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Vitamin A
0%
0/20
Vitamin B6
80%
16/20
Vitamin B12
15%
3/20
Vitamin C
Vitamin E
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This patient likely suffered from tuberculosis and underwent treatment with isoniazid, which should be prescribed with vitamin B6 (pyridoxine) to decrease the risk of developing peripheral neuropathy. The first-line agent used in the treatment of latent tuberculosis is isoniazid. Peripheral neuropathy and CNS effects are common side effects associated with the use of isoniazid, and are due to pyridoxine depletion. Patients with conditions that predispose them to neuropathy (e.g., diabetes, uremia, alcoholism, malnutrition, HIV), as well as pregnant women and those with seizure disorders should be given pyridoxine (10–50 mg/day) with isoniazid. Inge et al. review the treatment of tuberculosis. Nine months of isoniazid therapy is the treatment of choice for most patients with latent tuberculosis infection. When active tuberculosis is identified, combination therapy with isoniazid, rifampin, pyrazinamide, and ethambutol should be started for 2 months, followed by isoniazid and rifamycin combination therapy for 4 to 7 more months. Churchyard et al. discuss the effects of screening on the incidence of tuberculosis. They demonstrate that mass screening and treatment for latent tuberculosis does not lead to more effective tuberculosis control. This program resulted in a decreased incidence of tuberculosis during the 9-month treatment with isoniazid, but this benefit was not sustained after treatment was completed. Figure A shows a chest radiograph depicting a right sided apical cavitary lesion, a classic lesion associated with active tuberculosis infection. Illustration A lists the various antibiotics used in the treatment of tuberculosis, along with their adverse effects and interactions with other drugs. Incorrect answers: Answer 1: Vitamin A deficiency may result in night blindness. Answer 3: Vitamin B12 deficiency may also cause peripheral neuropathy, but it is not associated with isoniazid treatment. Answer 4: Vitamin C deficiency leads to impaired collagen synthesis, which can cause poor integrity of the gums and other tissues in the body. Answer 5: Vitamin E deficiency also causes neurological problems but is not associated with isoniazid therapy.
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