Final Exam

Question 1

CDI Treatment

Answer 1

Fidaxomicin 200 mg q12h x10days
OR
Vancomycin 125mg PO q6h x10days

Alternative: Metronidazole 500mg q8h x10-14 days (NOT FOR SEVERE DISEASE)

Question 2

CDI Fulminant Disease

Answer 2

Vancomycin 500mg PO/NG q6h
+/- Metronidazole 500mg IV q6-8h

IV Tigecycline as add-on or monotherapy

Question 3

SAB Empiric Treatment

Answer 3

Nafcillin or Oxacillin - 2g IV q4h
OR
Cefazolin 2g IV q8h

PLUS
Vancomycin 15-20mg/kg q8-12h
OR
Daptomycin 8-12mg/kg q24h

Uncomplicated: 2 weeks
Complicated: 4-6 weeks

Question 4

PCP Prophylaxis

Answer 4

Prophylaxis:
TMP-SMX DS 1 tab PO qd

OR
Dapsone 100mg q24h
Aerosolized pentamidine 300mg monthly
atovaquone 1500mg q24h

-Discontinue if CD4 is 100-200 and viral load undetectable for 3-6 months

Question 5

PCP Treatment

Answer 5

Mild-Moderate:
-TMP/SMX (15-20mg/kg/day/75-100mg/kg/day) over 3-4 doses
for 21 days

-Dapsone (100mg q24h) + trimethoprim (5mg/kg PO q8h)
-Primaquine (15-30mg base PO q24h) + Clindamycin (300-450 mg PO q6h)
-Atovaquone (750mg/5ml PO q12h)

Moderate-Severe:
-TMP-SMX
-Pentamidine (4mg/kg IV over 60 mins q24h)
-Primaquine + Clindamycin

PaO2<70
-Prednisone 40mg bid days 1-5,
40mg qd days 6-10
20mg qd days 11-21

*For 21 days

Question 6

MAC Prophylaxis

Answer 6

*Only if they aren’t starting ART
-Azithromycin 600mg 2x/week or
1200mg weekly
OR
-Clarithromycin 500mg BID

Question 6

MAC Treatment

Answer 6

Clarithromycin 500mg BID
AND
Ethambutol 15mg/kg qd

OR

Azithromycin 500-600mg qd
AND
Ethambutol 15mg/kg qd

*Continue for 12 months
and asymptomatic
and CD4>100 for >6months

Question 6

Biktarvy

Answer 6

Bictegravir 50mg
Emtricitabine 200mg (FTC)
TAF 25mg

Question 7

Descovy

Answer 7

Emtricitabine 200mg
TAF 25mg

Question 8

Truvada

Answer 8

Emtricitabine 200mg
TDF 300mg

Question 9

Tivicay

Answer 9

Dolutegravir

Question 10

Triumeq

Answer 10

Abacavir 600mg (ABC)
Dolutegravir 50mg
Lamivudine 300mg (3TC)

Question 11

PEP

Answer 11

Sanford:
Ratelgravir 1200mg (600mg x2)
OR
Dolutegravir 50mg q24h
AND
Descovy (FTC/TAF)

CDC:
Ratelgravir 400mg BID
AND
Truvada (FTC/TDF)

28 days

Question 12

PrEP

Answer 12

Truvada (FTC/TDF) q24h

OR

Descovy (FTC/TAF) q24h

Question 13

Osteomyelitis, Hematogenous IVDU

Answer 13

vancomycin
AND
Cefepime

Question 14

Osteomyelitis, Hematogenous Older Adults

Answer 14

Vancomycin
AND
Cefazolin or Nafcillin

Question 15

Osteomyelitis, Contiguous w/o vascular insufficiency

Answer 15

Vanco
AND
ceftriaxone 2g IV q24h

Question 16

Osteomyelitis, Contiguous w/ vascular insufficiency

Answer 16

Vancomycin
AND
Zosyn 3.375 gm IV q8h

Question 17

Native Valve endocarditis caused by strep or hacek

Answer 17

Penicillin G (+gentamicin)
Ceftriaxone (+gentamicin)
Vancomycin

HACEK:
Ceftriaxone (2g IV q24h)
Ampicillin or ampicilin-sulbactam
Ciprofloxacin

Question 18

Prosthetic Valve endocarditis

Answer 18

MSSA:
Nafcillin/oxacillin 2g IV q4h
AND
Rifampin 300mg tid
AND
gentamicin 1mg/kg q8h

MRSA:
Vancomycin 15-20mg/kg q8-12h
AND
Rifampin 300mg tid
AND
Gentamicin 1mg/kg q8h

Question 19

Enterococcus endocarditis

Answer 19

Ampicillin (2g IV q4h) + gentamicin (1mg/kg IV q8h)

Penicillin G + gentamicin

Ampicillin + ceftriaxone (2g IV q12h)

Vancomycin + gentamicin

Question 20

Osteomyelitis Treatment Durations

Answer 20

4-6 weeks
For MRSA: 8 weeks

Question 21

CA intra-abdominal low risk

Answer 21

ertapenem

OR

ceftriaxone + metronidazole

Question 22

CA intra-abdominal high risk

Answer 22

meropenem
OR
zosyn
OR
cefepime + metronidazole

Question 23

SBP Treatment

Answer 23

Ceftriaxone 2g IV q24h x5days

Question 24

SBP prophylaxis

Answer 24

after first episode

ciprofloxacin 500mg qd

Question 25

LTBI Treatment

Answer 25

INH 15m/kg (max 900mg) qw
AND
Rifapentine 900mg qw

for 12 weeks

Question 26

Active TB

Answer 26

INH (5mg/kg/day, max 300/day)
Rifampin (10mg/kg/day, max 600/day)
Pyrazinamide (25mg/kg/day)
Ethambutol 15-20mg/kg/day