Sunday, 7 May 2017
Saturday, 17 September 2016
LEGIONELLA
LEGIONELLA
Q.Which of the following organisms, if found on a sputum culture,
definitely indicates infection?
A. Chlamydia pneumoniae
B. Pneumococcus
C. Haemophilus influenzae
D. Legionella pneumophila
E. Moraxella
A. Chlamydia pneumoniae
B. Pneumococcus
C. Haemophilus influenzae
D. Legionella pneumophila
E. Moraxella
D. Legionella is not known to be a colonizer; if it is found on
culture, it should be treated. While Mycoplasma and Chlamydia cultures
are rarely sent, these organisms can be found in asymptomatic subjects, so
their mere presence does not require treatment. Moraxella, Haemophilus,
and Pneumococcus can also be colonizers in asymptomatic patients. However,
they should be treated in a patient with clinical signs of pneumonia and one of
these organisms predominating in a sputum Gram stain and culture.
ATD
ATD
Q.Which of the following drugs is a first-line agent against TB?
A. Streptomycin
B. Pyrazinamide
C. Para-aminosalicylic acid (PAS)
D. Levofloxacin
E. Cycloserine
A. Streptomycin
B. Pyrazinamide
C. Para-aminosalicylic acid (PAS)
D. Levofloxacin
E. Cycloserine
Ans:B.
Pyrazinamide is one of the four first-line TB drugs. The other listed
drugs are second line because of decreased or less proven efficacy, the
necessity for parenteral administration
(streptomycin), serious side effects (PAS and cycloserine), or cost and
reservation for other uses (levofloxacin).
RIFAMPICIN
RIFAMPICIN
Q. Which of the following side effects occurs commonly with the administration
of rifampin for N. meningitides chemoprophylaxis?
A. Liver failure
B. Renal failure
C. Orange discoloration of secretions
D. Anemia
E. Leukopenia
A. Liver failure
B. Renal failure
C. Orange discoloration of secretions
D. Anemia
E. Leukopenia
Ans: C.
Rifampin will turn all of an individual’s secretions, such as urine,
sweat, tears, and stool, an orange color. Contact lenses can be permanently
stained with this orange discoloration. This side
effect is a source of great consternation to individuals who are not
warned of its possibility.
EMPHYSEMATOUS CHOLECYSTITIS
EMPHYSEMATOUS CHOLECYSTITIS
Q. What is the
diagnosis in this diabetic woman?
(a) Toxic
megacolon
(b)
Emphysematous cholecystitis
(c) Ileus
(d)
Diverticular disease
(e) Volvulus
Ans: b.
The diagnosis here is emphysematous
cholecystitis because air can be seen in the wall of the gallbladder. The
condition, due to infection, most commonly occurs in elderly female diabetics
and is usually caused by coliforms.
Causes of gas in the biliary tree
Within the bile ducts
1.
Incompetence of the sphincter of Oddi following
sphincterotomy, passage of a
gallstone or in the elderly (‘patulous sphincter’)
2.
Postoperative cholecystectomy or choledochoenterostomy
3.
Spontaneous biliary fistula due to passage of
gallstone from gallbladder to bowel,
duodenal ulcer
perforating into common bile duct, tumour or malignancy
Within the gallbladder-
• Emphysematous cholecystitis
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