Saturday, June 6, 2009

Infectious Disease for MRCP Part 2a



39 years old 39 years old Malay Man presented with fever for 1 week associated with cough, yellowish sputum, pleuritic chest pain. No haemoptysis, loss of weight or night sweats. Chronic smoker. Also has diarrhoea for 1 week. 

Examination reveals clubbing, bibasal crepitations, hepatosplenomegaly. Multiple L/N enlargement.

Hb 10

WBC 4.1

Plt 43

Na 112 K3.2 U 3.8 Cr 69

 

pH 7.43 pCO2 2.4 pO2 9.8 HCO3 12 BE -10 SpO2 95%


What is your choice of treatment ?

A. IV Ceftazidime 2 g stat and 8H

B. IV (sulfamethoxazole and trimethoprim)Bactrim 3 ampules stat & qid

C. Isoniazid, Rifampicin, Ethambutol and Pyrazinamide

D. IV Acyclovir 500 mg stat and 8H

E. IV Amphotericin B 

7 comments:

Vimala said...

B

Wuchereria said...

What are the reasons for choosing the answer?

Vimala said...

Because thats the treatment for PCP{if i'm right}.

SE said...

My answer is B. Patient has legionellosis ?

Wuchereria said...

Yes, this patient has HIV and PCP.

lee said...

How we know this patient got PCP and HIV?

Anonymous said...

Why is the patient having clubbing here? HIV is not a cause for clubbing