drdg
Forum Senior
Topics: 31
Posts: 176
|
A 35-year-old HIV positive male comes to the physician's office because of pain on swallowing and substernal burning for the last 3 days. Exam of the oral cavity is undermarkable. Lungs are clear to auscultation and percussion. His current medications include zidovudine, didanosine, indinavir, TMP/SMZ, and azithromycin. His last CD4 count is 40 cells/microl. What is the most appropriate next step management of this patient?
A. Esophagoscopy with biopsy, cytology and culture.
B. Oral Fluconazole
C. Oral Famotidine
D. Oral Acyclovir
E. Oral Ganciclovir
|
| neuroblastoma
Forum Guru
Topics: 99
Posts: 1,011
|
B
___________________
yahoo mesenger and skype ID asdvsd2003
|
| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,242
|
B ) Candidiasis (Oral Trush is not necessary to make the diagnosis )
___________________
The elevator to succes is broke ,you must take the stairs
|
| titly
Forum Elite
Topics: 17
Posts: 290
|
B
___________________
we spend our days waiting for the ideal path to appear in front of us, but, what we forget is paths are made by walking, not by waiting. keep walking................................
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
 B. Oral Fluconazole
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
| aaroho
Forum Junior
Topics: 8
Posts: 75
|
I think it's A coz examination of the oral cavity was unremarkable and his last cd4 was 40 so it could be candida or cmv or herpes or even hiv induced lesions.
What do u say drdg?
___________________
Life is wonderful when doctors all around
|
| Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
|
B. oral fluconazole. if not resolution of symptoms, then follow up with esophagoscopy, w/cytology, biopsy and culture.
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
|
| dr_farheenaftab
Forum Newbie
Topics: 1
Posts: 8
|
E. Oral Gancyclovir.
I think this is Oral Gancyclovir because it seems to be CMV Esophagitis.
|
| Ivonne
Forum Guru
Topics: 52
Posts: 1,398
|
Right answer is B fluconazol, just checked UW.
Candida most common cause of esophagitis in HIV------->empiric treatment with fluconazol---------->if no response in 3 to 5 days---------->further work up(A)
___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)
|
|
| |
| | | | | | | | | |
