Q1) All of the following drugs are used in the treatment of Pneumocystis carni pneumonia, EXCEPT:
A. Pentamidine
B. Dapsone
C. Cotrimoxazole
D. Fluoroquinolones
ANSWER & EXPLANATION
Answer: D. Fluoroquinolones
Explanation: Trimethoprim-sulfamethoxazole (Cotrimoxazole) is the drug of choice of Pneumocystis carini pneumonia. Other drugs effective in its treatment are dapsone, pentamidine, atovaquone, primaquine and clindamycin. Methylprednisolone is also indicated in HIV positive patients with moderate to severe PCP. Fluoroquinolones are not indicated in its treatment.
Q2) A 30- year old HIV positive patient presents with fever, dyspnoea and non- productive cough. Patient is cyanosed. His chest X- ray reveals bilateral, symmetrical interstitial infiltrates. Which of the following is the most likely diagnosis?
A. Tuberculosis
B. Cryptococcosis
C. Toxoplasmosis
D. Pneunocystis carinii pneumonia
Answer: D. Pneunocystis carinii pneumonia
Explanation: This HIV positive patient is showing clinical features and X- ray findings suggestive of pneumocystis carnii pneumonia. PCP infection occur in HIV positive individuals with CD4 count less than 200. It is an opportunistic fungal pulmonary pathogen that is an important cause of pneumonia in the immunocompromised host.