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Katzung Pharm-Antimicrobials Pt. 1

Terms in this set (50)

A 21-year-old woman from Southeast Asia has been staying with family members in the United States for the last 3 mo and is looking after her sister's preschool children during the day. Because she has difficulty with the English language, her sister escorts her to the emergency department of a local hospital. She tells the staff that her sister has been feeling very tired for the last month, has a poor appetite, and has lost weight. The patient has been feeling somewhat better lately except for a cough that produces a greenish sputum, sometimes specked with blood. With the exception of rales in the left upper lobe, the physical examination is unremarkable and she does not seem to be acutely ill. Laboratory values show a white count of 12,000/μL and a hematocrit of 33%. Chest x-ray film reveals an infiltrate in the left upper lobe with a possible cavity. A Gram-stained smear of the sputum shows mixed flora with no dominance. An acid-fast stain reveals many thin rods of pinkish hue. A preliminary diagnosis is made of pulmonary tuberculosis. Sputum is sent to the laboratory for culture.
At this point, the most appropriate course of action is to
(A) Hospitalize the patient and start treatment with 4 anti-tubercular drugs
(B) Hospitalize the patient and start treatment with rifampin
(C) Prescribe isoniazid for prophylaxis and send the patient home to await culture results
(D) Provide no drugs and send the patient home to await culture results
(E) Treat the patient with isoniazid plus rifampin
A 21-year-old woman from Southeast Asia has been staying with family members in the United States for the last 3 mo and is looking after her sister's preschool children during the day. Because she has difficulty with the English language, her sister escorts her to the emergency department of a local hospital. She tells the staff that her sister has been feeling very tired for the last month, has a poor appetite, and has lost weight. The patient has been feeling somewhat better lately except for a cough that produces a greenish sputum, sometimes specked with blood. With the exception of rales in the left upper lobe, the physical examination is unremarkable and she does not seem to be acutely ill. Laboratory values show a white count of 12,000/μL and a hematocrit of 33%. Chest x-ray film reveals an infiltrate in the left upper lobe with a possible cavity. A Gram-stained smear of the sputum shows mixed flora with no dominance. An acid-fast stain reveals many thin rods of pinkish hue. A preliminary diagnosis is made of pulmonary tuberculosis. Sputum is sent to the laboratory for culture.
Which statement concerning the possible use of isoniazid (INH) in this patient is false?
(A) Dyspnea, flushing, palpitations, and sweating may occur after ingestion of tyramine-containing foods
(B) In patients from Southeast Asia, lower maintenance doses are necessary
(C) Peripheral neuritis may occur during treatment
(D) The patient should take pyridoxine daily
(E) The risk of the patient developing hepatitis from INH is less than 2%