CTU Block 2

Bugs & Drugs

100

True or false - yeast in 1/2 blood cultures is a contaminant and should not be treated

FALSE 

Yeast in a blood culture is never considered a contaminant and warrants further investigation plus an ID consult

200

2 common antimicrobials for VRE in our centre

Daptomycin 

Linzeolid

300

How would you dose ceftriaxone for bacterial meningitis?

Ceftriaxone 2g IV q12h

400

At what CD4 count do you provide prophylaxis against PJP in an HIV patient?

<200

500

Name 3 opportunistic fungal infections in HIV

Blastomycosis, candidiasis, coccidiomycosis, histoplasmosis, penicilliosis, PJP, sporotrichosis

Love Your Liver

100

How often is HCC screening performed and by what method?

q6monthly, U/S (+/-AFP in some guidelines)

200

What 2 diuretic medications are used in fluid management of a cirrhotic and at what optimal ratio are they prescribed?

Spironolactone, furosemide 

5:2

300

Name 4 physical exam findings from the hands of a cirrhotic patient

Clubbing, Terry's nails, Dupuytren's contracture, palmar erythema, asterixis, muscle wasting, spider angiomas

400

You suspected a variceal bleed in your cirrhotic patient. Which three medications should you start? 

Pantoprazole IV 

Octreotide 

Ceftriaxone 

500

How is SBP diagnosed on ascitic fluid analysis and what is the treatment?

PMNs 250 mm³

Positive culture (do not wait for culture to treat!)

Absence of secondary causes (e.g., bowel perforation)

Tx: Ceftriaxone x 7 days

Kidney Beans

100

What is the first step of treating hyperkalemia (>6.5)?

Stabilize the myocardium (calcium gluconate) 

200

Name 3 types of vascular access in a dialysis patient

Temporary dialysis catheter, tunneled dialysis catheter, AV fistula, vascular graft 

300

Name 3 methods to excrete potassium after shifting

1. Diuretics (lasix)

2. Binding resins (kayexalate) 

3. Dialysis (if refractory)

400

What are the the 5 ACUTE indications to initiate hemodialysis?

Refractory to medical management:

1. Acidosis, 2. Electrolytes (hyperK), 3. Ingestion (toxins, overdose). 4. Overload (pulmonary edema), 5. Uremia 

500

Name 5 ECG changes in hyperkalemia

Peaked T waves, flat Ps, PR prolongation, wide QRS, bradycardia, sine wave, v fib, asystole

IM Wild Card

100

Name a partial opioid agonist

Buprenorphine

200

What is an iatrogenic complication of normal saline?

Hyperchloremic metabolic acidosis (non-anion gap)

300

What is "triple therapy" for HRS?

Albumin

Octreotide

Midodrine

400

At what CD4 count do you provide prophylaxis against MAC in an HIV patient?

<50

500

How do you diagnose PD peritonitis?

WBC 100 cells/mm³

Effluent culture positive 

Clinical symptoms