Chapter 64 Tuberculosis Sample Questions
1. JM is a 30 year old woman showed up for her monthly check-up at her OB-GYN’s clinic. She is on first trimester of pregnancy. At this encounter, JM brought up her concern regarding her medical history that she thinks might put her baby at risk. JM has history of tuberculosis. JM denied signs or symptoms such as cough, blood-tinged sputum, fever, or weight loss. However, a positive result (15 mm induration) on her purified protein derivative (PPD) tuberculin skin test was noted. OB-GY diagnosed JM with latent tuberculosis infection (LTBI). JM is only taking prenatal vitamins and indicates that she is living in an INH-resistant area. What is the best choice her doctor can give her as prophylaxis for TB reactivation?
- A. Wait until the second trimester to initiate treatment
- B. Start immediate INH + Rifadin
- C. Rifadin for 4 months
- D. INH+RIF+PZA+EM for 6 months
Ans:
C
Tips: This is not an active therapy, therefore no aggressive therapy required; the need for combinations is not needed. Patient is in INH-resistant area thus better option is Rifadin for 4 months. However, in patients without high risk of disease, withhold latent therapy until 3 months postpartum to reduce the risk of hepatotoxicity.
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