American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the recommended dose of dexamethasone for patients with tuberculous meningitis?

6 mg/d for 2 weeks
12 mg/d for 3 weeks
15 mg/d for 4 weeks
10 mg/d for 1 week

The correct answer is: 12 mg/d for 3 weeks

The recommended dose of dexamethasone for patients with tuberculous meningitis is consistent with current guidelines that advocate for reducing inflammation and preventing complications associated with the disease. A dosage of 12 mg per day for 3 weeks is specifically designed to address the needs of patients suffering from this serious condition. Dexamethasone serves to mitigate the risk of complications such as neurological deficits which can arise due to the inflammatory processes involved in tuberculous meningitis. The initial higher dose is meant to provide a rapid anti-inflammatory effect, followed by a tapered approach to facilitate gradual withdrawal. While the other dosages provided may seem appropriate in other contexts, they do not align with the established protocols for treating tuberculous meningitis. Studies have demonstrated that a daily regimen of 12 mg over this duration is effective in improving outcomes, making it the evidence-based recommendation for managing this type of meningitis.