32. Antimycobacterials Flashcards
A 38 year old patients comes to the doctor with complaints of persistent cough with productive bloody sputum. The patient also has been suffering night sweats and weight lost. Lab test are done positive for acid fast. The patient is giving a medication that works by blocks transcription by binding to the B-subunit of the bacterial DNA-dependent RNA Poly. What is a possible side effect of this medication?
A. Red Green color Blindness B.Inhibitor of CYP 450 C. Non Gouty polyarthralgia D. Lupus Like Syndrome E. Orange red color to body fluids
RFA
Ans. E. Orange red color to body fluids- The medication described in Rifampin being used to treat TB
A. Is a side effect of Ethambutol- which inhibits arabinosyltransferase decreasing cell wall polymerization
B. Inhibitor of CYP450- describes Isoniazid- is a drug activated by KatG and then inhibits InhA and KasA
C. Non-Gouty Polyarthralgia- Pyrazinamide- MOA is it pyrazinoic acid some how( MOA unuclear)
D. Lupus Like Syndrome- is another AE of Isoniazid
A 19 year old homeless girl is brought to a clinic in India. She noticeable granulomas starting to develop through his skin. Blood sample is taken and labs are run showing non gram staining organism but positive for acid fast. The chief resident of the clinic says he want to start the patient on Acedapsone. But want you to run a histological examination of the blood smear first. If the test yield which of the following would you not recommend to start the patient on Acedapsone.
A. Bite Cells B. Maltese Cross appearance C. Starry Sky appearance D. Auer Rods E.Howell Jolly Bodies
RFA
Ans. A. Bite Cells- Dapsone is known to cause hemolysis especially in G6PD deficiency patients, another hallmark cell of G6PD is Heinz bodies
B. Maltese Cross- Babbessia infection
C. Starry Sky Appearance- Burkitt’s Lymphoma
D. Auer Rods- AML
E. Howell Jolly Bodies- Hereditary Spherocytosis ( after splenectomy) or Sickle Cell Anemia
A 33 year old female who recently traveled to West Africa presents with SOB and a productive cough with blood-tinged sputum. CXR shows a 3cm masses in the upper lung lobes bilaterally. She recalls being bitten a lot by mosquitos while on her trip. The drug you treat her with is known to cause peripheral neuritis. What should you also prescribe to prevent this adverse effect? (MG)
A. Isoniazid B. Pyridoxine supplement C. Folate supplement D. Rifampin E. Rifabutin
B. Pyridoxine supplement
Dx = mycobacterium tuberculosis
First line tx is isoniazid which causes peripheral neuritis which can be prevented with pyridoxine supplementation
A 44 year old immigrant form India presents with peripheral nerve deterioration with small pits in the oral mucosa. Biopsy of the lungs shows granulomatous material. You treat with Dapsone. What other disease that we learned about can you treat with dapsone if the patient is HIV+? (MG)
A. CMV B. RSV C. H. Influenzae D. P. jiroveci E. Asperillis
D. P. jiroveci
Dx = leprosy
