Ptosis, Erythema, and Vision Loss - Case

Check out this cool ophtho case in JAMA 2013. I think the answer to the What would you do next? segment is the most important learning point.

Then, do these questions and review the answers. (Not posted here so as to not spoil the case).

Surgical Site Infections Prophylaxis

After reviewing this 2011 review article from the AFP, you should be able to answer the following questions:

1. What are the six Surgical Care Improvement Project (SCIP) performance measures?

2. In the recent study referenced in the article, approximately what percentage of surgical patients received prophylactic antibiotics within the appropriate time frame?

3. When should repeat antibiotic administration be done?

4. What is the go-to prophylactic antibiotic for most clean-contaminated surgeries?

5. When should vancomycin be used prophylactically?

6. When should metronidazole be added to the prophylactic regimen?

Answers

Tuberculosis

Comprehensive review article on tuberculosis from NEJM by Zumla et al, 2013.

Related: An article from Journal of ID, Metcalfe, et al. 2011, re: the use of inteferon-gamma release assays in diagnosis of active pulmonary TB.

CME Questions for this article from the NEJM website:

1. Risk of developing active TB among pt's with latent infection?
2. Which is true re: diagnosis of latent or active TB?
1. TB skin test is as specific as interferon-gamma release assay but less sensitive in diagnosing latent TB. 
2. solid culture medium is the standard for diagnosis of active TB. 
3. interferon gamma release assays are useful in the diagnosis of active TB. 
4. the Xpert MTB/RIF assay test is more sensitive than smear microscopy. 
3. Which is true re: HIV & TB coinfection?
1. Early ART therapy has no effect on mortality. 
2. Early ART therapy improves outcomes in pts with TB meningitis. 
3. IRIS occurs in at least 10% of HIV-infected patients who start ART during TB treatment. 
4. The most common manifestation of IRIS is a maculopapular rash.