A 38-Year-Old Man Comes to the Physician Because of a 1-Month

question 114

Multiple Choice

A 38-year-old man comes to the physician because of a 1-month history of fever and a cough productive of a moderate amount of yellowish sputum. He has had a 6-kg (13-lb) weight loss during this period. He emigrated from the Middle East around 2 years ago. His father died of lung cancer at the age of 54 years. He has smoked one pack of cigarettes daily for 18 years. His only medication is a daily multivitamin. He appears malnourished. Sputum cultures grow acid-fast bacilli that are susceptible to most antimycobacterial drugs in vitro.  Isoniazid monotherapy in this patient would most likely result in:

• A)Bacteriocidal effect on only extracellular bacilli
• B)Decreased transport protein expression on the cell surface
• C)Beta-lactamase induction within bacterial cells
• D)Rapid mycobacterial elimination from the body
• E)Selective survival of bacterial cells secondary to gene mutation

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Definitions:

Problem

An issue or situation that presents difficulty and requires a solution.

Methods/Procedure

Established and systematic ways of doing something, involving steps or actions taken to achieve a particular end.

Interviewing

The process of asking questions and receiving answers from participants, typically used in job selection, research, or journalism.

Catastrophe

A large-scale disaster, misfortune, or failure.