ID Jeopardy

Immunosuppression

100

This is the effective risk of transmitting HIV to a sexual partner in a patient who has had an undetectable viral load for >6 months.

What is 0%

Undetectable = Untransmissible

200

This EBV related lesion is most commonly seen in severely uncontrolled HIV

What is Primary CNS lymphoma?

300

A patient presents with a history of recurrent N. meningitidis infections. His mother also had recurrent bouts of CNS and pulmonary infections. What lab testing should be ordered for him?

Total Hemolytic Complement (CH50)

Deficiency in late or terminal complements leads to a low total complement level

400

A patient with poorly controlled HIV presents with multiple lesions as shown in the picture, which have been growing for multiple weeks. His only symptom is painful swelling in the affected area. What is the most likely causitive organism?

HHV-8

Kaposi's sarcoma

500

Name either an oral two-drug PrEP (pre-exposure prophylaxis) or an intramuscular one drug regiment for PrEP for HIV prevention. 

Tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) plus emtricitabine; Cabotegravir

TDF is less preferred with osteoporosis or reduced eGFR 30 to 60%

Fungi/STDs

100

This stage of syphilis is characterized by diffuse rash, generalized lymphadenopathy, condyloma lata, and mucous patches.

What is secondary syphilis?

200

The USPSTF recommends screening for chlamydia in all sexually active women ___ years and younger and in women ____ years or older who are at increased risk for infection.

What is 24 and 25?

Grade B level of evidence

300

A 55 year old patient with a history of liver transplant presents to the hospital with fevers, cough, sinus pressure and malaise for a few days. His CT scan is shown below. Gram stain of blood cultures demonstrated gram negative septating hyphae. What is the most likely microbe?

What is Aspergillus?

Halo sign on CT scan indicative of hemorrhage of the adjacent tissues 

400

Give one of three possible parenteral (IV) antibiotic regiments for Pelvic Inflammatory Disease.

Ceftriaxone, Doxycycline and Metronidazole or Cefotetan plus doxycycline or Cefoxitin plus doxycyline

Foxy Doxy!

Parenteral is indicated for inability to exclude a surgical emergency, pregnancy, severe systemic toxicity, tubo-ovarian abscess, inability to tolerate orals, or failure of outpatient management.

500

What duration of maintenance fluconazole is indicated for an HIV patient with a CD4 count < 50 after disseminated cryptococcal infection?

1 year of maintenance fluconazole and until their CD4 counts are greater than 100 with an undetectable viral load

Antimicrobials

100

This class of antibiotics is the currently preferred treatment for serious infections caused by ESBLs

What are carbapenems?

200

Name two antibiotics that have a high risk of C Diff infection as a complication.

Basically all of them have been associated at one time or another

Highly testable are clindamycin, fluoroquinolones, and broad spectrum

300

What organ system is most commonly adversely affected by amphotericin B?

Kidneys

Renal toxicity correlates with conventional amphotericin B use and can lead to renal failure and the requirement for dialysis. But the azotemia often stabilizes with therapy, and renal damage is reversible after discontinuation of amphotericin B.

400

What is the mechanism of creatinine elevation after TMP/SMX administration?

Competitive inhibition of creatinine excretion by Trimethoprim

500

What is the mechanism of action of Doxycycline?

Inhibition of protein synthesis via obstruction of the 50S ribosomal subunit

SSTI/CNS Infections

100

Mr Smith walks into your office with a well-demarcated, tender, brightly erythematous rash with associated fevers for the past 5 days. What is his diagnosis?

What is erysipelas?

More superficial infection of the dermis than cellulitis

200

This bug is the most common cause of bacterial community acquired meningitis.

What is Strep Pneumoniae?

N. Meningitidis is a close second in certain populations

300

Ms Jones presents to the hospital with a deep, dirty bite from a dog. She has an incomplete tetanus vaccine primary series, with her last shot coming 7 years ago. What is the most appropriate tetanus prevention strategy?

Both tetanus vaccination and tetanus Immunoglobulin

TIG is recommended for dirty or major wounds with unknown vaccination history, those who have never gotten a vaccine or have an incomplete primary series, or those with a severe immunodeficiency.

Repeat vaccination is indicated for anyone with an incomplete primary series

400

This is the appropriate antibiotic regiment for an immunocompetent 45yo patient who recently underwent a CSF shunt placement and now presents with signs of meningitis.

Give either specific antibiotics or the bugs you need to cover.

What is IV vancomycin plus either IV ceftazidime, cefepime, or meropenem?

MRSA, resistent strep Pneumo, and Pseudomonas coverage.

500

What lab values are used to calculate a LRINEC score in necrotizing fascitis?

Don't need the cutoffs, just the lab tests. Bonus 200 points for the cutoff values :)

CRP > 15, WBC count 15-25 or >25, Hgb 11-13.5 or <11, Na <135, Cr > 1.6, Glucose >180

Any wound with a high suspicion of necrotizing fasciitis should proceed directly to surgery. LRINEC recently was shown to have a low external validity but is still helpful for stratifying complicated abscess vs NF

Lung/Kidney Infections

100

Among patients aged 18 or older without contraindications, how often is the influenza vaccination recommended?

Annually

Recommended for all persons aged 6 months or older without contraindications

Only true contraindication is a history of Guillain Barre after previous vaccination. Egg allergy is not a true contraindication

200

A 50M with a history of anaphylaxis to Vancomycin presents to the hospital for community acquired pneumonia. His blood cultures grow MRSA. What is the most appropriate antibiotic per the 2019 IDSA guidelines?

Linezolid

Daptomycin has poor penetration due to surfactant

300

If their infection was confined to the bladder, describe 3 patient populations that would have previously been described as complicated UTI in the IDSA guidelines prior to the 2025 IDSA Guideline update that would now classify them as uncomplicated.

Males, recurrent UTIs, immunocompromised patients, diabetics, underlying urologic abnormalities, urologic stents, non-indwelling urinary catheters all were previously complicated and are now uncomplicated.

400

What are the indications for prophylactic daily antimicrobial agents in females with recurrent UTIs?

Three or more UTIs in the previous 12 months, two or more in the previous 6 months, or failure of other prevention strategies.

500

What was the name of French study which demonstrated a lower risk of death at Day 28 in those patients admitted to the ICU who received hydrocortisone in addition to antibiotics for CAP?

What is the CAPE COD trial?

Demonstrated a 28-day all cause mortality of in 6.2% in the intervention arm and 11.9% in the control arm.