A 40-year old patient presents with symptoms suggestive of tuberculosis (TB). What is the confirmatory test for TB?
Interferon Gamma Release Assays (IGRAS)
Sputum culture
Tuberculin Skin Test (TST)
Chest X-ray
The Correct Answer is B
A. Interferon Gamma Release Assays (IGRAs): IGRAs are useful for detecting TB infection but do not confirm active TB disease. They measure the immune response to TB bacteria but don’t differentiate between latent and active infection.
B. Sputum culture: Sputum culture is the gold standard for confirming active TB because it identifies Mycobacterium tuberculosis bacteria directly, confirming active infection.
C. Tuberculin Skin Test (TST): The TST can indicate TB infection but cannot distinguish between latent and active TB, making it unsuitable as a confirmatory test for active disease.
D. Chest X-ray: A chest X-ray can show signs suggestive of TB but cannot confirm the presence of TB bacteria, so it is not definitive for diagnosing active TB.
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Correct Answer is A
Explanation
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.
Correct Answer is B
Explanation
A. Ciprofloxacin, Metronidazole, and Ranitidine: Ciprofloxacin and ranitidine are not recommended for H. pylori treatment. Ciprofloxacin is not typically used, and ranitidine is an H2 blocker, not a proton pump inhibitor.
B. Amoxicillin, Clarithromycin, and Omeprazole: This combination is a standard triple therapy for H. pylori infection. Amoxicillin and clarithromycin are antibiotics, and omeprazole (a proton pump inhibitor) reduces stomach acid to help eradicate the bacteria.
C. Metronidazole, Tetracycline, and Bismuth subsalicylate: This combination is part of quadruple therapy rather than triple therapy. Quadruple therapy is usually reserved for cases resistant to initial treatment.
D. Erythromycin, Amoxicillin, and Famotidine: Erythromycin is not part of standard triple therapy, and famotidine is an H2 blocker, not a proton pump inhibitor.