Cert Pulmonology(SA) Phys Practice Questions - Sub-specialty Certificate In Pulmonology Of The College Of Physicians Of South Africa Exam

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A 29-year-old HIV-infected male with pulmonary TB started ART 3 weeks ago (baseline CD4 18 cells/µL). He presents with worsening fever, cough, new cervical lymphadenopathy, and expanding pulmonary infiltrates on chest radiograph. Sputum Xpert Ultra shows no new drug resistance. What is the most appropriate management step?

Discontinue ART immediately and switch anti-TB drugs to second-line regimen Continue ART and anti-TB therapy, and initiate oral Prednisone (1.5 mg/kg/day) Add broad-spectrum antifungal cover with Fluconazole and stop ART Stop anti-TB therapy and perform immediate lymph node excisional biopsy

Correct Answer:

Continue ART and anti-TB therapy, and initiate oral Prednisone (1.5 mg/kg/day)

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