Old ID Written Exams

Question 1

2 clinical manifestations of Bordetella henslae?

Answer 1

1) Cat Scratch Disease

2) Bacillary Angiomatosis

Question 2

3 active antibiotics for Bordetella henslae?

Answer 2

1) Doxycycline
2) Azithromycin
3) Erythromycin

4) TMP-SMX (for Peds)

Question 3

Fever, red eyes, arthritis months after leprosy treatment.

Answer 3

Reversal Reaction

Erythema Nodosum Leprosum

Question 4

Mode of transmission of leprosy?

Answer 4

Nasal discharge from lepromatous leprosy patients

Question 5

3 clinical manifestations of Whipples?

Answer 5

1) Culture negative endocardititis
2) Chronic GI illness (Classic whipples)
3) CNS - reversible dementia

Also Asymptomatic carriers and ocular disease

Question 6

How to detect Whipples disease on biopsy?

Answer 6

Large Foamy macrophages in lamina propria

Electron microscopy, immunostain or PCR

Question 7

Treatment for Whipples?

Answer 7

Ceftriaxone 2 g IV daily x 2 weeks, then TMP-SMX for 1 year

Question 8

4 principles to consider when setting up a pet visitation program?

Answer 8

1) Hand hygiene before and after animal contact
2) Written policy
3) Designated trained personnel
4) Suitable animals - no reptiles, not <1 year old animals, vaccinated, in good health, no licking, free of fleas, always leashed, not for patients on isolation

Question 9

4 elements of MRSA infection control program?

Answer 9

1) Active surveillance
2) Hand hygiene
3) Patient isolation
4) PPE

Question 10

Treatment of VGS IE with Penicillin MIC of 1?

Answer 10

Ampicillin OR Penicillin G + Gentamycin for 4-6 weeks

Treat like an enterococcus endocarditis

Question 11

Treatment of MRSA Prosthetic valve IE?

Answer 11

Vancomycin 6 weeks + Rifampin 6 weeks + Gentamicin 2 weeks

Question 12

Treatment of Enterococcus faecalis IE, Amp S and Gent R

Answer 12

Ampicillin + Streptomycin for 4-6 weeks

Question 13

2 Treatments for Legionella?

Answer 13

1) Azithromycin x 7-10 days

2) Levofloxacin x 7-10 days

Question 14

2 measures to stop water associated Legionella outbreaks?

Answer 14

1) Flush pipes with water >65 degrees celcius for 30 minutes
2) UV light treatment

Also copper-silver ionization

Question 15

4 measures to prevent/manage HBV in diaysis patients?

Answer 15

1) Vaccination of all dialysis patients
2) Designated machines for positive patients
3) Survillance with annual serology
4) Segretate positive patients

Question 16

2 reasons differences in HBV vaccination for dialysis patients?

Answer 16

1) Double dose of vaccine

2) If titre <10 give a booster dose

Question 17

2 advantages of live flu vaccine?

Answer 17

1) No needle exposure

2) Increased immunogenicity in children

Question 18

4 contraindications to live flu vaccine?

Answer 18

1) Children less than 2 years old
2) Immunocompromised patients
3) Pregnancy
4) History of hypersensitivity to any component of the vaccine

Question 19

2 parasites that cause biliary obstruction?

Answer 19

1) Clonorchis sinensis
2) Opisthorcis viverrini
Also..
3) Fasciola hepatica
4) Ascaris

Question 20

What organism causes neurocystocercosis?

Answer 20

Taenia solium

Question 21

Treatment of neurocystocercosis?

Answer 21

Albendazole x 28 days

Question 22

Treatment of African Tick Bite fever?

Answer 22

Doxycycline x 10 days

Question 23

Malaria prophylaxis for Haiti:

• Preferred treatment
• 2 alternatives if patient is leaving tomorrow

Answer 23

Preferred = Chloroquine (once a week, start 1 week before, stop 4 weeks after)

2 alternatives:
Atrovaquone/Proguanil (2 days before, 7 days after)
Doxycycline (2 days before, 28 days after)

Question 24

Malaria prophylaxis for a pregnant woman going to India?

