Exam 5 - Random Practice Questions (NOT DONE) Flashcards by Rehman Hameed

Q

Mutations in the mycobacterial gene encoding the KatG protein confer resistance to this anti-TB drug.

a. Ethambutol
b. Isoniazid
c. Pyrazinamide
d. Rifampin

A

b. Isoniazid

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Q

This anti-tuberculosis drug binds to and inhibits mycobacterial RNA polymerase.

a. Ethambutol
b. Isoniazid
c. Pyrazinamide
d. Rifampin

A

d. Rifampin

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Q

This component of the preferred combination of drugs used to treat active TB infections does NOT require activation by a bacterial enzyme.

a. Isoniazid
b. Pyrazinamide
c. Pyrethrin
d. Rifampin

A

d. Rifampin

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Q

Which of the following best describes the mechanism of action of rifampin?

a. It blocks the addition of dNTPs to the growing DNA chain
b. It inhibits peptide synthesis
c. It blocks elongation of new RNA molecules
d. It inhibits the synthesis of 20 carbon precursors needed for mycolic acid synthesis

A

c. It blocks elongation of new RNA molecules

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Q

This anti-tuberculosis drug interferes with synthesis of Coenzyme A (CoA).

a. Ethambutol
b. Isoniazid
c. Pyrazinamide
d. Rifampin

A

c. Pyrazinamide

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Q

How does the mycobacterial cell wall differ from the cell walls of Gram-negative and Gram-positive bacteria?

a. Mycobacterial cell walls contain b(1,3)-glucans
b. Mycobacterial cell walls contain endotoxin
c. Mycobacterial cell walls contain mycolic acid and arabinogalactans
d. Mycobacterial cell walls contain peptidoglycan

A

c. Mycobacterial cell walls contain mycolic acid and arabinogalactans

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Q

Inhibits arabinosyl transferase

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

c. ethambutol

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Q

inhibits DNA gyrase (topo II)

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

e. moxifloxacin

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Q

inhibits heme polymerization

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

b. chloroquine

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Q

inhibits InhA

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

d. isoniazid

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Q

inhibits PanD

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

g. pyrazinamide

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Q

inhibits RNA polymerase

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

h. rifampin

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Q

produces free radicals and/or inhibits PI3K

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

a. artemisinin

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Q

produces H2O2 (hydrogen peroxide)

a. artemisinin
b. chloroquine
c. ethambutol
d. isoniazid
e. moxifloxacin
f. primaquine
g. pyrazinamide
h. rifampin

A

f. primaquine

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Q

Which of the following is a prodrug?

a. Mebendazole
b. Chloroquine
c. Pyrazinamide
d. Rifampin

A

c. Pyrazinamide

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Q

Nonprescription pyrethrins are used to treat this ectoparasite

A. Lice
B. Pneumocystis jirovecii
C. Plasmodium vivax
D. Tinea pedis

A

A. Lice

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Q

Which of the following best describes why pyrethrins generally have low toxicity in humans?

A. Humans do not express the enzyme that is inhibited by pyrethrins
B. Pyrethrins are only active against bacterial ribosomes
C. Pyrethrins are rapidly metabolized if absorbed
D. Pyrethrins are unstable if exposed to light

A

C. Pyrethrins are rapidly metabolized if absorbed

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Q

All of the following are natural products or derivatives of natural products, EXCEPT

A. Artemisinin
B. Permethrin
C. Pyrethrins
D. Spinosad

A

B. Permethrin

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Q

Which of the following best describes the MOA of Spinosad?

A. Activation of nicotinic ACh receptors leading to rapid nervous system excitation and death
B. Inhibition of a key enzyme in the pathway that synthesizes CoA, which disrupts a wide array of cellular processes.
C. Inhibition of microtubule growth by cooping the plus end, which inhibits cell division
D. Production free radical that damage cellular proteins, lipids and DNA, which upregulates of the unfolded protein response

A

A. Activation of nicotinic ACh receptors leading to rapid nervous system excitation and death

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Q

All the following are treatments for lice, EXCEPT

A. Artemisinin
B. Permethrin
C. Pyrethrins
D. Spinosad

A

A. Artemisinin

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Q

Which of the following best describes the mechanism of action of pyrethrins?

