Infectious Disease

Question 1

T/F: If asking for Proteus, nitrofurantoin is never the answer.

Answer 1

True, nitrofurantion does not cover proteus.

Question 2

What seems to be the class of A/B that has highest risk of c.diff?

Answer 2

Fluoroquinolones

Question 3

What does a test for sensitivity test for? Specificity?

Answer 3

Sensitivity:
Think of a screening tool, a negative test rules OUT the disease

Specificity:
Think of confirmation tool, a positive test rules IN the disease

Question 4

T/F: all test for c.diff can only show presence of bacteria, cannot differentiate between colonization or infection

Answer 4

True

Question 5

What is the most current recommendation from 2021 about c.diff treatment?

Answer 5

Preferred therapy is fidaxomicin over vanc.

Data showing that it reduces risk for recurrence

Fulminant: is still vanc and metronidazole

Question 6

When can a patient consider fecal microbiota transplantation (FMT)?

Answer 6

When they have had two recurrent episodes (so first episode plus two more)

Question 7

Why can’t heart failure patients use bezlotoxumab?

Answer 7

It can cause edema and put patient in decompensated HF

Question 8

T/F: if patient is allergic to a macrolide, they can not be treated with fidaxomycin

Answer 8

T. it is a macrolide base molecule

Question 9

T/F: fidaxomicin is preferred therapy for non-severe and severe initial occurrence of CDI only

Answer 9

F. Should be treating initial and first occurence.

Vanc and IV metronidazole for fulminant CDI

Question 10

What is the most common pathogen for pneumonia?

Answer 10

Viruses, ie influenza, but for bacteria it would be strep pneumo

Question 11

For CAP infections with pathogens are we most concerned about?

Answer 11

HAP
Haemophilus influenzae
Atypicals
Strep Pneumoniae

**moxi, levo (cipro not good for CAP coverage due to not covering s.pneumo)

**moxi does not cover p.aeruginosa

Question 12

T/F: Oral cations bind to fluoroquinolones

Answer 12

True

Question 13

T/F: no more HCAP

Answer 13

True.

Question 14

T/F: beta-lactams have no atypical coverage and always must be accompanied by a macrolide for empiric therapy

Answer 14

True.

Question 15

T/F: Cystic fibrosis and bronchiectasis are risk factors for pseudomonas

Answer 15

True

Question 16

what is psi/port?

Answer 16

Pneumonia test, pneumonia severity test.

Patient outcomes research team

predict risk of mortality, does not used for treatment

Question 17

What is the target trough for vanc?

Answer 17

15-20

Question 18

What patient population requires double pseudomonas coverage?

Answer 18

septic, mech vents, bronchiestasis, cystic fibrosis, in facility without primary anti-pseudonal

Question 19

T/F: For pyelonephritis, mono therapy with oral beta lactam is ok if patient is given 1 dose of IV 1g ceftriaxone.

Answer 19

True.