ID

Question 1

What abx leads to increased mortality in VAP?

Answer 1

Tigecycline

Question 2

What antifungal for aspergillus liver enzymes elevated on Voriconazole?

Answer 2

Isavuconazole if mild elevation

Amphotericin B if severe liver failure or worsening hepatitis (3-4x normal LFTs)

Question 3

Coccidioidomycosis radiographic findings

Answer 3

Solitary nodules 10-20 mm in diameter in the periphery of the lungs
Can have thin walled cavities

Question 4

Nocardia gram stain

Answer 4

Gram positive beaded organisms with a branching morphology

Question 5

Nocardia infects which parts of the body

Answer 5

Lungs, skin (draining pustules), brain (abscesses)

Question 6

Nocardia treatment

Answer 6

Bactrim, Amikacin, Linezolid, Imipenem, Ertapenem

Question 7

First month post transplant infections

Answer 7

MDR MRSA
Pseud
Candida
Gram negative organisms
Viruses passed from donor or recipient

Question 8

1-6 month post transplant infections

Answer 8

Depends on prophylactic meds
Opportunistic infections

Crypto
Hep C
Respiratory viruses
Mycobacterium

Question 9

6-12 month post transplant infections

Answer 9

Community based organisms

BK Virus

Question 10

When to start ART in TB with CD4 <50

Answer 10

ART within 2 weeks

Prednisone within 4 weeks

Question 11

When to start ART in TB with CD4 >50

Answer 11

ART within 8-12 weeks

Question 12

When to start ART in TB meningitis

Answer 12

No matter the CD4 not until at least >8 weeks

Question 13

Treatment of MAC

Answer 13

Clarithromycin
Ethambutol
+/- Rifamycin

Question 14

Treatment of Tularemia

Answer 14

Severe - Gentamicin, Streptomycin

Mild - Doxycycline, Ciprofloxacin

Question 15

What antibiotics for K pneumonia carbapanemase resistant strain?

Answer 15

Tigecycline
Colistin
Ceftazidime-Avibactam

Question 16

Normal CSF glucose

Answer 16

50-80

Question 17

Normal CSF protein

Answer 17

15-45

Question 18

Sensitivity and specificity of Legionella urine antigen

Answer 18

80 and 100% respectively for the serougroup 1 (80% of the ones found)

Question 19

Treatment of anthrax meningitis

Answer 19

Cipro
Merrem
Linezolid

Question 20

Clostridium botulinum presentation

Answer 20

Descending paralysis, wound infection

Question 21

Echinocandin MOA

Answer 21

Noncompetitive inhibitors of the synthesis of 1,3-B-d-glucan which is an integral component of the fungal cell wall

Question 22

Babesiosis lab findings

Answer 22

Hemolytic anemia
Thrombocytopenia
Elevated aminotransferases
Oval or pear shaped trophozoites with a a blue cytoplasm and red chromatin dots

Question 23

Babesiosis epidemiology

Answer 23

Blood transfusion within 6 months

Northeast and upper Midwest US

Question 24

Babesiosis treatment

Answer 24

Atovaquone and Azithromycin x 7-10d

Question 25

Tularemia gram stain

Answer 25

Gram - coccobacillus

Question 26

Sites of Tularemia infection

Answer 26

skin (ulcer) | pneumonia (biowarfare)

Question 27

Severe C dif

Answer 27

WBC >15,000 Albumin <3.0 And/or Creatinine >1.5

Question 28

Baloxavir marboxil use

Answer 28

Anti-influenza medication

Question 29

Baloxavir vs oseltamivir

Answer 29

Provides a greater reduction in viral load by 1 day after treatment but not in symptom alleviation

Question 30

Baloxavir MOA

Answer 30

Prodrug, selectively inhibits cap-dependent endonuclease enzyme

Question 31

Oseltamivir MOA

Answer 31

Inhibits the neuraminidase enzyme

Question 32

Blastomycosis clinical pic

Answer 32

``` Acute or chronic PNA Extrapulmonary disease: Skin 20% Bone 5% CNS 2% ```

Question 33

Blastomycosis incubation period

Answer 33

4-8 weeks

Question 34

Blastomycosis endemic to

Answer 34

Mississippi

Question 35

Histoplasmosis endemic to

Answer 35

Arkansas

Question 36

Coccidioidomycosis under microscope

Answer 36

Very large spherules

Question 37

Histoplasmosis under microscope

Answer 37

Small and round organisms, significantly smaller than the surrounding cells

Question 38

How to treat carbapenemase-producing organisms

Answer 38

Ceftazidime-Avibactam Meropenem-Vaborbactam Colistin

Question 39

Virus most likely to cause AE-COPD

Answer 39

1. Rhinovirus | 2. Influenza A

Question 40

How to differentiate Nocardia from Actinomyces

Answer 40

On modified acid fast stain, Nocardia stains positive | Nocardia aerobic, actinomyces anaerobic

Question 41

Chest wall infection not uncommon

Answer 41

Actinymycosis

Question 42

Infections that cavitate

Answer 42

Actinomyces Nocardia TB

Question 43

CF with pseudomonas treatment

Answer 43

Inhaled tobramycin or aztreonam