WorksheetsID Exam 3
Total questions: 28
Worksheet time: 17mins
What is the appropriate continuation phase therapy for a patient who has cleared his or her primary TB infection (assume initial therapy with rifampin, isoniazid, pyrazinamide, ethambutol)?
Rifampin and Ethambutol for 6 months
Pyrazinamide and Rifampin for 6 months
Isoniazid and Pyrazinamide for 4 months
Rifampin and Isoniazid for 4 months
Interpret the TB skin test results:
Baseline skin test = negative
Retest = positive
Patient has a TB infection
Patient has latent TB
Patient does not have TB
Patient needs to undergo one more skin test to determine a diagnosis
Which of the following is true regarding testing for TB and Latent TB vs Active TB? Select all that apply.
The treatment for latent TB is done primarily as prevention of spread to the population
Active TB has a positive AFB sputum upon presentation in addition to symptoms consistent with the disease
Anergy testing results are negative for control and TB indicating that the person is immunocompromised and should take an IGRA for conclusive results
If a healthcare worker tests positive on TST after a recent exposure, a second test is indicated in less than 8-10 weeks
TH, a 56 year old male failed his second TB skin test and the team has determined he has a latent TB infection. The team wants to pursue therapy. Which of the following are NOT correct drug and dosage pairings for the treatment of latent TB?
Rifampin alone for 4 months
Isoniazid alone for 4 months
Isoniazid + Rifampin for 2 months
Isoniazid alone for 6 months
Which of the following is the 4 month TB treatment regimen and the correctly paired contraindication for initiating this therapy?
Rifapentine, Isoniazid, Moxifloxacin, Ethambutol - QT prolongation
Rifapentine, Isoniazid, Pyrazinamide, Ethambutol - pregnancy
Rifapentine, Isoniazid, Moxifloxacin, Pyrazinamide - 88 kg patient
Rifapentine, Isoniazid, Moxifloxacin, Pyrazinamide - QT prolongation
Which of the following statements is correct regarding TB treatment and prevention options?
A person who took the BCG vaccine as a child and has tested positive recently on TST does not have TB
Bedqauiline requires baseline and monthly renal function tests during treatment duration
Pretomanid can only be used in combination with linezolid and isoniazid for TB treatment
Bedaquiline and Pretomanid both can cause hepatotoxicity that must be monitored with liver enzyme tests and alcohol avoidance is recommended
Which of the following are correctly matched to their mode of transmission? Select all that apply
Vector borne → Yellow Fever
Water borne → Typhoid
Food borne → Cholera
Vector borne → Dengue
Which of the following is FALSE regarding the yellow fever vaccine?
It is a live attenuated vaccine
It must be administered at least 30 days prior to travel
It is a one dose vaccine
It must be administered by a certified center with a “uniform stamp”
DC is a 78 year old female with PMH of COPD, T2DM, hypertension, and anaphylactic related penicillin allergy who presents short of breath, wheezing, and cyanotic. Important vitals noted are O2 saturations in the 60s, HR 112, RR 28. A chest x-ray is performed and she is diagnosed with left lobe pneumonia. The provider is concerned and is admitting her directly to the ICU due to the required respiratory support. You are asked to order antibiotics for this patient prior to admission, which should you order?
Ampicillin/sulbactam + Moxifloxacin
Ceftriaxone + Moxifloxacin
Piperacillin/tazobactam + Azithromycin
Cefotaxime + Ceftriaxone
Which of the following would be appropriate for treatment of Influenza B for a 57 year old male with a history of COPD who just started having symptoms 24 hours ago? Select all that apply
Amantadine
Zanamivir
Oseltamivir
Baloxivir
A 14 year old male presents to the clinic with a sore throat. It is red upon appearance and it is noted that he has a mild fever and swollen lymph nodes. The patient has no known drug allergies. Throat swab is currently pending, but the physician wants to know which of the following drugs and durations is appropriate to be used to treat this suspected group A strep pharyngitis? Select all that apply.
Amoxicillin x 5 days
Azithromycin x 10 days
TMP-SMX x 10 days
Cephalexin x 10 days
Cases of acute bacterial rhinosinusitis where symptoms do not improve after 7 days could be treated with:
Amoxicillin
Levofloxacin
Ciprofloxacin
Doxycycline
Which of the following statements are correct regarding Malathion?
