Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What is the treatment for toxoplasmosis?

Azithromycin and Doxycycline
Pyrimethamine and Sulfadiazine
Vancomycin and Clindamycin
Metronidazole and Clindamycin

The correct answer is: Pyrimethamine and Sulfadiazine

The treatment for toxoplasmosis, particularly in cases where the patient is immunocompromised or presents with severe disease, typically involves a combination of pyrimethamine and sulfadiazine. Pyrimethamine is an antifolate drug that inhibits dihydrofolate reductase, leading to a depletion of folate and ultimately inhibiting the replication of the Toxoplasma gondii parasites. Sulfadiazine acts as a sulfonamide antibiotic that also inhibits folate synthesis, enhancing the therapeutic efficacy when used in combination with pyrimethamine. This combination therapy is the cornerstone of treating acute toxoplasmosis and is particularly effective in reducing the parasitic load, subsequently improving the patient's symptoms and overall health. Monitoring for potential side effects, such as bone marrow suppression from pyrimethamine, is also essential during treatment, thus requiring the administration of folinic acid in some cases to mitigate this risk. The other options are not appropriate selections for the treatment of toxoplasmosis. Options involving azithromycin and doxycycline, vancomycin, or metronidazole generally apply to different infections or conditions and do not provide the specific action needed against Toxoplasma gondii.