Cert ID(SA) Phys Practice Questions - CMSA Sub-specialty Certificate In Infectious Diseases Cert ID(SA) Phys - South Africa Exam

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A 50-year-old woman with pre-XDR pulmonary tuberculosis (rifampicin-resistant and moxifloxacin-resistant) is started on an individualized treatment regimen containing Linezolid 600 mg daily, Bedaquiline, Pretomanid, Clofazimine, and Terizidone. Four weeks into therapy, she develops progressive numbness, tingling, and burning pain in both feet, along with routine laboratory monitoring showing hemoglobin drop from 11.5 g/dL to 8.1 g/dL. Which drug is responsible for these adverse effects, and what is the optimal management?

Pretomanid; discontinue pretomanid and monitor liver enzymes weekly Linezolid; reduce dose to 300 mg daily (or temporary hold if severe) and administer Pyridoxine (Vitamin B6) Terizidone; stop terizidone and initiate Pyrazinamide Bedaquiline; stop bedaquiline permanently and switch to Amikacin

Correct Answer:

Linezolid; reduce dose to 300 mg daily (or temporary hold if severe) and administer Pyridoxine (Vitamin B6)

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