10-08-2008, 07:30 PM
A 42 year old man has a 1-month history of fever, night sweats, weight loss, and cough. Ten months ago, he was briefly incarcerated because of injection drug use. At that time, a tuberculin skin test and serologic titers for HIV were negative. A chest radiograph now shows a right upper lobe infiltrate with a small cavity. Sputum examination shows numerous acid fast bacilli, and sputum samples were obtained for culture.
Which of the following is the most appropriate initial therapy for this patient?
a. Isoniazid
b. Isoniazid, pyrazinamide, ethambutol
c. Isoniazid, pyrazinamide, ethambutol, rifampin
d. Isoniazid, pyrazinamide, rifampin, zidovudine
e. Para-aminosalicylic acid, cycloserine, ethionamide
A 19 year old female college student has a 2-week history of an increasing vaginal discharge. She denies vaginal odor, or bleeding, dyspareunia, dysuria, urinary urgency or frequency, abdominal pain, nausea, vomiting, or diarrhea. The patient became sexually active with a partner 3 months ago and has not had a menstrual period for past 2 months.
Pelvic examination shows edema of the cervix with mucosal friability. A purulent discharge is present in the cervical os and vagina. A wet mount preparation shows many leucocytes but no yeast forms, motile Trichomonas organisms, or clue cells. Vaginal pH is 4.5. A urine pregnancy is positive. The patient tells you that she leaves for a 1-week vacation tomorrow.
In addition to ceftriaxone, 125 mg intramuscularly in a single dose, for possible gonorrhea, which of the following is most appropriate at this time?
a. Ofloxacin 300 mg orally twice daily for 7 days
b. Doxycycline 100 mg orally twice daily for 7 days
c. Metronidazole 500 mg orally twice daily for 5 days
d. Erythromycin base, 500 mg orally four times daily for 7 days
e. Benzathine penicillin 2.4 million units intramuscularly
Which of the following is the most appropriate initial therapy for this patient?
a. Isoniazid
b. Isoniazid, pyrazinamide, ethambutol
c. Isoniazid, pyrazinamide, ethambutol, rifampin
d. Isoniazid, pyrazinamide, rifampin, zidovudine
e. Para-aminosalicylic acid, cycloserine, ethionamide
A 19 year old female college student has a 2-week history of an increasing vaginal discharge. She denies vaginal odor, or bleeding, dyspareunia, dysuria, urinary urgency or frequency, abdominal pain, nausea, vomiting, or diarrhea. The patient became sexually active with a partner 3 months ago and has not had a menstrual period for past 2 months.
Pelvic examination shows edema of the cervix with mucosal friability. A purulent discharge is present in the cervical os and vagina. A wet mount preparation shows many leucocytes but no yeast forms, motile Trichomonas organisms, or clue cells. Vaginal pH is 4.5. A urine pregnancy is positive. The patient tells you that she leaves for a 1-week vacation tomorrow.
In addition to ceftriaxone, 125 mg intramuscularly in a single dose, for possible gonorrhea, which of the following is most appropriate at this time?
a. Ofloxacin 300 mg orally twice daily for 7 days
b. Doxycycline 100 mg orally twice daily for 7 days
c. Metronidazole 500 mg orally twice daily for 5 days
d. Erythromycin base, 500 mg orally four times daily for 7 days
e. Benzathine penicillin 2.4 million units intramuscularly