It is a lipophilic compound that is readily absorbed through the skin
CYP450 in humans converts malathion to a derivative that is around 70 times more toxic
In insects, use causes ACh accumulation in nerve junctions which paralyzes and kills the insect
Its toxic metabolites are not readily detoxified upon systemic exposure
LC is a 68yo female who presented to the ED from a skilled nursing facility after her O2 Saturation was in the 70s despite 3L of Oxygen. LC recently had a long hospital admission where she was treated with broad-spectrum Antibiotics for HAP. CXR shows ground glass opacities consistent with bilateral pneumonia. MRSA nasal swab and sputum/respiratory cultures are all pending. Which of the following would you use for empiric treatment for LC? Select all that apply
Cefepime
Levofloxacin
Vancomycin
Azithromycin + Ampicillin/Sulbactam
From the previous question, LC’s MRSA nasal swab came back positive, and the culture stain shows many gram-positive cocci on board. How do we continue antibiotics? Select all that apply
Cefepime
Levofloxacin
Ampicillin/Sulbactam
Vancomycin
A patient who has a positive serologic antibody test for COVID-19 has acute SARS-COV-2.
True
False
Which of the following is suggested for a non-hospitalized COVID-19 patient? Select all that apply
Dexamethasone + Paxlovid
Dexamethasone
Paxlovid
Dexamethasone + Baricitinib
Which of the following are oral COVID-19 drugs that require dose adjustment in severe hepatic impairment? Select all that apply
Paxlovid
Molnupiravir
Remdesivir
Baricitinib
Which of the following drugs would decrease levels of Paxlovid and decrease its efficacy? Select all that apply
Amiodarone
Carbamazepine
Lurasidone
Phenytoin
Which of the following correctly describes the mechanism of action for Permethrin?
Blockage of the GABA-gated chloride channels reduces neuronal inhibition, which leads to hyperexcitation of the CNS, convulsions, and death of the insect
Disrupts sodium conductance of nerve cell membranes of the parasites, which paralyzes and kills the insect and their nits
Competitive inhibition of pseudocholinesterase and acetylcholinesterase results in ACh accumulation in nerve junctions, resulting in paralysis of the insects and their nits
Causes excessive release of GABA in the nervous system of the parasite, resulting in paralysis and death
Which of the following statements accurately describes Spinosad? Select all that apply.
Low systemic absorption and in vivo conversion to non-toxic metabolites limits the toxicity of this product
It disrupts the neurotransmission of ACh by targeting binding sites on the nicotinic ACh receptors
It is formulated with piperonyl butoxide, which blocks parasite degradation of the drug
Acts as a GABA neurotransmitter agonist
Which of the following is FALSE regarding the anti-tuberculosis therapy?
It is preferred anti-tuberculosis agents have no cross reactivity with standard bacteria to avoid selection of resistance
Mycobacteria exist extracellularly and have a lipophilic outer layer which makes it difficult for antibiotics to penetrate them
Mycobacteria grow and multiply slowly compared to other bacteria, thus long term therapy is required
In most TB populations there is inherent resistance and multi-drug therapy should be used
Which of the following accurately describe the mechanism of action of Isoniazid?
KatG metabolizes INH to isonicotinic acid via reactive intermediates. The reactive intermediates inhibit inhA, which inhibits mycolic acid synthesis
Binds to ribosomal protein S1 and blocks DNA decoding, thus halting protein synthesis
Inhibits DNA-dependent RNA polymerase in the mycobacteria through chelation of zinc atoms
Interrupts cell-wall synthesis by inhibiting the incorporation of mycolic acid into the mycobacterial cell wall
What do the three compounds below have in compound?
I only
I & II
II & III
I, II, & III
Which of the following pairing of drug/drug class and mechanism of action is INCORRECT? Select all that apply.
Benzimidazoles- binds beta-tubulin and inhibits assembly of microtubules
Pyrantel - depolarizing agent that causes spastic paralysis in susceptible helminthes
Niclosamide - induces rapid contraction of muscle and paralysis leading to worm expulsion
Praziquantel - kills on contact by uncoupling oxidative phosphorylation
Which of the following statements regarding the metabolism of Isoniazid (INH) are correct? Select all that apply.
Rapid acetylators are more prone to INH-induced hepatitis and neuropathy with chronic use
N-Acetyl Transferase is responsible for inactivating isoniazid
Acetyl radicals can form if metabolites are not inactivated by NAT, causing hepatotoxicity
It is a potent inducer of hepatic microsomal enzymes
This antimalarial agent has an endoperoxide structure that results in formation of a free radical:
Hydroxychloroquine
Artesunate
Lumefantrine
Atovaquone
All of the following are characteristics of the bezimidazoles except?
Albendazole requires oxidation to active sulfoxide
Bind beta tubulin and inhibit microtubule formation
Highly selective for worm beta-tubulin
Have killing activity through oxidative phosphorylation
