Tuberculosis Treatment

A 32-year-old man from rural Maharashtra presents with a 3-month history of cough, fever, and weight loss. Sputum smear microscopy is positive for acid-fast bacilli. He is started on standard first-line anti-TB therapy (HRZE). After 2 months of treatment, repeat sputum smear microscopy remains positive. Which investigation is most appropriate to assess treatment failure and guide further management?

A 28-year-old woman with newly diagnosed pulmonary tuberculosis is started on standard first-line therapy (HRZE). She is also on oral contraceptives for menstrual regulation. After 1 month, she reports breakthrough bleeding and is concerned about contraceptive failure. What is the mechanism of this drug–drug interaction and which anti-TB agent is primarily responsible?

A 28-year-old woman with newly diagnosed pulmonary TB is about to start anti-TB therapy. She reports taking oral contraceptives for the past 2 years. Before initiating treatment, which investigation is most appropriate to assess baseline organ function and guide drug dosing?

A 32-year-old man from rural Maharashtra presents with a 3-month history of productive cough, fever, and night sweats. Chest X-ray shows cavitary lesions in the right upper lobe. Sputum smear microscopy is positive for acid-fast bacilli. He is started on standard first-line anti-TB therapy (HRZE). After 2 months of treatment, repeat sputum smear remains positive despite good adherence. What is the most appropriate next step in management?

A 28-year-old woman with newly diagnosed pulmonary TB is started on standard first-line therapy (HRZE). She is also on oral contraceptives for menstrual regulation. After 4 weeks of TB treatment, she reports breakthrough bleeding and is concerned about contraceptive failure. What is the most appropriate counseling and management?