Bugs & Drugs
Name a bacteria that is catalase AND coagulase positive
staphylococcus aureus
what is the preferred antibiotic for treatment of Pneumocystis pneumonia?
This infection spread by the Aedes mosquito manifests with the abrupt onset of high fever, headache, retro-orbital pain, myalgia, arthralgia, and lower back pain (break-bone fever); a positive tourniquet test is characteristic.
Dengue
Name two antivirals that are indicate for HIV pre-exposure prophylaxis
Tenofovir (TDF / TAF) - emtricitabine
Cabotegravir
Name the most important action healthcare workers can take to reduce the spread of hospital-associated infections
hand washing
Name a gram-positive rod detected by BCID that has "tumbling motility"
Listeria Monocytogenes
This antibiotic is used in the treatment of pulmonary tuberculosis and requires coadministration of B6 (pyridoxine) to prevent neuropathy
These two species of malaria have a latent hepatic stage and following treatment should receive primaquine or tafenoquine to prevent relapse
Plasmodium vivax / ovale
A patient has been diagnosed with cryptococcal meningitis. CD4 is <100. Two days after starting treatment they report slightly worsened blurry vision. What is the next step?
Lumbar puncture, management of ICP
Name three patient risk factors associated with heightened risk of surgical site infections
-malnutrition
-hyperglycemia
-immunosuppression
-tobacco use
-staph aureus nasal carriage
-obesity
Name two ways that bacteria can become resistant to antibiotics
-cell wall changes
-efflux pumps
-decreased permeability/porin mutations
-drug inactivation via enzyme production
A patient presents for a red, annular skin rash that often has central clearing after hiking in the Virginia Appalachia region two years ago. What is the work up and treatment for the spirochete you are suspecting?
-lyme
-early localized
-no need for testing, treat with doxycycline
This live vaccine protects against a flavivirus that causes a viral hemorrhagic fever. Name 3 contraindications (absolute or relative) and two concerning adverse events related to this vaccine
yellow fever vaccine: YEL-AND, YEL-AVD (first time vaccine receipt)
absolute: thymus disorder, immunocompromised patients, infant < 6-8 months, anaphylaxis egg protein
relative: pregnancy/breastfeeding, age >60
Name an antiviral medication used in the treatment of HIV one that can cause a life-threatening hypersensitivity in patients with an HLAB5701 allele
abacavir
Name 3 ways to reduce the risk of a central-line associated bloodstream infection (CLABSI)
daily review of need, minimum number of lumens, subclavian when possible, chlorhexidine antisepsis, daily chlorhexidine bathing (ICU), CVC insertion bundles, disinfect caps when accessing
A patient has Staphylococcus Aureus bacteremia. the lab reports it is resistant to oxacillin. which gene is most likely present in this bacteria?
-VanA
-MecA
-CTX-M
-VIM
MecA
This nontuberculous mycobacteria has been associated with contamination of heater-cooler units during cardiac surgery
Mycobacterium chimaera
This gram-negative intracellular coccobacillus is known for causing an "undulent fever" and can be spread through undercooked meat or unpasteurized milk
Brucellosis
What is the up front treatment of choice in a patient with disseminated histoplasmosis and CD4 < 100
Amphotericin
Name 2 ways to prevent the spread of C. Difficile infection in hospitalized patients
hand hygiene with soap and water (60 seconds), contact precautions (gown and gloves), single patient room, appropriate sporicidal agents for room disinfection, single room medical supplies (Bp cuff, thermometer)
Name two antibiotics that only have gram positive activity
Vancomycin, Daptomycin, linezolid, tedezolid, dalbavancin, oritavancin
A Giemsa stain on a blood smear detects multiple intraerythrocytic ring forms. It is summer and the patient has been hiking in the Nantucket area. what is the treatment?
Atovaquone + Azithromycin
This Lyssavirus infects mammals worldwide and has no effective antiviral treatment
Rabies
Name a vaccine that is contraindicated in patients living with HIV regardless of CD4 count
(CD4 < 200 can't give MMR, varicella)
you are worried about shingles in a patient on immunosuppression (Tac, MMF, pred) after renal transplant. she has 3 lesions to the left side of torso that seem to be within one dermatome. what precautions are appropriate?
contact + airborne