IDS Fungal P. jirovecci

Question 1

The following statements are true regarding P jirovecci infection

a. surfactant abnormality.
b. provokes mononuclear response
c. alveolar-capillary injury
d. AOTA
e. all except A

Answer 1

D

Question 2

Manifestations of P. jirovecci EXCE{T

a. subacute progressive dyspnea
b. fever
c. productive cough
d. chest discomfort that worsens within days to weeks
e. fulminant pneumonia is not common

Answer 2

C; nonproductive cough

Question 3

CD 4 count susceptible to P. jirovecci

Answer 3

CD4 <200 cells/ul

Question 4

Risk factors for P. jirovecci except

a. CD4 cell percentage <14%
b. previous episodes of PCP
c. oral thrush
d. recurrent fungal pneumonia

Answer 4

D; bacterial pneumonia

CD4 cell percentage <14%
previous episodes of PCP
oral thrush
recurrent bacterial pneumonia
unintentional wt loss
higher plasma HIV RNA

Question 5

Xray findings in P. jirovecci could be

a. normal
b. hyperinflation
c. normal to diffuse bilateral symmetrical interstitial infiltrates emanating from hila
d. AOTA
e. A and C

Answer 5

E

Question 6

T/F pnuemothorax rules out PCP

Answer 6

F; pneumothorax raises suspicion of PCP

Question 7

How to diagnose P. jirovecci

Answer 7

demonstration of organism in

BTS

BAL
Tissue
Sputum

Question 8

Drug of choice for P. jirovecci

Answer 8

TMP-SMX (Cotrimoxazole)

Question 9

Dose of TMP SMX for P. jirovecci severe

Answer 9

TMP 15-20mg and SMX 75-100 mg/kg/day IV for 21 days

Question 10

Indications for corticosteroid in P. jirovecci

Answer 10

PaO2 <70mmHg at room air

A-a-O2 gradient >35mmHg