A. Activation by CYP2D6 followed by production of free radicals
B. Activation of voltage-gated sodium channels
C. Inhibition of ATP synthase
D. Inhibition of b1-3 glucan synthase

A

B. Activation of voltage-gated sodium channels

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Q

Sometimes called the resurrection drug for its ability to treat patients who have late stage (CNS) infections with West African trypanosomes

a. Albendazole
b. Miltefosine
c. Amphotericin B
d. Praziquantel
e. Eflornithine

A

e. Eflornithine

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Q

a phospholipid compound that was the first oral antileishmanial drug

a. Albendazole
b. Miltefosine
c. Amphotericin B
d. Praziquantel
e. Eflornithine

A

b. Miltefosine

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Q

Causes muscular contraction leading to spastic paralysis of flatworms (cestodes and trematodes), but has no effect on nematodes

a. Albendazole
b. Miltefosine
c. Amphotericin B
d. Praziquantel
e. Eflornithine

A

d. Praziquantel

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broad spectrum antihelminth that is drug of choice to treat cysticercosis; also used for pinworms, hookworms, and ascariasis a. Albendazole b. Miltefosine c. Amphotericin B d. Praziquantel e. Eflornithine

a. Albendazole

This drug is active against hypnozoites a. Artemisinin b. Chloroquine c. Doxycycline d. Primaquine e. Quinine

d. Primaquine

The active group of this antimalarial drug is an endoperoxide a. Artemisinin b. Chloroquine c. Doxycycline d. Primaquine e. Quinine

a. Artemisinin

This drug has a short half life and is often combined with a longer half life drug such as mefloquine to eliminate any remaining parasites a. Artemisinin b. Chloroquine c. Doxycycline d. Primaquine e. Quinine

a. Artemisinin

This natural compound from cinchona tree bark is metabolized by CYP3A4 and may cause hemolysis in people with G6PD deficiency a. Artemisinin b. Chloroquine c. Doxycycline d. Primaquine e. Quinine

e. Quinine

This drug is used for chemoprophylaxis in areas with high resistance to mefloquine and targets components of the plant-like organelle called the apicoplast a. Artemisinin b. Chloroquine c. Doxycycline d. Primaquine e. Quinine

c. Doxycycline

A broad spectrum, OTC antihelminthic drug that acts as a neuromuscular blocking agent; commonly used to treat pinworm infections a. Albendazole b. Ivermectin c. Metronidazole d. Praziquantel e. Pyrantel pamoate

e. Pyrantel pamoate

The drug of choice to treat schistosome infections; also active against tape worms a. Albendazole b. Ivermectin c. Metronidazole d. Praziquantel e. Pyrantel pamoate

d. Praziquantel

This drug is active against anaerobic microbes including Entamoeba and Giardia a. Albendazole b. Ivermectin c. Metronidazole d. Praziquantel e. Pyrantel pamoate

c. Metronidazole

This drug binds to tubulin in helminths and blocks formation of microtubules a. Albendazole b. Ivermectin c. Metronidazole d. Praziquantel e. Pyrantel pamoate

a. Albendazole

A semisynthetic compound that paralyzes microfilariae; used in mass treatment programs for onchocerciasis a. Albendazole b. Ivermectin c. Metronidazole d. Praziquantel e. Pyrantel pamoate

b. Ivermectin

isoniazid A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

D. Activated by KatG

rifampin A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

E. Does not require activation

pyrazinamide A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

C. Activated by PncA

ethambutol A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

E. Does not require activation

moxifloxacin A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

E. Does not require activation

artemisinin A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

B. Activated by heme iron

primaquine A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

A. Activated by CYP2D6

chloroquine A. Activated by CYP2D6 B. Activated by heme iron C. Activated by PncA D. Activated by KatG E. Does not require activation

E. Does not require activation

Select the medication used in the treatment of OIs that is associated with the greatest risk of causing neutropenia. A. Clotrimazole B. Flucytosine C. Pentamidine D. Streptomycin

B. Flucytosine (bone marrow suppression)

Which mechanism of action is shared by amikacin and streptomycin? a. 30S inhibitor b. 50S inhibitor c. folate inhibitor d. gyrase inhibitor

a. 30S inhibitor

A provider is curious as to why dapsone is referred to as a “CYP 450 substrate.” What is the correct explanation? A. CYP 450 substrate usually refers to a med that binds other meds in the GI tract. B. CYP 450 substrate primarily refers to a med that has to be activated in the body before exerting its effects. C. CYP 450 substrate commonly refers to a med whose metabolism may be increased or decreased by other meds. D. CYP 450 substrate mainly refers to a med that displaces another med from protein binding sites.

