By Eric P. Purdy, MD

ISBN-10: 1615251081

ISBN-13: 9781615251087

Covers systemic health conditions probably to impact ophthalmic sufferers, corresponding to infectious, metabolic, neurologic and cardiovascular illnesses; melanoma; and rheumatic and endocrine issues. incorporates a dialogue of preventive drugs and scientific emergencies, in addition to geriatrics and facts. Ophthalmic issues are highlighted all through. comprises a number of up to date references and tables directory the names, symptoms and uncomfortable side effects of antibiotic, antihypertensive and anticancer medications. lately revised 2010 2011.

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Extra info for 2011-2012 Basic and Clinical Science Course, Section 1: Update on General Medicine (Basic & Clinical Science Course)

Sample text

All of the agents currently used have toxic side effects, especially hepatic and neurologic, which should be carefully monitored during the course of therapy. Isoniazid and ethambutol can cause optic neuritis in a small percentage of patients, and rifampin may cause pink-tinged tears and blepharoconjunctivitis. Outbreaks of nosocomial and community-acquired multidrug-resistant TB (MORTB) have increased, particularly in the presence of concurrent HIV infection. MORTB in patients infected with HIV is associated with widely disseminated disease, poor treatment response, and substantial mortality.

PCP is generally treated with IV trimethoprim-sulfamethoxazole (TMP-SMX; Bactrim. Septra). Inhaled pentamidine (NebuPent) prevents the recurrence of PCP (secondary prophylaxis) and appears to be efficacious for primary prophylaxis when used in patients with HIV infection and CD4 counts less than 200/mm' . The regimen for inhaled pentamidine is generally 300 mg every 4 weeks using a nebulizer. This form of therapy avoids the toxicity of systemically administered pentamidine. Several studies show that oral TMP-SMX prophylaxis is more effective than aerosolized pentamidine for PCP prophylaxiS in those patients who can tolerate it.

It also appears to be less affected by previous BCG (bacille Calmette-Guerin) vaccination. The BCG vaccine causes false-positive reactions to the PPO skin test and thus interferes with the efficacy of the test as a diagnostic and epidemiologic tool. The false-positive effect of BCG decreases over time, so PPO may still be useful in patients with previous BCG administration. Among patients in whom skin testing yields positive results, the overall risk of reactivation of the disease is 3%-5%. A positive PPO test result should be considered in light of the individual patient's radiologic and clinical data as well as age to determine the need for prophylactic treatment.

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