Shock
Which of the following hemodynamic profiles is typically observed in a patient with obstructive shock (i.e. preload, cardiac output, afterload)?
High preload, low cardiac output, high afterload
Alpha-1, Beta-1/2 (lesser extent)
Community-acquired bacterial pneumonia is most commonly caused by which organisms?
Streptococcus sp., Haemophilus sp., Mycoplasma and other atypical organisms
Which neuraminidase inhibitor is given via inhalation?
Zanamivir
What is recommended for hospitalized patients requiring supplemental oxygen?
Dexamethasone, remdesivir
If given in large but equivalent volumes, which crystalloid is most likely to yield hyponatremia?
Lactated Ringer's solution
What fluid is considered initially for resuscitation in sepsis assuming no electrolyte abnormalities are present?
0.9% sodium chloride
Which antibiotic is considered a first-line antibiotic therapy for MRSA pneumonia?
Ceftaroline, linezolid, vancomycin
What is the recommended dose of baloxavir for a 100-kg patient admitted to the intensive care unit for influenza A infection?
80 mg PO x 1 (40 mg if 40-80 kg); in combination with NAI
For non-hospitalized patients not requiring supplemental oxygen with no risk factor for severe infections, what therapy would be recommended?
Supportive therapy
Which vasopressor predominantly stimulates alpha adrenergic receptors with minimal effects on beta adrenergic receptors?
Phenylephrine
Stimulation of which receptor is likely to lead to vasodilation?
Beta-2, alpha-2
Which class of antimicrobials is considered a first-line antibiotic therapy for ESBL E. coli pneumonia?
Carbapenems (with or without aminoglycoside OR anti-pseudomonal fluoroquinolone)
Under what circumstances is it appropriate to use amantadine/rimantadine for treatment of influenza infections?
Currently, amantadine/rimantadine have no role in the treatment or prophylaxis of influenza
A 56 year old female with a prior history of renal transplantation due to type 1 diabetes is admitted to the medical ICU due to COVID-19 respiratory failure. She is supported on high-flow nasal cannula. Which therapies should be considered for this patient to treat her acute respiratory failure?
Remdesivir
Dexamethasone
+/- tocilizumab/baricitinib
What adverse drug effect is NOT observed with dobutamine?
Bradycardia
Which vasopressor is preferred as the initial agent when treating hypotension in a patient with septic shock?
Norepinephrine
What is the strongest risk factor for multidrug-resistant hospital-acquired pneumonia?
Receipt of intravenous antimicrobials within the past 90 days
A 21-year-old, otherwise healthy, female college student presents to clinic with history of 4 days of fever, myalgia, dry cough, and malaise. She is diagnosed with rhinovirus infection. What would be the most appropriate initial therapy for her?
Supportive care
A 26 year old male reports mild viral symptoms consistent with SARS-CoV-2 infection. A nasal PCR at the urgent care clinic is positive for COVID-19. The patient has a past medical history significant for seasonal allergies. What treatment should be considered for this patient in the ambulatory setting?
No therapy is warranted at this time
A 36 year old male with a history of cirrhosis is admitted to the ICU with acute lower GI bleed. His admission hemoglobin is 5.4 g/dL. What is the most appropriate initial resuscitation fluid?
Packed red blood cells
A 56 year old female is admitted to the ICU for septic shock. She develops atrial fibrillation while on norepinephrine at a dose of 0.5 mcg/kg/min. What interventions may be considered in this setting?
Addition of vasopressin/hydrocortisone, change to phenylephrine
Which antibiotic regimen is considered appropriate empiric therapy for a patient with VAP who is currently in septic shock?
Anti-MRSA agent + two anti-pseudomonal agents from different classes
An 81 year old male is admitted to the ICU for severe influenza A pneumonia requiring mechanical ventilation. He has no enteral access at this time. What is the most appropriate antiviral agent?
Peramivir
A 78 year old male with a history of coronary artery disease and chronic kidney disease tests positive for COVID-19 at an urgent care clinic after a close contact with a infected person. He is currently asymptomatic. Which treatments should be considered at this time?
Remdesivir, nirmatrelvir/ritonavir or molnupiravir