starcraftbw
Forum Senior
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1) B
2) B
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| Kamsi
Forum Guru
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1 A
If she had TB ,it would have manifested since 10 years ago,there's no need for anything now
2 D
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| Dr.D
Forum Senior
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B It's never late to give the RX. I think so.
D Her is the exception rule for HIV patients and < 2yr old.
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| GOGETA
I'm Dr. GOGETA
Topics: 323
Posts: 2,725
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1- B (my second best answer would be D)
2- D because it is wrist if she gets the disease than the side effects from the medication(base on fisher)
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| spmvj
Forum Newbie
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1.B
2.D
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| Doc750
transfer:step 3 prison
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1. a
2. b
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| peraspera
Forum Elite
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Kamsi you're correct.
A
D
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| starcraftbw
Forum Senior
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^^Ahhhhhhhhh I'll jump down the river  ........ explain pleaseeee
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| peraspera
Forum Elite
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#1. A. If the pt had not developed TB becouse of the previous exposure, she is not going to now, there is no point in giving a pt isoniazid now to prevent TB thet would have happened years ago after the initial exposure.
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| Doc750
transfer:step 3 prison
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so on the second question, say the chick has a cd4 of 500+, are your still going to place her on prophylaxis?
I'm looking at FA, and it says for HIV+, you need an induration >5 to be considerered +. The stem says PPD neg. Now it could possibly be too soon for the test result to be positive. Which is why I think you would test again in 3 months, rather then put her on pills.
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| peraspera
Forum Elite
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According to Conrad Fischer:
Answer:
(D) Start isoniazid for a full nine months
Explanation:
If a patient has been exposed to tuberculosis (TB), and the tuberculosis skin test (PPD) is negative, you do not have to do a chest x-ray. The PPD should be repeated at three months. Most patients who have been exposed to TB and who are going to develop a positive PPD will do so within three months of the exposure, and the PPD should be repeated at 12 weeks. So, she should have the repeat test. However, it is more important to start treatment with isoniazid. There is no reason to give isoniazid to most patients if the PPD is negative. The only exception to this rule is in small children under two years of age who can have a serious exposure but still have a negative PPD because of immature T cells. The other exception is an HIV-positive patient with profound immunosupression and a very low T-cell count who has a serious exposure, such as someone in their own household. There is no routine indication for yearly chest x-rays in any population. Any person with a newly positive PPD should get a chest x-ray. This person's test, however, was negative.
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| Doc750
transfer:step 3 prison
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"The other exception is an HIV-positive patient with profound immunosupression and a very low T-cell count who has a serious exposure, such as someone in their own household"
ok that's the ticket. So if they say low CD4, or give other indications of severe immunosuppression then start INH. Otherwise it's retest in 3 months even for HIV+ individual.
thanks for the explanation.
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| starcraftbw
Forum Senior
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thanks for the explaination......... good to know now lol.....
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| usmle12
Forum Senior
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if this is the case that in hiv positive person with immunosupression we have to give isoniazid then why are we doing ppd in the first place....why not go ahead n treat every exposure of such person with isoniazid...i dont get thsi logic.....and why are u repeating ppd if u are treating the patient ....
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