You are seeing a patient in clinic who recently started treatment for active tuberculosis. The patient is currently being treated with rifampin, isoniazid, pyrazinamide, and ethambutol. The patient is not used to taking medicines and is very concerned about side effects. Specifically regarding the carbohydrate polymerization inhibiting medication, which of the following is a known side effect?
AVision loss
BParesthesias of the hands and feet
CCutaneous flushing
DArthralgias
EElevated liver enzymes
A 25-year-old male is brought to the emergency department by his friends after a camping trip. He and his friends were in the woods camping when the patient started experiencing severe right upper quadrant abdominal pain after foraging and ingesting some wild mushrooms about 3 hours earlier. The patient is lethargic on exam and appears jaundiced. He has scleral icterus and is severely tender to palpation in the right upper quadrant. He has scattered petechiae on his extremities. Liver function tests are: Serum: Na+: 134 mEq/L Cl-: 100 mEq/L K+: 4.2 mEq/L HCO3-: 24 mEq/L Urea nitrogen: 50 mg/dL Glucose: 100 mg/dL Creatinine: 1.4 mg/dL Alkaline phosphatase: 400 U/L Aspartate aminotransferase (AST, GOT): 3278 U/L Alanine aminotransferase (ALT, GPT): 3045 U/L gamma-Glutamyltransferase (GGT): 100 U/L The most likely cause of this patient’s clinical presentation acts by inhibiting which of the following molecules?
ARNA polymerase II
BRNA polymerase III
CTopoisomerase
DRNA polymerase I
EProkaryote RNA polymerase
An investigator is studying the genetic profile of an isolated pathogen that proliferates within macrophages. The pathogen contains sulfatide on the surface of its cell wall to prevent fusion of the phagosome and lysosome. She finds that some of the organisms under investigation have mutations in a gene that encodes the enzyme required for synthesis of RNA from a DNA template. The mutations are most likely to reduce the therapeutic effect of which of the following drugs?
APyrazinamide
BEthambutol
CRifampin
DStreptomycin
ELevofloxacin
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