the hospital for active pulmonary tuberculosis with a positive sputum acid-fast bacilli smear. He is HIV positive with a CD4 count of 85/μL and is not on highly active antiretroviral therapy. In addition to pulmonary disease, he is found to
have disease in the L4 vertebral body. What is the most appropriate initial therapy?
A. Isoniazid, rifampin, ethambutol, and pyrazinamide
B. Isoniazid, rifampin, ethambutol, and pyrazinamide;
initiate antiretroviral therapy
C. Isoniazid, rifampin, ethambutol, pyrazinamide, and
streptomycin
D. Isoniazid, rifampin, and ethambutol
E. Withhold therapy until sensitivities are available.
bingousmle - 07-27-10 02:40
A 50-year-old man is admitted to the hospital for active pulmonary tuberculosis with a positive sputum acid-fast bacilli smear. He is HIV positive with a CD4 count of 85/μL and is not on highly active antiretroviral therapy. In addition to pulmonary disease, he is found to
have disease in the L4 vertebral body. What is the most appropriate initial therapy?
A. Isoniazid, rifampin, ethambutol, and pyrazinamide
B. Isoniazid, rifampin, ethambutol, and pyrazinamide;
initiate antiretroviral therapy
C. Isoniazid, rifampin, ethambutol, pyrazinamide, and
streptomycin
D. Isoniazid, rifampin, and ethambutol
E. Withhold therapy until sensitivities are available.
The correct answer and explanation will be available after you answer.
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#1
Re: int med babbu5508 - 07-27-10 02:57 My answer is: b.
This disease is particularly dangerous for persons infected with HIV. Worldwide, TB is a leading cause of death among persons infected with HIV
#2
Re: int med
bingousmle - 07-27-10 07:15 My answer is: a.
its prudent to avoid using HAART in this patient even though he is having a depressed CD4 count to avoid the risk of developing IRIS
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