C. CYP 450 substrate commonly refers to a med whose metabolism may be increased or decreased by other meds.

MAC is a slow-growing aerobic bacilli transmitted via inhalation or ingestion of organisms. Select the mechanism of action that is shared by first-line therapy options for MAC prophylaxis? a. 30S inhibitor b. 50S inhibitor c. folate inhibitor d. gyrase inhibitor

b. 50S inhibitor ("mac"rolides such as azithro and clarithro are first line for MAC; bactrim is folate inhibitor; FQs are gyrase inhibitors)

A pt with a past medical history of HIV has not been adherent to ART. Subsequently, the pt has been admitted to the hospital with complications resulting from a CD4 T cell count of 15 cells/mm3. A depression in which of the following cell types is expected to present in the patient's laboratory report as a result of this finding? a. lymphocytes b. basophils c. erythrocytes d. eosinophils

a. lymphocytes

Which therapy commonly warrants premedication prior to administration? a. Clotrimazole b. Amphotericin B c. Micafungin d. Nystatin

b. Amphotericin B

A pt is living with uncontrolled COPD secondary to nonadherence to therapy. The pt is also immunosuppressed and is at risk for the development of opportunistic PJP. Select the option available for PJP prophylaxis that should be AVOIDED in this pt because of the past medical history. a. Atovaquone b. Dapsone c. Pentamidine d. Bactrim

c. Pentamidine (this is administered as a nebulizer)

A pt with HIV presents with a CD4 count of 150 and an undetectable viral load. Which statement accurately reflects the interpretation of the pt's medical information? A. A CD4 count of 150 indicates attenuated HIV infection; however, the pt is not at increased risk of developing opportunistic infections. B. An undetectable viral load suggests that the pt is no longer infected with HIV and does not require ART. C. A CD4 count of 150 indicates a weakened immune system, but the undetectable viral load indicates effective control of HIV replication with ART. D. An undetectable viral load and a CD4 count of 150 are within normal range, and the pt does not require any further medical intervention.

C. A CD4 count of 150 indicates a weakened immune system, but the undetectable viral load indicates effective control of HIV replication with ART.

Disseminated MAC infection is an opportunistic infection seen in severely immunocompromised patients with HIV. Which medication is administered least frequently as a MAC prophylaxis regimen? a. azithromycin b. clarithromycin c. erythromycin d. rifabutin

a. azithromycin (this is once weekly for prophylaxis; the others are daily)

Pyrimethamine is utilized in the management of toxoplasmosis. What vitamin supplement is routinely administered with pyrimethamine therapy? a. Vitamin A b. Vitamin B c. Vitamin C d. Vitamin D

b. Vitamin B

JT, a 55-year-old man, has been living with HIV for 15 years but has not been compliant with ART. He presents with a persistent cough, night sweats, and unintentional weight loss. Laboratory tests reveal a CD4 cell count of 42. Further evaluation confirms the presence of disseminated MAC . JT agrees to initiate tx. Which combination of meds would be appropriate as initial therapy for JT's MAC infection? A. Azithromycin + rifampin B. Tobramycin + ethambutol C. Rifampin + isoniazid + pyrazinamide + ethambutol D. Clarithromycin + ethambutol + rifabutin

D. Clarithromycin + ethambutol + rifabutin (c. is for tuberculosis)

A patient is taking losartan, phenytoin, omeprazole, and atorvastatin. Which drug interaction potential should be assessed upon fluconazole's initiation? A. Antiacidic properties that decrease drug absorption B. Chelating agent that binds other drugs and decreases drug absorption C. Cytochrome P450 inhibition that decreases drug metabolism D. High protein binding/drug displacement that increases drug levels in the body

C. Cytochrome P450 inhibition that decreases drug metabolism (this will increase exposure of atorvastatin and phenytoin, leading to increased risk of myopathy and phenytoin toxicity)

