Infectious Disease Management Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Infectious Disease Management flashcards as text
A 42-year-old man with HIV (CD4 50 cells/μL, not on ART) develops progressive dyspnea. Chest CT shows bilateral ground-glass opacities. LDH is elevated. Which prophylaxis failure does this presentation most likely represent?
Answer: Pneumocystis jirovecii pneumonia (PCP) prophylaxis failure
Bilateral ground-glass opacities with elevated LDH in a severely immunocompromised HIV patient is classic for PCP; prophylaxis with TMP-SMX is indicated when CD4 <200 cells/μL.
A patient is being treated for PCP with TMP-SMX. She has room air PaO2 of 62 mmHg. What adjunctive therapy should be added within 72 hours of starting antibiotics?
Answer: Systemic corticosteroids (prednisone)
Adjunctive corticosteroids reduce mortality in moderate-to-severe PCP (PaO2 35 mmHg) by blunting the inflammatory response triggered when organisms are killed.
A 25-year-old woman presents with high fever, headache, and a non-blanching petechial rash evolving to purpura. CSF shows gram-negative diplococci. What empiric treatment should be administered IMMEDIATELY?
Answer: Ceftriaxone 2 g IV immediately
Meningococcal meningitis/septicemia requires immediate ceftriaxone without delay; dexamethasone adjunctively reduces meningitis complications.
A 48-year-old man develops fever and flank pain 10 days after a kidney transplant. Urinalysis shows pyuria. Urine culture grows Escherichia coli (ESBL-producing). What is the preferred treatment?
Answer: Meropenem or ertapenem
ESBL-producing Enterobacteriaceae are resistant to most cephalosporins and require carbapenems as the definitive treatment for serious infections in immunocompromised hosts.
Which of the following is the MOST important measure to prevent catheter-associated urinary tract infections (CAUTIs) in hospitalized patients?
Answer: Prompt removal of urinary catheters when no longer needed
The most effective CAUTI prevention strategy is daily reassessment and prompt catheter removal, as infection risk increases with each catheter-day.
A 35-year-old traveler returns from India with watery diarrhea that progresses to rice-water stools and profound dehydration. Stool culture grows a curved gram-negative rod. What is the cornerstone of management?
Answer: Aggressive IV fluid resuscitation with oral rehydration salts
Cholera (Vibrio cholerae) management relies on rapid fluid and electrolyte replacement as the primary life-saving intervention; antibiotics (doxycycline or azithromycin) are adjunctive.
A 60-year-old man with advanced COPD is admitted with fever, productive cough, and a new right lower lobe infiltrate 5 days into his hospital stay. He was intubated for 3 days. Which pathogen is of GREATEST concern for hospital-acquired pneumonia in this setting?
Answer: Pseudomonas aeruginosa or MRSA
Hospital-acquired and ventilator-associated pneumonia are most commonly caused by drug-resistant gram-negatives (including Pseudomonas) and MRSA, requiring empiric coverage of these organisms.