Exam 6 review

a 59 year old with end-stage renal disease, 85 kilos, went to an outpatient clinic for evaluation of fever, cough and sore throat, had begun three days prior. Rapid molecular assay performed on a swab of the nose identified influenza B. The question is which management strategy is most appropriate for the patient?

• Amoxicillin-clavulanate 875 mg/125 mg twice daily for 7 days

• Supportive care only, no antiviral treatment needed

• Baloxavir marboxil 80 mg PO once

• Zanamivir 5 mg inhaled twice daily for 5 days

• Oseltamivir 75 mg by mouth twice daily for five days

Which antiviral medication can cause nephrotoxicity?

• Cidofovir

• Letermovir

• Oseltamivir

• acyclovir (oral)

• valganciclovir

Which is a risk factor for complications from COVID-19 but not seasonal influenza?

• Obesity (BMI ≥30)

• Chronic kidney disease

• Age over 65

• Chronic lung disease (e.g., COPD)

• Diabetes mellitus

Which of the following is a risk factor for complications from COVID-19 but not seasonal influenza?

• Chronic kidney disease

• pulmonary fibrosis.

• Age over 65

• Depression

• Diabetes mellitus

What is the recommended treatment for a patient hospitalized with symptomatic COVID-19, risk factors for complicated disease, and not on supplemental oxygen?

• Baricitinib

• Remdesivir

• Dexamethasone

• Tocilizumab

• Paxlovid (nirmatrelvir/ritonavir)

Which is the correct neuraminidase inhibitor dose for seasonal influenza post-exposure chemoprophylaxis in a patient without renal impairment?

• Zanamivir 10 mg (2 inhalations) once daily for 7 days

• Peramivir 600 mg IV once

• Oseltamivir 75 mg BID

• Oseltamivir 75 mg once daily

• Zanamivir 5 mg once daily

What is the recommended treatment for a patient hospitalized with symptomatic COVID-19, risk factors for complicated disease, and not on supplemental oxygen?

• dexamethasone

• Tocilizumab

• Remdesivir

• Baricitinib

• Paxlovid

Prophylactic antimicrobial therapy is important for which organisms causing bacterial meningitis? (select all that apply)

• Haemophilus influenzae

• Neisseria meningitidis

• Streptococcus pneumoniae

• Escherichia coli

• Listeria monocytogenes

What empiric therapy is needed to treat a 77-year-old female with bacterial meningitis, recent chemotherapy, and normal renal function?

• Meropenem

• Ceftriaxone 2g Q12H, dexamethasone 0.15 mg/kg Q6H

• Vancomycin and cefepime

• Ceftriaxone 2g Q12H, dexamethasone 0.15 mg/kg Q6H, ampicillin 2g Q4H, and acyclovir 10 mg/kg

• Ampicillin and gentamicin

Empiric therapy for a newly diagnosed HIV patient with cryptococcal meningitis (CD4 = 5, positive cryptococcal antigen):

• ceftriaxone plus vancomycin

• fluconazole monotherapy

• liposomal amphotericin B plus flucytosine

• acyclovir

• amphotericin B alone