Part 3 questions

Question 1

Itraconazole: which azole ?

Answer 1

Same family as fluco and vorico
Not a choice to tx candidemia as inferior

Question 2

What are the different types of echinocandin ?

Answer 2

Anidulafungin, caspofungin, micafungine

Question 3

When should you use ampho B ?

Answer 3

If pregnant ou SNC infection
Less used as more side effects and renal toxicity ++

Question 4

How do you treat Bell paralysis ?

Answer 4

Start tx within 3 days of sx, max 7 days
- Pred 60-80 die x 1 w
- Valacycolvir or acyclovir if severe

Question 5

Which tx for serratia marcescens in expectorations ?

Answer 5

BLSE
TMP SMX > azithro

Question 6

What type of bacteria is nocardia ?

Answer 6

Branching gram positive rods
Indistinguishable from actinomyces

Question 7

What is the clinical presentation of nocardia infection ?

Answer 7

Mainly in immunocompromised patients
Lung is the most common site of infection : lung nodules with or without cavitation
But can disseminate : brain abscesses with ring enhancing lesions, nodular and ulcerative skin lesions

Question 8

What does a AV block indicated in endocarditis ?

Answer 8

Good specificity for aortic perivalvular involvement, like an abscess

Question 9

Tx kwellada pour ?

Answer 9

= perméthrine
Tx pour la gale
Tx crème a appliquer sur la totalité du corps

Question 10

Which pathogen causes bloody diarrhea between
- Cryptosporiose
- Giardiase
- Campylobacter
- Norwalk virus

Answer 10

Campylobacter

Question 11

Thombocytopenia due to HIV ?

Answer 11

PTI common initial presenting finding in people with new dx of HIV
Si PLT 20-30 : IvIg, corticotx
Si PLT 40-50: AART seulement

Question 12

PCP tx : how quickly should the patient improve ?

Answer 12

Consider failure if lack of improvement or progression after 5 days of tx
Some worsening may occur during initial days of tx

Question 13

PJP tx : should you use TMP SMX or pentamidine ?

Answer 13

TMP SMX and pentamidine considered equally effective
Both parenteral
Pendamidine IV can have serious side effetcs
In TR for moderate/severe primaquine + clinda also an option

Question 14

How does MAC infection presents ?

Answer 14

Bronchiectasies lobe moyen droit + lingula chez non fumeur avec sx constitutionnels
Femme de plus de 50 ans

Question 15

What is the clinical presentation of :
- Mycobacterium bovis
- Myocobecterium gordonae

Answer 15

Bovis : manifestations indistinguables de M tuberculosis
Garodonae est un contaminant

Question 16

Prescrire azithro seul en CAP outpatient tx ?

Answer 16

If healthy outpatinet without comorbidities or risk factors
Only in areas with low pneumococcal resistance so not appropriate in majority of canada

Question 17

Prise en charge d’une patiente enceinte avec suspicion de zika ?

Answer 17

Serologie zika et dengue
Si + : echo a la recherche de zica congenital +/- amniocentèse

Typique : rash, arthalgies, conjonctivitie, fievre

Question 18

When should you test for zika virus ?

Answer 18

• Within 2 weeks of sx onset
  = sx pts within 3 days or arriving, 14 days of departing high risk area
• Sx pregnant woman

NO longer recommend screening asx pregnant women

Question 19

What is the tx of zika ?

Answer 19

Supportive
Avoid NSAIDs until dengue ruled out

Question 20

Presentation clinique trichinellose ?

Answer 20

CK majorés, myalgies, hémorragies conjonctivales, oedème périorbital
Associé à viande d’ours cru

Question 21

When should you ask for legionella ?

Answer 21

En cas de CAP severe ou de contexte epidemio. Suspicion augmentée si sx GI/hyponatrémie/enzymite hépatique/CRP > 100 ou echec aux B lactames