supportive care

Question 1

for F+N which patients would you consider adding vancomycin?

Answer 1

• AML patients receiving high dose cytarabine, due to risk of S.viridans infection associated with septic shock and ARDS
• presented with hypotension/shock
• mucositis
• prior history of alpha hemolytic strep infection
• colonization with resistant bugs
• vegetations on echo

Question 2

for F+N when would you consider adding flagyl?

Answer 2

• typhlitis
• significant mucosal breakdown
• perianal skin breakdown
• c-diff infection
• peritoneal signs or other abdominal pathology

Question 3

what infections are BMT patients at risk for within the first 30 days post BMT?

Answer 3

gram negatives
staph
aspergillus
candida
HSV-1

Question 4

what infections are BMT patients at risk for within 30-120 days post BMT?

Answer 4

candida
aspergillus
PJP
CMV, adeno, EBV, HHV-6

Question 5

what are three findings on imaging that suggest Invasive fungal infection of lower resp tract?

Answer 5

dense circumscribed lesion with or without halo sign
air crescent sign
cavitation

Question 6

what is the best antifungal to use to treat aspergillus

Answer 6

voriconzole

Question 7

amphotericin does not cover which species of candida the best and is not recommended?

Answer 7

candida albicans

fluconazole is the treatment of choice

Question 8

what is the treatment of choice for mucormycosis

Answer 8

Ampho B

Question 9

for neutropenic patients what is the initial therapy for candidemia?

Answer 9

echinocandin is the therapy of choice

Ampho B is an alternative

Question 10

What are the principles of chemotherapy?

Answer 10

• multi-drug therapy
• neo-adjuvant vs adjuvant therapy
• dose intensity

Question 11

Identify 2 subtle CT signs suggestive of invasive aspergillosis.

Answer 11

• halo sign

- air-crescent sign

Question 12

Identify 3 ethical principles of TCSP2

Answer 12

Respect for persons
Concern for welfare
Justice