Select the potential drug–drug interaction with fluconazole. A. Lisinopril B. Lamotrigine C. Loratadine D. Levofloxacin E. Levetiracetam

D. Levofloxacin (additive effects on the QT interval and increase the risk of cardiac adverse events)

A patient comes in with a toxoplasma gondii infection. The attending physician wants to start pyrimethamine 75 mg PO QD, leucovorin 20 mg PO QD, and sulfadiazine 1000 mg PO QD to treat the infection. Which AE widely associated with pyrimethamine warrants leucovorin's use? a. arrythmias b. bone marrow toxicity c. GI distress d. Stevens Johnson syndrome

b. bone marrow toxicity

Which of the following human immunodeficiency virus (HIV) medications is associated with increased bilirubin? a. acyclovir b. atazanavir c. abacavir d. tenofovir DF

b. atazanavir

Based upon the potential development of central nervous system (CNS) side effects, which of the following nonnucleoside reverse transcriptase inhibitors (NNRTIs) would you expect to have the highest concentration distributed into the CNS? a. nevirapine b. efavirenz/emtricitabine/tenofovir c. elvitegravir/cobicistat/emtricitabine/tenofovir d. abacavir/dolutegravir/lamivudine

b. efavirenz/emtricitabine/tenofovir (efavirenz is associated with CNS side effects and includes hallucinations and vivid dreams; a. causes rash and hepatotoxicity)

what drug class does dolutegravir belong to? a. protease inhibitor b. integrase strand inhibitor c. capsid inhibitor d. nucleoside reverser transcriptase inhibitor

b. integrase strand inhibitor

A treatment experienced patient receiving atazanavir therapy as part of combination therapy for HIV infection should avoid the addition of which of the following medications? a. metoprolol b. metronidazole c. pravastatin d. omeprazole

d. omeprazole (Atazanavir requires an acidic environment for optimal absorption)

Which of the following is true regarding basic laboratory tests indicated for persons with HIV at entry into care? A. Baseline liver function tests are indicated only for persons coinfected with hepatitis. B. All persons should have a baseline thyroid-stimulating hormone test. C. All persons should have a baseline random or a fasting glucose. D. All persons should have a baseline serum phosphorus level.

C. All persons should have a baseline random or a fasting glucose.

Which of the following coformulated antiretrovirals (ART) is administered as an IM injection every 2 months for maintenance tx of HIV? A. Atazanavir/cobicistat B. Lopinavir/ritonavir C. Cabotegravir/rilpivirine D. Dolutegravir/lamivudine E. Dolutegravir/rilpivirine

C. Cabotegravir/rilpivirine

Which antifungal agent binds to the fungal cell membrane component ergosterol, forming pores that cause rapid leakage of monovalent ions (K+, Na+, H+, and Cl−) and subsequent fungal cell death. a. Amphotericin B b. Voriconazole c. Flucytosine d. Micafungin

a. Amphotericin B (b. inhibits 14a-demethylase; c. converts to 5-FdUMP; d. inhibits synthesis of beta-glucan)

A 56-year-old man is diagnosed with fungal meningitis after receiving a glucocorticoid injection in his knee. The patient is started on liposomal amphotericin B. When preparing this medication, what is the most important point to consider? a. should be reconstituted with NS b. should be diluted with dextrose in water c. should be handled similar to a chemotherapeutic agent d. should have a final concentration of 5 mg/mL

b. should be diluted with dextrose in water

A 60-year-old woman weighing 120lbs is being treated for invasive aspergillosis of the lung with amphotericin B deoxycholate. Her current dose is 45 mg IV daily. The attending physician wants to switch the patient to liposomal amphotericin B. What would the most appropriate daily dosage be? a. 60 mg b. 90 mg c. 150 mg d. 240 mg

d. 240 mg (120/2.2 = 54.5 kg, 3-5 mg/kg for liposomal, 163-272 mg, 240 falls within this range)

The goals of TB treatment include controlling the spread of TB, reducing the development of drug resistance, and preventing relapse to active disease. Select the patient group that should get drug susceptibility testing for M. tuberculosis. a. all latent TB pts b. latent TB pts over age 35 c. all active TB disease pts d. active TB pts over age 35

c. all active TB disease pts (Drug susceptibility testing should be initially done in all patients with active disease to determine proper drug therapy to control spread of drug-resistant strains.)

