UW - mycobacteria in HIV

[osli]

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So one question describes an HIV patient with vague symptoms and disseminated acid fast bacteria, and asks for the likely organism. I go with MAC, and miss it because UW says "Tuberculous mycobacteria are still much more common in AIDS than MAC - you should remember that stupid!"

So another recent question describes an HIV patient with vague symptoms and disseminated AFB, and asks what prophylactic antibiotic might have prevented the current condition. And I miss it because I chose isoniazid which is prophylactic for TB, and "azithromycin is prophylactic for MAC, you stupid!"

🙄 Way to go UW. That's why 15% got that last question, and not much better on the first.

Sorry, just finished a block with at least half a dozen "15%" questions and silently shaking my head at the screen wasn't giving me enough satisfaction. 🙂 On a happy note, my last three blocks have averaged 10% above my cumulative... and the big change was that I started reviewing FA finally for the low hanging fruit. All hail FA! I guess I should be prepared for that 40% ego smackdown that I know must now be coming...

 

[DrFraud]

So one question describes an HIV patient with vague symptoms and disseminated acid fast bacteria, and asks for the likely organism. I go with MAC, and miss it because UW says "Tuberculous mycobacteria are still much more common in AIDS than MAC - you should remember that stupid!"

So another recent question describes an HIV patient with vague symptoms and disseminated AFB, and asks what prophylactic antibiotic might have prevented the current condition. And I miss it because I chose isoniazid which is prophylactic for TB, and "azithromycin is prophylactic for MAC, you stupid!"

🙄 Way to go UW. That's why 15% got that last question, and not much better on the first.

Sorry, just finished a block with at least half a dozen "15%" questions and silently shaking my head at the screen wasn't giving me enough satisfaction. 🙂 On a happy note, my last three blocks have averaged 10% above my cumulative... and the big change was that I started reviewing FA finally for the low hanging fruit. All hail FA! I guess I should be prepared for that 40% ego smackdown that I know must now be coming...

I can tell you first hand a lot of the <25% UW questions can be disheartening, but when I was taking the step, I saw question after question almost verbatum from UW.

 

[Femtochemistry]

that's too funny...i am going through UW for the 2nd time around and I noticed that last night! I thought I was just hallucinating...

UW is tricky...they use the same question a few times I noticed and change ONE word and the whole answer changes...So, you can't depend on reading the first few words of a question you "might" have answered correctly before.

 

[Its_MurDAH]

that's too funny...i am going through UW for the 2nd time around and I noticed that last night! I thought I was just hallucinating...

UW is tricky...they use the same question a few times I noticed and change ONE word and the whole answer changes...So, you can't depend on reading the first few words of a question you "might" have answered correctly before.

Yea, the word prophylaxis immediately tells you you have to watch out for MAI. Still, that is tricky as ****.

 

[doc20]

this is a little bit step 2 stuff,
but either ways TB prophylaxis is really PPD test, we dont give INH to everyone who are HIV + , just to the one who are ppd + ve.

 

[ladynice]

this is a little bit step 2 stuff,
but either ways TB prophylaxis is really PPD test, we dont give INH to everyone who are HIV + , just to the one who are ppd + ve.

What do you do when the PPD test is negative due to AIDS?

 

[45408]

What do you do when the PPD test is negative due to AIDS?

lol, now you've gone and done it...

 

[ladynice]

lol, now you've gone and done it...

What have i done now?

 

[doc20]

What do you do when the PPD test is negative due to AIDS?

umm we do nothing if the PPD -ve on HIV + patients.
only when HIV + PPD+VE , start INH, and there are different standards on reading PPD on this patients, and how often they should be getting one

 

[osli]

But AIDS can easily cause a PPD to be negative in a TB + patient due to anergy. Even with the reduced size criteria, you can easily miss a lot of TB.

But your answer stands... you do nothing, because we have no better/quicker/easier screening test. It sucks to have AIDS.