Infectious Disease

Question 1

Live vaccines vs inactivated vaccines (list)

Answer 1

Live/ attenuated:
Live influenza vaccine
MMR
oral polio (not used in US)
Rotavirus
Varicella virus
Herpes zoster

Inactivated:
DTAP
IPV
HEP B
HEP A
HPV
INFLUENZA
LYME
RABIES

Question 2

Live vaccine rules:

Answer 2

Do not administer to immunocompromsied pt

Do not give with febrile illness

Do not administer if pt pregnant

Can give two live vaccines on the same day OR spaces 4 weeks apart

Question 3

Live influenza vaccine

Answer 3

Flumist

Contraindicated: egg allergy, asthma, pregnancy, immune compromised

Question 4

MMR vaccine contraindicated

Answer 4

• live vaccine

Contraindicated: neomycin allergy, pregnancy, febrile illness, immune compromised
Egg allergy ok.

Question 5

MMRV vaccine contraindicated

Answer 5

Same contraindications as MMR but more likely to cause febrile seizures! Educate parents.

Question 6

Oral polio vaccine

Answer 6

Not used in the United States
Rare risk of vaccine associated paralytic poliomyelitis in patient of exposed family members

Question 7

Varicella vaccine contraindications

Answer 7

Live vaccine

Contraindicated: neomycin allergy, febrile illness, immune compromised, pregnancy

Question 8

Inactivated vaccine rules:

Answer 8

May be administered with other vaccines.

Contraindications: anaphylactic allergies to vaccine

• may give antipyritics to patients who have had febrile seizures in the past

Question 9

How many doses of HPV vacccine?

Answer 9

Two doses if started age 14 or younger
Three doses if started age 15 or older

Question 10

Inactivated influenza vaccine reacts with:

Answer 10

Immunosuppressants
Theophylline
Warfarin

Question 11

Start flu vaccine

Answer 11

Patients 6 months and older. Patients younger than 9 get two doses the first year.

Flumist is only for pts 2 years and older

Question 12

4 elements of antibiotic stewardship

Answer 12

Commitment
Action for policy and practice
Tracking and reporting
Education and expertise

Question 13

First line therapy for AOM

Answer 13

Amoxicillin

Question 14

First line therapy for strep throat

Answer 14

Penicillin

Question 15

First line therapy for infected bites (including human)

Answer 15

Amoxicillin/clavulanate

Question 16

Cephalosporins primarily used for

Answer 16

Skin and soft tissue infections- first generation. Ex cephalexin keflex

Or UTIs

Question 17

Skin infections prescribe:

Answer 17

Cephalosporins.

Question 18

Fluoroquinolones black box warning for:

Answer 18

Tendon rupture

Question 19

Fluroquinolone uses:

Answer 19

Ciprofloxacin
Not first line anymore because of resistance and ADRs

• second line for complicated UTI, pyelonephritis, pneumonia

Question 20

Get EKG before prescribing

Answer 20

Moxifloxacin

Question 21

Clindamycin black box warning for:

Answer 21

Severe colitis

Question 22

Clindamycin used for

Answer 22

Dental infections

Infections in pcn allergic pts

First line for MRSA in some areas

• first line therapy for pregnant women and children , otherwise second line therapy

Question 23

___________ PlayStation may cause myopathy

Answer 23

Macrolides (azithromycin, erythromycin)

Question 24

___________ can cause prolonged QT interval

Answer 24

Azithromycin

Question 25

Drug of choice for CAP

Answer 25

Azithromycin

Question 26

Tetracycline and doxycycline do not prescribe to:

Answer 26

Pregnant women Children less than 8

Question 27

_________ used to treat P acnes

Answer 27

Tetracycline and minocycline

Question 28

Vanco used for:

Answer 28

Severe gram positive infections (such as MRSA) Give IV

Question 29

______ causes red man syndrome if infused too fast

Answer 29

Vanco

Question 30

TB treatment:

Answer 30

INH plus ……

Question 31

Black box warning for Hep C antivirals, first test for:

Answer 31

HPV infection, can cause reactivation

Question 32

All azoles have __________ as an ADR

Answer 32

Hepatotoxicity

Question 33

Metronidazole

Answer 33

Treats both parasitical and bacterial infections. Used for BV

Question 34

Severe HIV/AIDS CD4 cells:

Answer 34

Less than 200 indicates severe

Question 35

Post HIV exposure prophylaxis :

Answer 35

Effective if exposure occurred less than 72 hours earlier. Tenofovir + emtricitabibe + raltegravir

Question 36

Pre exposure HIV prophylaxis

Answer 36

For patients at high risk of HIV Two drug combo: Tenofovir + emtricitabine

Question 37

ART failure:

Answer 37

Defined as failure to achieve or maintain suppression of viral replication to less than 50 copies

Question 38

Diagnosing TB

Answer 38

PPD or Quantiferon-TB serum test

Question 39

Treatment for TB:

Answer 39

MUST be multi drug Initiation phase: first 2 months Continuation phase: 4 months * 6 month regimen

Question 40

Treating TB pregnancy

Answer 40

INH + RIF + EMB (4th drug if pt is HIV positive)

Question 41

Pediatric treatment for TB

Answer 41

INH + RIF

Question 42

Monitoring during TB treatment

Answer 42

Sputum cultures monthly until negative Chest X-ray at completion to document baseline post TB X-ray Monitor liver enzymes cbc platelets Monitor for hepatitis monthly if in INH Monitor for peripheral neuropathy on INH

Question 43

Prevention of TB

Answer 43

Asymptomatic may have positive TB test INH alone for 6-9 months Monthly monitoring

Question 44

Length of treatment for UTI

Answer 44

3 days * longer if child or fever/chills, pregnancy

Question 45

First line treatment for UTI

Answer 45

Nitrofurantoin or bactrim