Final Exam: Treatments

Question 1

Paxlovid: who should use it?

Answer 1

Positive for COVID
12+ years old and 40+ kg
=< 5 days since symptom onset
Have 1+ risk factor for severe illness progression

Question 2

Paxlovid: what is the dosing?

Answer 2

Two 150 mg tabs nirmatrelvir + one 100 mg tab ritonavir
BID
X 5 days

Question 3

Molnupiravir: MAINLY beneficial at decreasing what?

Answer 3

Hospitalizations or death from serious illness

Question 4

Molnupiravir: who SHOULD take?

Answer 4

Positive COVID
Mild-moderate illness
18+ years old
1+ risk of severe illness progression

Question 5

Molnupiravir: who should NOT take?

Answer 5

X PREGNANT X
Hospitalized patients
Prophylaxis
Longer than 5 days

Question 6

Molnupiravir: what is the dose?

Answer 6

ONE TIME 200 mg tablet with high fat meal*

Question 7

Remdesivir: what is the dose?

Answer 7

200 mg IV loading dose
100 mg IV maintenance dose for 5-10 days

Question 8

Remdesivir: what is the GFR cutoff?

Answer 8

<30

Question 9

Remdesivir: originally used for what?

Answer 9

Ebola

Question 10

Remdesivir: hospital or outpatient? Oxygen treatment or no?

Answer 10

Hospital only
Can be used in patients w/ O2 treatment or not

Question 11

What should ALL COVID patients receive?

Answer 11

Dexamethasone

Question 12

Corticosteroids: what dose should be used?

Answer 12

Dexamethasone 6 mg IV or PO daily x 10 days or discharge

Question 13

Tocilizumab: what class of drug is it?

Answer 13

IL-6 antagonist

Question 14

Tocilizumab: what is the dose?

Answer 14

ONE DOSE 8 mg/kg IV over 1 hour

Question 15

Tocilizumab: hospital or outpatient? Oxygen treatment or no?

Answer 15

Hospital only
Oxygen treatment (conventional, HFNC or ECMO) patients only

Question 16

Baricitinib: what class of drug is it?

Answer 16

Kinase inhibitor

Question 17

Baricitinib: what symptom does it primarily treat?

Answer 17

Inflammation

Question 18

Baricitinib: what is the dose?

Answer 18

4 mg PO daily x 14 days or discharge

Question 19

Baricitinib: hospital or outpatient? Oxygen therapy or no?

Answer 19

Hospital only
Oxygen treatment (conventional, HFNC or ECMO) patients only

Question 20

If patient with COVID is admitted to the ICU under normal circumstances, should we administer therapeutic-dose anticoagulant?

Answer 20

No

Question 21

If patient with COVID is admitted to the ICU with THIS LAB RESULT, we should administer therapeutic-dose anticoagulant

Answer 21

> = 4x D-dimer

Question 22

What patients should receive prophylactic anticoagulation?

Answer 22

All!

Question 23

What parasite class causes malaria?

Answer 23

Plasmodium

Question 24

Malaria: what is the go-to treatment regimen?

Answer 24

Artemisinin backbone combo:

Ie)
Arthemeter + lumefatrine
Artesunate + amodiaquine
Artesunate + mefloquine

Question 25

What are the administration routes for arthemeter and artesunate?

Answer 25

Arthemeter = IM, PO Artesunate = IV, PO

Question 26

Malaria: what is the duration of treatment?

Answer 26

3 days

Question 27

Syphilis: What are the stages?

Answer 27

Primary = chancre at site Secondary (6 months) = rash, fatigue, malaise, sore throat Early latency (1 year) = asymptomatic Late latency (>1 year) = progressive organ involvement

Question 28

Syphilis: what is the treatment?

Answer 28

ONCE DOSE IM benzathine penicillin G 2.4 million units

Question 29

Chlamydia: what is the treatment?

Answer 29

Doxycycline 100 mg PO BID x 7 days (Alt. = Azithromycin)

Question 30

Gonnorhea: what is the treatment?

Answer 30

ONCE DOSE Ceftriaxone 250 mg IM (Alt. = ONCE cefixime 800 mg PO)

Question 31

Pelvic Inflammatory Disease: what is the treatment? (Inpatient vs outpatient)

Answer 31

Inpatient = cefoxitin IV + doxycycline po (Alt. Clindamycin IV + gentamicin) Outpatient = ceftriaxone IM + doxycycline po

Question 32

EPT: if the patient ONLY has chlamydia (no gonorrhea), what should they take?

Answer 32

Azithromycin 1g PO ONCE

Question 33

EPT: if the patient has gonorrhea, what should they take?

Answer 33

Cefixime 400 mg PO + Azithromycin 1g PO ONCE