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  #1  
Old 02-23-2012
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Default pediatrics...TB

A 3-year-old girl is admitted with the x-ray shown below. The child lives
with her parents and a 6-week-old brother. Her grandfather stayed with the
family for 2 months before his return to the West Indies 1 month ago. The
grandfather had a 3-month history of weight loss, fever, and hemoptysis.
Appropriate management of this problem includes which of the following?

a. Bronchoscopy and culture of washings for all family members
b. Placement of a Mantoux test on the 6-week-old sibling
c. Isolating the 3-year-old patient for 1 month
d. Treating the 3-year-old patient with isoniazid (INH) and rifampin
e. HIV testing for all family members

please give your reason too
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  #2  
Old 02-23-2012
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Quote:
Originally Posted by tyagee View Post
A 3-year-old girl is admitted with the x-ray shown below. The child lives
with her parents and a 6-week-old brother. Her grandfather stayed with the
family for 2 months before his return to the West Indies 1 month ago. The
grandfather had a 3-month history of weight loss, fever, and hemoptysis.
Appropriate management of this problem includes which of the following?

a. Bronchoscopy and culture of washings for all family members
b. Placement of a Mantoux test on the 6-week-old sibling
c. Isolating the 3-year-old patient for 1 month
d. Treating the 3-year-old patient with isoniazid (INH) and rifampin
e. HIV testing for all family members

please give your reason too
It depends on chest x ray..if its positive then answer should be d. but it should be isoniazid for 9 months ..i am not sure of rifampin..

may be B also but 1 month isolation is good with therapy
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  #3  
Old 02-23-2012
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Quote:
Originally Posted by tyagee View Post
A 3-year-old girl is admitted with the x-ray shown below. The child lives
with her parents and a 6-week-old brother. Her grandfather stayed with the
family for 2 months before his return to the West Indies 1 month ago. The
grandfather had a 3-month history of weight loss, fever, and hemoptysis.
Appropriate management of this problem includes which of the following?

a. Bronchoscopy and culture of washings for all family members
b. Placement of a Mantoux test on the 6-week-old sibling
c. Isolating the 3-year-old patient for 1 month
d. Treating the 3-year-old patient with isoniazid (INH) and rifampin
e. HIV testing for all family members

please give your reason too
if the x ray shows findings of TB then D...
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  #4  
Old 02-24-2012
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Originally Posted by missgeorge View Post
Bronchoscopy and culture of washings for all family members
whats the reason??
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  #5  
Old 02-24-2012
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D is the correct answer,
Bronchoscopy and culture of washings for all family members
is not correct.
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  #6  
Old 02-25-2012
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Originally Posted by tyagee View Post
D is the correct answer,
Bronchoscopy and culture of washings for all family members
is not correct.
I thought any patient with positive chest x ray we give isoniazid for 9 months ....so we should give rifampicin also?...and for how many months?...what are indication for rifampicin?...

I think we have to give rifampicin only to
meningitis exposure
close contacts
and health care worker dealing with patient
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