If you find the material on this website useful, you will find that the two books ACES for PACES and KEYS to SUCCESS in Medicine complement the material on these sites and will enhance your studying and revision
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If you find the material on this website useful, you will find that the two books ACES for PACES and KEYS to SUCCESS in Medicine complement the material on these sites and will enhance your studying and revision
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BOF: 10 A 55-year-old male comes for his follow up appointment to the respiratory clinic. He has been diagnosed as having pulmonary tuberculosis and has been discharged from hospital 2 weeks prior to clinic attendance on a regime that consists of rifampicin, isoniazid, ethambutol, pyrazinamide and pyridoxine. He is a homeless alcoholic who has been housed in a hostel. He says he does not feel well, no appetite, he is losing weight and has a productive cough. His urine is clear and not discoloured. On examination he looked unwell, had lost weight and examination of the respiratory system revealed fine crepitations in both upper zones. The chest x-ray shows shadowing in the upper lobes that are more extensive than the changes seen whilst he was an inpatient. In this patient which one of the following would be the best option to follow: a) Take repeat samples of sputum for culture and sensitivity and adjust treatment according to the sensitivities b) Add streptomycin to his treatment regime c) Start him on steroids d) Give him treatment as directly observed therapy (DOT) e) Add ciprofloxacin |
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