Test TOM - Ordre Des Médecins Practice Questions - Test Préalable à L'Inscription Au Tableau De L'Ordre Des Médecins (Test TOM, DR Congo) Exam

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A 38-year-old HIV-infected woman (CD4 count 85 cells/uL) presents with a 2-week history of worsening dry non-productive cough, progressive exertional dyspnea, and low-grade fever. Arterial blood gas on room air shows PaO2 of 58 mmHg (pulse oximetry 88%). Chest radiograph reveals bilateral symmetrical perihilar interstitial ground-glass infiltrates. What is the most appropriate definitive therapeutic regimen?

Intravenous Ciprofloxacin 400 mg twice daily alone for 7 days High-dose oral or intravenous Trimethoprim-Sulfamethoxazole (TMP-SMX, 15–20 mg/kg/day of TMP) for 21 days PLUS adjunctive systemic Prednisone tapered over 21 days Inhaled Pentamidine 300 mg once monthly as primary monotherapy without oral steroids Amoxicillin-Clavulanate 1g three times daily plus Clarithromycin for 10 days

Correct Answer:

High-dose oral or intravenous Trimethoprim-Sulfamethoxazole (TMP-SMX, 15–20 mg/kg/day of TMP) for 21 days PLUS adjunctive systemic Prednisone tapered over 21 days

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