Infection Flashcards
A 45-year-old man presents to emergency department with a history of fever and rigors for 2 weeks. On examination he is pyrexial
tachycardic and noted to have splinter hemorrhages on right middle and index fingers. Where on the echocardiogram are vegetations most likely to occur?
a. Aortic and mitral valve
b. Aortic valve
c. Mitral valve
d. Pulmonary valve
e. Tricuspid valve
c—Mitral valve
A 61-year-old man presented with a right frontal cerebral abscess which was drained under image-guidance, and investigations revealed infective endocarditis (IE). Blood cultures and pus samples grew Streptococcus bovis.Which one of the following is the next appropriate investigation?
a. Bronchoscopy
b. Chest CT
c. Colonoscopy
d. Repeat blood cultures
e. Transesophageal echo
c—Colonoscopy
A 72-year-old woman presents 3 months after
having a metallic mitral valve replacement.
She was fatigued, pyrexia 38.6 °C (101.4 °F),
BP 155/80, and pulse rate 124. On auscultation she had a mechanical first heart sound
and a late diastolic murmur best heard at the
apex. Blood cultures were taken from three
sites. What is the most likely organism?
a. Candida
b. Coagulase negative Staphylococcus
c. Gram negative bacilli
d. No growth
e. Staphylococcus aureus
e—Staphylococcus aureus
Which one of the following antibiotics are
associated with high risk of Clostridum difficile
pseudomembranous colitis?
a. Clindamycin
b. Gentamicin
c. Metronidazole
d. Tetracycline
e. Vancomycin
a—Clindamycin
Central line infections are most commonly
caused by which one of the following?
a. Candida
b. Enterococci
c. Gram negative bacilli
d. Staphylococci
e. Streptococci
d—Staphylococci
Which one of the following statements
regarding ventilator associated pneumonia
(VAP) in adults is most accurate?
a. Defined as pneumonia that occurs more
than 1 week after endotracheal intubation
b. Risk factors include age over 70, aspiration and depressed conscious level
c. Methicillin-resistant Staphylococcus aureus
(MRSA) is responsible in >50%
d. Diagnosis is primarily made on chest Xray showing bilateral infiltrates
e. Antibiotics should not be started until microbiological confirmation
a—Defined as pneumonia that occurs more
than 1 week after endotracheal intubation
Which one of the following is not a mechanism of antibiotic resistance?
a. Decreased permeability of cell to antibiotic
b. Efflux pump (active transport)
c. Inactivating enzyme
d. Sequestration in cytoplasmic vesicles
e. Target site modification
d—Sequestration in cytoplasmic vesicles
Which one of the following antimicrobials is not first line therapy for active Mycobacterium tuberculosis infection?
a. Ethambutol
b. Isoniazid
c. Pyrazinamide
d. Rifampicin
e. Streptomycin
e—Streptomycin
Which one of the following statements about human immunodeficiency virus (HIV) infection is most accurate?
a. Pneumocystis carnii pneumonia is likely if the CD4 count is 300
b. Toxoplasma encephalitis is likely when the CD4 count is 200
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c. In an HIV positive individual AIDS is diagnosed when CD4 count is below 200
d. HIV seroconversion usually occurs 2-6 weeks after infection without a drop in CD4 count
e. Highly active antiretroviral therapy is normally initiated when the CD4 count is below 400
c—In an HIV positive individual, AIDS is
diagnosed when CD4 count is below 200
An 82-year-old is brought into the emergency department with pyrexia and reduced level of consciousness. She has known chronic obstructive airways disease and was recently started on antibiotics by her doctors for a lower respiratory tract infection. Her temperature is 39 °C (102.2 °F), heart rate 124, and respiratory rate 32. Blood pressure on arrival was 95/67. Which one of the following best classifies her condition?
a. Multiple organ dysfunction syndrome
(MODS)
b. Sepsis
c. Septic shock
d. Severe sepsis
e. Systemic inflammatory response syndrome
b—Sepsis
