E5 Infxn in immunocomp - Wrin

Question 1

ANC value we consider to be neutropenia (risk factor for infection)

Answer 1

ANC <1000 cells/mm3

Question 2

ANC formula

Answer 2

WBC x (%polys+%bands)

Question 3

3 highlighted common bacterial pathogens

Answer 3

• staph aureus
• enterobacterales
• pseudomonas

Question 4

3 common fungi pathogens

Answer 4

candida spp
aspergillus
zygomycetes

Question 5

3 common viruses

Answer 5

HSV
VZV
CMV

Question 6

Cell-mediated immunity:
A. T-lymphocytes
B. B-lymphocytes

Answer 6

A

Question 7

Primary defense against intracellular pathogens.
A. cell-mediated immunity
B. humoral immunity

Answer 7

A

Question 8

Humoral immunity:
Primary defense against ___________ pathogens

Answer 8

extracellular

Question 9

2 things that reduce ability of host to defend against INTRAcellular pathogens

Answer 9

• underlying disease
• immunosuppressive drugs

Question 10

2 things that reduce ability of host to defend against EXTRAcellular pathogens

Answer 10

• underlying disease
• immunosuppressive drugs

Question 11

3 common pathogens in skin

Answer 11

• staph aureus
• staph epidermidis
• candida

Question 12

5 common pathogens that cause alteration of flora

Answer 12

• enterobacterales
• pseudomonas
• staph aureus
• candida
• aspergillus

Question 13

aspergillus spp:
Heme and HSCT pts -> prolonged ________

Answer 13

neutropenia

Question 14

what is the DoC for prophylaxis in protozoan infections?

Answer 14

TMP/SMX

Question 15

most important and often only clinical finding for presentation + diagnosis

Answer 15

fever

Question 16

3 labs used for diagnosis

Answer 16

• blood cultures
• CBC
• BMP or CMP

Question 17

2 diagnostic tools used

Answer 17

• imaging
• aspiration or biopsy

Question 18

management of febrile neutropenia:
empiric tx regimen should include anti__________ coverage

Answer 18

pseudomonal

Question 19

2 empiric options we give for management of febrile neutropenia (NKDA)

Answer 19

• cefepime 2gm q8h
• Piper/tazo
  he said these were the “top two” that we give so im ignoring the rest

Question 20

which agent is NOT recommended initially as empiric tx for management of febrile neutropenia

Answer 20

vanc

Question 21

Empiric management of febrile neutropenia if penicillin allergy (1 regimen)

Answer 21

ciprofloxacin + aztreonam + vancomycin

Question 22

empiric management of febrile neutropenia, low-risk, oral agents (3 options)

Answer 22

• cipro + amox/clav
• levo
• cipro + clinda

Question 23

pathogen-directed therapy:
- MRSA -> (1)
- VRE -> (2)
- ESBL -> (1 class)
- KPC -> (3 options)
- NDM/IMP/VIM -> (1)

Answer 23

• vanc
• dapto or linezolid
• carbapenem
• mero/vabor, imipenem/cilastatin, ceftaz/avibactam
• cefiderocol *

Question 24

how long do you treat with antifungals in management of febrile neutropenia

Answer 24

2 weeks in absence of s/sx of IFI, often continued for duration of neutropenia

Question 25

viral, management of febrile neutropenia: HSV/VZV: (2) CMV: (2)

Answer 25

- acy, val - ganc, valgan

Question 26

2 most common bacterias for catheter-related bloodstream infections

Answer 26

staph aureus staph epidermidis

Question 27

whats the most important determinant in patient outcomes

Answer 27

resolution of neutropenia

Question 28

2 options for prophylaxis during infection with febrile neutropenia

Answer 28

cipro or levo

Question 29

slide 33 throwing me off

Answer 29

okay