Answer 24

Mefloquine (once a week, start 1 week before, stop 4 weeks after)

Question 25

Plasmodium vivax in pregnancy: - 1 test - 1 treatment

Answer 25

``` Test = G6PD test (before giving primaquine) Treatment = Chloroquine until delivered then treat for liver form with Primiquine after delivery for 14 days ``` Can also just give the Chloroquine 0, 6, 24, 48 hours and not treat through the whole pregnancy

Question 26

4 pseudomonas virulence factors?

Answer 26

1) Pyocyanin 2) Pyoveridin 3) LPS 4) Exotoxin A 5) Pili 6) Adhesins 7) Proteolytic enzymes 8) Alginate

Question 27

4 Mechanisms of resistance of pseudomonas?

Answer 27

1) Efflux pumps 2) Porin mutations 3) Carbapenemases 4) AmpC 5) Beta lactamases 6) Aminoglycoside modifying enzymes

Question 28

3 steps of treatment for prosthetic knee MRSA?

Answer 28

1) 2 step revision 2) Vancomycin 3) Rifampin

Question 29

Trough level for Vancomycin in an MRSA prosthetic joint infection?

Answer 29

15-20

Question 30

Diagnosis of acute Histoplasma?

Answer 30

Culture organisms Or serology with positive H band M band positive in acute and previous infection

Question 31

Principle of the IGRA test?

Answer 31

Measures cell mediated immune response to TB antigen. Cells are exposed to a TB antigen (ESAT6 or CFP10) and if there is latent infection they will release interferon resulting in a positive IGRA.

Question 32

3 advantages and 3 disadvantages of the IGRA test?

Answer 32

3 advantages: - Only requires 1 visit - No cross reaction with BCG vaccination - Less subjectivity in reading results 3 disadvantages: - Cross reaction with M. africum, M. bovis, M. microtti - Expensive - Requires a fresh blood sample - Requires laboratory equipment

Question 33

List 3 airborne pathogens

Answer 33

1) Mycobacterium tuberculosis 2) Measles 3) SARS 4) Varicella

Question 34

6 fungi resistant to echinocandins?

Answer 34

1) Cryptococcus 2) Histoplasma 3) Blastomyces 4) Coccioides 5) Fusarium 6) Pseudoalecheria boydii 7) Trichosporon 8) Sporothrix 9) Mucor

Question 35

4 complications of persistent yeast in the blood?

Answer 35

1) Endocarditis 2) Endophthalmitis 3) Hepatic absecess 4) Splenic absecess 5) Osteomyelitis 6) Death

Question 36

4 signs of poor prognosis for cryptococcus meningitis?

Answer 36

1) CSF WBC 1:1024 | 4) Increased ICP

Question 37

2 natural reservoirs of cryptococcus?

Answer 37

1) Bird droppings | 2) Soil

Question 38

3 drugs to treat CMV and 1 adverse reaction of each?

Answer 38

1) Ganciclovir - Neutropenia 2) Foscarnet - Renal failure, electrolyte imbalances 3) Cidofovir - Nephrotoxicity

Question 39

3 indications for suppressive HSV genital ulcer treatment?

Answer 39

1) Immunocompromised 2) Decrease transmission to partner 3) Recurrence associated with systemic symptoms

Question 40

Extragenital complications of genital HSV

Answer 40

- aseptic meningitis - thigh and buttock lesions - saccral autonomic nervous system dysfunction

Question 41

2 non beta lactam regimes for gonorrhoea?

Answer 41

1) 2 g azithromycin x 1 | 2) Doxycyline 100 mg PO bid x 7 days

Question 42

4 viruses causing encephalitis from Thialand?

Answer 42

1) HSV 2) Japenese encephalitits 3) Rabies 4) Nipah virus 5) Me Tri virus 6) Far Eastern Virus

Question 43

4 manifestations of Dengue severity?

Answer 43

1) Hemorrhage 2) Plasma leak 3) AST or ALT >1000 4) Impaired consciousness

Question 44

4 respiratory viruses that cause severe disease in HSCT?

Answer 44

1) RSV 2) Influenza 3) Adenovirus 4) Parainfluenza 5) Rhinovirus 6) Human Metapneumovirus

Question 45

Oseltamivir: - Coverage? - Dose/Duration? - Side Effects? - Age - Contraindications

Answer 45