GP is a 67-year-old man being treated for active TB. He is currently on two meds that can prolong the QT interval. Which of the following meds would have the MOST risk for adding to the risk of QT prolongation if utilized in TB management? a. rifampin b. isoniazid c. moxifloxacin d. ethambutol

c. moxifloxacin

A 68-year-old woman is admitted from an outside hospital with Listeria monocytogenes bacteremia and suspected meningitis. She is currently receiving piperacillin-tazobactam and daptomycin. What is the most appropriate recommendation? a. continue current regimen until meningitis is confirmed or ruled out with a lumbar puncture b. change regimen to amp + gent c. change regimen to meropenem d. change regimen to ceftriaxone

b. change regimen to amp + gent (ampicillin is DOC for listeria)

A 36-year-old woman presents to the emergency department with severe headache, her worst to date. She reports returning from her honeymoon in Mexico 2 days prior to the onset of symptoms and acknowledges consuming food from street vendors. Blood cultures reveal gram-positive rods. Which β-lactam antibiotic is the most appropriate initial therapy? A. Ceftriaxone 2 g intravenously every 12 hours B. Cefepime 2 g intravenously every 8 hours C. Ampicillin 2 g intravenously every 4 hours D. Ertapenem 1 g intravenously every 24 hours

c. Ampicillin 2 intravenously every 4 hours (The clinical presentation suggests bacterial meningitis should be in the differential. The finding of gram-positive rods in blood cultures could indicate the finding of Listeria monocytogenes. The drug of choice for this organism in the setting of bacterial meningitis is ampicillin.)

Which of the following is the biggest risk factor for tuberculosis (TB) reactivation? A. Heart failure B. Alcohol abuse C. Human immunodeficiency virus (HIV) D. Asthma

C. Human immunodeficiency virus (HIV)

Which of the following antimicrobials has the greatest penetration into cerebrospinal fluid? a. vancomycin b. cefdinir c. linezolid d. gentamicin

c. linezolid (d. aminoglycosides don't penetrate well)

Which one would be the LEAST likely to prolong the QTc interval? a. itraconazole b. isavuconazole c. posaconazole d. fluconazole

b. isavuconazole (can shorten QTc)

PR is a 32-year-old woman who was diagnosed with active TB. She is pregnant and current medications include prenatal vitamins. Her PMH is not significant. Which of the following meds would be CI as part of the medication regimen to treat active TB? a. isoniazid b. rifampin c. ethambutol d. levofloxacin

d. levofloxacin

A 71-year-old woman is transferred from an outside hospital with Listeria monocytogenes meningitis. Her medical record indicates she is allergic to PCN (anaphylaxis requiring medical intervention). She is started on IV TMP/SMX. Which laboratory parameter should be monitored? a. serum creatinine b. eosinophils c. creatine phosphokinase d. magnesium

a. serum creatinine

Rifampin is a first-line therapeutic utilized in the tx of active tuberculosis (used as part of combination treatment). Select the MOA for rifampin against Mycobacterium tuberculosis. A. Inhibition of DNA-dependent RNA polymerase in bacterial cells B. Inhibition of mycolic acid production which is necessary for mycobacterial cell walls C. Inhibition of mycobacterial arabinosyl transferase to inhibit cell wall production D. Inhibition of mycobacterial ATP synthase

A. Inhibition of DNA-dependent RNA polymerase in bacterial cells (b. is isonaiazid; c. is ethambutol; d. is bedaquiline)

Which of the following pathogen is the leading cause of acute bacterial meningitis in adults in the western societies? a. Streptococcus group B b. Neisseria meningitides c. Streptococcus pneumoniae d. Haemophilus influenzae

c. Streptococcus pneumoniae

The following are true regarding initiation of anti-infective therapy in acute CNS infection, EXCEPT: a. Empiric anti-infective therapy should be initiated as soon as possible after a diagnosis is suspected. b. Blood samples should be collected before administration of anti-infective agents. c. Supportive care including fluids, electrolytes, antipyretics, and antiemetics should also be given during treatment for possible CNS infections. d. Corticosteroids should NOT be initiated until a final diagnosis of meningitis is confirmed.

