Infectious

Question 1

Management of post exposure prophylaxis for pertussis?

Answer 1

Macrolide like Azithromycin for 5 to 7 days within 3 weeks of starting the symptoms

Question 2

Gold standard diagnosis for pertussis?

Answer 2

PCR for nasopharyngeal swab.
It is gram negative coccobacilli

Question 4

I Cause upper cavitary lesion in COPD patients After exposure to me in missisipi river

Answer 4

Histoplasmosis
Can cause
1) Acute respiratory disease in immunocompetent patient: Hilar LAP + Erythema multiforme
2) Disseminated disease: GI ulcers + Adrenal Insufficiency
3) CNS disease
4) Cavitary lesions in COPD patients

Question 5

A Cannon ball, the same size of RBC, I can cause pneumonia and verroucus skin lesion

Answer 5

Blastomycosis.

Question 7

Definition of VAP?

Answer 7

Pneumonia occur 48 hours after intubation

Question 8

What to cover in VAP initially?

Answer 8

Pneumoccoci + Pseudomonas
Others:
- MRSA if high risk
- Double pseumonas coverage if indicated

Question 9

Indications for double coverage of pseudomonas + MRSA in VAP?

Answer 9

1) CF or bronchiectasis.
2) Septic shock.
3) ARDS.
4) Recent IV antibiotic use in the last 3 months.
5) HAP\VAP occur after more than 5 days of hospitalization
Acute renal replacement therapy prior to VAP

Question 10

Drug of choice for pertussis?

Answer 10

Macrolide for 2 weeks
For exposure: 5 days macrolide

Question 11

Antibiotic of choice for chemical pneumonitis?

Answer 11

Supportive management. No need to start antibiotics

Question 13

What are the risk factors to develop IRIS?

Answer 13

1) Low CD4 count before initiation of ART
2) High Viral load before initiation with rapid drop after starting ART
3) Latent infection
4) Dissimenated infection