``` Flu A and B 75 mg PO BID x 5 days GI upset >1 year old CI = Hypersensitivity ```

Question 46

Zanamivir: - Coverage? - Dose/Duration? - Side Effects? - Age - Contraindications

Answer 46

``` Flu A and B 10 inhaled BID x 5 days GI, Bronchospasm >=7 years old CI: Hypersensitivity ```

Question 47

Amantidine - Coverage? - Dose/Duration? - Side Effects? - Age - Contraindications

Answer 47

``` NOT Flu B, H3N2 or pH1N1 100 mg po BID x 5 days CNS side effects (insomnia, dizzy) renal toxicity >1 year Hypersensitivity ```

Question 48

4 reasons HIV viral load is not suppressed after 6 months?

Answer 48

1) Resistant virus 2) Non compliance 3) Malabsorption of medications 4) Drug interactions

Question 49

1 treatments for HIV with TB (other than NRTIs).

Answer 49

Efavrinez

Question 50

2 classes of HIV drugs contraindicated in TB/HIV?

Answer 50

1) NNRTIs | 2) ??

Question 51

5 manifestations of parvovirus B19?

Answer 51

1) Erythema infectiosum 2) Fetal hydrops 3) Transient aplastic anemia 4) Pure red blood cell aplasia 5) Arthropathy

Question 52

GNB grows from joint after having monoarthritis after diarrheal illness?

Answer 52

Campylobacter

Question 53

3 organisms that cause reactive arthritis?

Answer 53

Salmonella Shigella Yersinia Neisseria gonorrhea

Question 54

Mechanism of action of daptomycin?

Answer 54

Binds to bacterial membrane and causes rapid depolarization of the membrane potential causing inhibition of protein, DNA and RNA synthesis

Question 55

Spectrum of daptomycin

Answer 55

Staphyloccous, Enterococcus

Question 56

3 indications for daptomycin?

Answer 56

Complicated skin and soft tissue infection caused by susceptible organism MRSA or MSSA Bacteremia MRSA or MSSA Endocarditis VRE

Question 57

4 techniques for antimicrobial stewardship?

Answer 57

1) Formulary restrictions 2) Automatic substitutions 3) Audit and feedback 4) Educational programs

Question 58

Baylisascaris procyonis disease and animal?

Answer 58

Racoon | Acute Eosinophilic meningitis

Question 59

Monkey disease and organism?

Answer 59

Herpes B Virus | Encephalomyelitis

Question 60

Organism and vector for relapsing fever?

Answer 60

``` Borrelia recurrentis (Louse) Borrelia hermsii (Tick) ```

Question 61

3 tests before HCV treatment that affect prognosis?

Answer 61

1) HCV viral load 2) Genotype 3) Liver fibrosis stage 4) HIV test 5) Il28 polymorphism (fails interferon)

Question 62

4 hematological manifestations of TMP-SMX?

Answer 62

1) Agranulocytosis 2) Thrombocytopenia 3) Aplastic anemia 4) Acute hemolytic anemia 5) Leukopenia 6) Methylglounemia

Question 63

5 microbes associated with cancer?

Answer 63

1) HTLV-1 2) EBV 3) HPV 4) HCV 5) HBV 6) Helicobacter pylori 7) HHV8

Question 64

Treatment of toxoplasma lymphadenopathy?

Answer 64

Self limiting unless: Immunocompromised, pregnant or severe Then: Pyramethamine + Sulfadiazine