d. Corticosteroids should NOT be initiated until a final diagnosis of meningitis is confirmed. (The IDSA recommends corticosteroids be administered 10 to 20 minutes prior to or concomitant with the first dose of antibiotics)

In children <2 years of age and adults >50 years of age, empiric coverage of which of the following pathogen is recommended? a. Listeria monocytogenes b. Legionella pneumophila c. Neisseria meningitidis d. Mycoplasma pneumoniae

a. Listeria monocytogenes

According to the IDSA, the recommended treatment regimen for a 40-year-old patient with suspected acute, community-acquired bacterial meningitis consists of: a. Cefazolin, vancomycin, and levofloxacin b. Ceftriaxone and vancomycin c. Ceftriaxone, ampicillin, and aminoglycoside d. Ceftriaxone and ampicillin

b. Ceftriaxone and vancomycin (The IDSA recommends vancomycin plus a 3rd-gen cephalosporin as empiric therapy for suspected acute, community-acquired bacterial meningitis in patients 2 to 50 years old.)

The generally recommended duration of intravenous antibiotic treatment of meningitis caused by Streptococcus pneumo is: a. 7 days b. 10-14 days c. 4-6 weeks d. 12-18 weeks

b. 10-14 days

Which of the following is NOT one of the most common causes of viral encephalitis in the United States? a. Arbovirus b. Herpes simplex virus c. Zika virus d. Enterovirus

c. Zika virus

The best option for the treatment of a HIV-infected patient with esophageal candidiasis would be which of the following options? a. Clotrimazole troches b. Fluconazole oral tablets c. Itraconazole oral suspension d. Nystatin oral suspension

b. Fluconazole oral tablets (Nystatin and clotrimazole are not suitable for esophageal candidiasis. Fluconazole is superior to ketoconazole and itraconazole tablets and comparable to itraconazole suspension with fewer drug interactions.

Which of the following regimens would be most appropriate for prophylaxis of PJP in a double-lung transplant recipient? a. Trimethoprim–sulfamethoxazole two double-strength tablet orally twice daily b. Trimethoprim–sulfamethoxazole one double-strength tablet orally once daily c. Pentamidine 4 mg/kg intravenously once daily d. Pentamidine 300 mg inhaled once monthly

b. Trimethoprim–sulfamethoxazole one double-strength tablet orally once daily

Therapeutic drug monitoring is recommended during use of all of the following agents, except: a. Voriconazole b. Vancomycin c. Posaconazole d. Isavuconazonium

d. Isavuconazonium

TG is a 45-year-old man traveling to Kenya in 6 months. According to the CDC Yellow Book, the relative risk for malaria is moderate and chloroquine-resistant P. falciparum is prevalent. His current medications include lisinopril, duloxetine, and zolpidem as needed for insomnia. A recommended malaria chemoprophylaxis regimen is: a. Doxycycline 100 mg orally once daily b. Primaquine 30 mg base orally once daily c. Mefloquine 228 mg base orally once weekly d. Hydroxychloroquine 310 mg base orally once weekly e. Atovaquone/proguanil 62.5 mg/25 mg orally once weekly

a. Doxycycline 100 mg orally once daily (e. Pediatric dose of atovaquone-proguanil 62.5 mg/25 mg is inappropriate for this 45-year-old man.)

Severe falciparum malaria requires a patient to be admitted to an acute care unit and treated with: a. Artesunate b. Artemether-lumefantrine c. Atovaquone-proguanil d. Mefloquine e. Quinine sulfate

a. Artesunate

An artemisinin-based regimen that may be used to treat uncomplicated chloroquine-resistant malaria includes: a. Artesunate b. Artemether-lumefantrine c. Atovaquone-proguanil d. Mefloquine e. Quinine sulfate

b. Artemether-lumefantrine (this is the only oral artemisinin-based therapy listed)

Tx of severe malaria: after IV artesunate has been given and parasite density is < 1%, we can transition to any of the following oral treatments EXCEPT: a. artemether-lumefantrine b. atovaquone-proguanil c. azithromycin d. quinine plus doxy or clinda e. mefloquine

c. azithromycin