Which one of the following adverse effects is most likely to occur with sulfonamides?

Correct Answer: D

Rationale: The correct answer is D) Skin reaction. Sulfonamides are known to commonly cause skin reactions such as rash, hives, and photosensitivity. This is due to their mechanism of action and their potential to cause allergic reactions in some individuals. It is important to recognize and monitor for these skin reactions when administering sulfonamides to patients. Option A) Neurologic effects are not typically associated with sulfonamides. While some medications can cause neurologic side effects, sulfonamides are more commonly known for their dermatologic effects. Option B) Hematuria is not a typical adverse effect of sulfonamides. Hematuria, which is the presence of blood in urine, is not a commonly reported side effect of this class of drugs. Option C) Fanconi's aminoaciduria syndrome is not a known adverse effect of sulfonamides. This syndrome is a rare genetic disorder that affects the kidneys' ability to reabsorb certain substances, and it is not directly related to sulfonamide medications. Educationally, understanding the common adverse effects of different classes of drugs is crucial for healthcare professionals to provide safe and effective care to their patients. By knowing the characteristic side effects of sulfonamides, healthcare providers can monitor for, manage, and educate patients about potential reactions to these medications.

Correct Answer: D

Rationale: In this scenario, the optimal management for a patient with AIDS and a CD4 cell count of 100/μL presenting with invasive pulmonary disease due to M avium complex is to treat the patient with clarithromycin, ethambutol, and rifabutin (Option D). This combination of drugs is a standard regimen for treating M avium complex infections, especially in immunocompromised patients like those with AIDS. Clarithromycin is a macrolide antibiotic that is effective against MAC, while ethambutol and rifabutin are also recommended for this type of infection. Ethambutol helps prevent the development of resistance, and rifabutin is used to prevent MAC bacteremia. Option A is incorrect because rifabutin alone is not sufficient for treating MAC infections. Option B is also incorrect because waiting for drug susceptibility results may delay treatment, and MAC is inherently resistant to many antibiotics. Option C is incorrect as INH and pyrazinamide are used for treating tuberculosis, not MAC infections. Educationally, understanding the appropriate treatment for opportunistic infections in immunocompromised patients is crucial for healthcare providers caring for such individuals. This case highlights the importance of prompt and effective treatment to improve patient outcomes and prevent disease progression in vulnerable populations.

Correct Answer: A

Rationale: The correct answer is A) Amikacin. Amikacin is an aminoglycoside antibiotic that is known for its ototoxicity and potential to cause loss of equilibrium and auditory damage. Aminoglycosides can damage the sensory cells in the inner ear and the vestibular system, leading to symptoms such as dizziness, loss of balance, and hearing loss. Option B) Ethambutol is used in the treatment of tuberculosis and is known to cause optic neuritis, which can result in visual disturbances but not loss of equilibrium or auditory damage. Option C) Isoniazid is also used in the treatment of tuberculosis, but it is not associated with loss of equilibrium or auditory damage. Option D) Para-aminosalicylic acid is another anti-tuberculosis medication that is not known to cause loss of equilibrium or auditory damage. In an educational context, understanding the side effects of medications is crucial for healthcare professionals to provide safe and effective care to patients. By knowing the potential adverse effects of drugs like Amikacin, healthcare providers can monitor patients closely, educate them on what to look out for, and take appropriate actions to prevent or manage these side effects. This knowledge helps in promoting patient safety and optimizing treatment outcomes.

Correct Answer: D

Rationale: In the context of ABVD chemotherapy drugs and the treatment of esophageal candidiasis, the correct answer is D) Griseofulvin. Griseofulvin is an antifungal medication primarily used to treat dermatophyte infections of the skin, hair, and nails. It is not typically effective against systemic fungal infections like esophageal candidiasis because it is not well-absorbed when taken orally. Amphotericin B (Option A) is a broad-spectrum antifungal agent used for severe systemic fungal infections but is not the ideal choice for esophageal candidiasis due to its toxicity and route of administration. Clotrimazole (Option B) is an antifungal medication commonly used for local infections like vaginal yeast infections or oral thrush, but it is not the first-line treatment for esophageal candidiasis. Fluconazole (Option C) is an antifungal drug that is frequently used for esophageal candidiasis because it is well-absorbed orally and has good efficacy against Candida species. In an educational context, understanding the appropriate use of antifungal medications is crucial for healthcare professionals involved in the treatment of fungal infections. Knowing the mechanisms of action, spectrum of activity, routes of administration, and potential side effects of these drugs helps in making informed decisions for patient care. Correctly identifying which antifungal agent is most suitable for specific fungal infections is essential to ensure effective treatment outcomes and prevent the development of drug resistance.

Correct Answer: B

Rationale: The correct answer is B) The reverse transcriptase of HIV is 30-50 times more sensitive to inhibition by indinavir than host cell DNA polymerases. This statement is least accurate because antiviral drugs like indinavir target viral enzymes specifically, not host cell enzymes. Indinavir is a protease inhibitor that interferes with the activity of the HIV protease enzyme, not host cell DNA polymerases. Option A is accurate because famciclovir is activated by viral thymidine kinase in HSV-infected cells. Option C is also accurate as ganciclovir inhibits viral DNA polymerase but does not cause chain termination. Option D is true as interferons induce the degradation of viral RNA by activating host cell enzymes like phosphodiesterases that degrade tRNA. In an educational context, understanding the mechanisms of action of antiviral drugs is crucial for healthcare professionals to effectively treat viral infections. Knowing how these drugs specifically target viral components without harming host cells is essential for providing safe and efficient patient care. Understanding the inaccuracies in statements helps in ensuring accurate knowledge and practice in clinical settings.