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 grewStreptococcus 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 e1
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 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
- Common Gram Positive organisms:
a. Actinomyces israelii
b. Clostridium difficile
c. Enterococcus faecalis
d. Streptococcus pneumoniae
e. Streptococcus pyogenes
f. Streptococcus bovis
g. Staphylococcus aureus
h. Staphylococcus epidermidis
i. Streptococcus agalactiae
j. Viridans streptococci
For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. No Lancefield antigen, appears as lancetshaped diplococci and contains a polysaccharide capsule. These organisms are αhemolytic and a common cause of pneumonia and meningitis in adults and of otitis
media and conjunctivitis in children.
2. Commonly cause dental caries, subacute
endocarditis, and brain abscesses.
3. Can cause pharyngitis, skin infection, scarlet
fever, toxic shock syndrome, rheumatic
fever, and acute post-streptococcal glomerulonephritis.
1—d, Streptococcus pneumoniae; 2—j, Viridans
streptococci; 3—e, Streptococcus pyogenes
- Common Gram negative organisms:
a. Campylobacter
b. Escherichia coli
c. Haemophilus
d. HACEK group
e. Klebsiella pneumoniae
f. Neisseria meningitidis
g. Pseudomonas
h. Salmonella
i. Shigella
For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. Can produce hemolytic uremic syndrome
2. Associated with Guillain-Barre syndrome
3. Associated with Waterhouse-Friderichsen
syndrome
b—E. coli; a—Campylobacter; f—Neisseria meningitidis
- Antibiotic classes:
a. Aminoglycosides
b. Antimetabolite
c. Carbapenems
d. Cephalosporin
e. Fluoroquinolones
f. Glycopeptides
g. Lincosamides
h. Lipopeptides
i. Macrolide
j. Monobactam
k. Oxazolidinones
l. Penicillins
m. Rifampin
n. Tetracyclines
For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. Class of beta lactam antibiotic where newer
generations have reduced gram positive coverage and increased gram negative coverage
2. Antiribosomal antibiotic with gram positive
cover including MRSA and vancomycinresistant Enterococcus (VRE), but no activity
against most gram negatives
3. DNA gyrase inhibitors
d—Cephalosporins; k—Linezolid; e—Fluoroquinolones
