WorksheetsClinical Case-Based Infection Control Worksheet
Total questions: 10
Worksheet time: 5mins
A 62-year-old man is being treated in the ICU with a CVC for 8 days. Your team wants to reduce the rate of central line-associated bloodstream infection (CLABSI). An audit shows that CVC placement is often done when busy, without a checklist, and the dressing is often damp. Which intervention is the strongest to reduce CLABSI as part of a bundle?
Vancomycin prophylaxis before CVC placement
Routine replacement of CVC every 5–7 days
Hand hygiene + skin antisepsis with chlorhexidine
Routine blood cultures every 48 hours for patients with CVC
Applying antibiotic ointment at the exit site daily
55-year-old woman, on mechanical ventilation for 6 days. The incidence of VAP in the ICU has increased. Which of the following is not a component of the bundle to reduce VAP?
Fixed-dose sedation to prevent patient agitation
Head-of-bed elevation 30–45°
Deep vein thrombosis prophylaxis
Administration of medications that reduce gastric acidity
Oral hygiene with chlorhexidine
3. A 70-year-old man post-surgery, has a urinary catheter in place for 4 days "for comfort" even though he can mobilize. The rate of CAUTI has increased. Which of the following is NOT included in the CAUTI bundle?
A. Routine irrigation of the bladder with antiseptic
B. Maintaining a closed drainage system
C. Catheter fixation
D. Positioning the bag below the bladder
E. Daily evaluation of the catheter and removal as soon as there is no indication
A patient has a high fever. Two sets of blood cultures were taken. Results: aerobic bottle set 1 grew Staphylococcus epidermidis in 20 hours; set 2 all bottles negative. The patient is stable, has no prosthetics, and shows no signs of catheter infection. What is the most accurate interpretation?
True bacteremia; start vancomycin immediately
Contamination is most likely; clinical evaluation and repeat cultures if necessary
Definitely endocarditis; perform TEE
Severe sepsis; add meropenem
Blood cultures from urine must also be taken
A 45-year-old woman is suspected of having pneumonia. Sputum Gram stain shows many squamous epithelial cells and few PMNs; culture grows mixed flora. What is the best step?
Continue interpreting the culture as a definitive etiology
Request a repeat specimen: deep sputum/induction, or aspirate/BAL if necessary
Add anaerobic media for more accuracy
Administer broad-spectrum antibiotics based on mixed flora
No need for Gram stain for sputum
A 24-year-old woman presents with dysuria. A urine sample was collected at home and stored at room temperature for 6 hours before being taken to the lab. Culture shows growth of a mixed population of 3 types of bacteria, each at 104 CFU/mL. What is the most accurate interpretation?
This is definitely polymicrobial UTI; combination therapy
The results do not reflect the actual condition due to delay/improper storage; repeat midstream clean-catch sample, send quickly
There are no pre-analytical issues with the urine culture
This indicates severe pyelonephritis
Repeat culture from blood only
29-year-old woman serology results: HBsAg negative, anti-HBs positive, anti-HBc negative. What is the most accurate interpretation?
Acute HBV infection
Chronic HBV infection
Window period
Immunity due to vaccination
Past infection that has resolved naturally
A 56-year-old woman with diabetic ketoacidosis presents with facial pain, fever, nasal congestion, and blackened palatal lesions. CT shows sinus invasion into the orbit. Tissue preparation shows broad, pauciseptate hyphae, branching at right angles (≈90°). What is the most appropriate therapy that significantly affects mortality?
Fluconazole alone
Voriconazole alone
High-dose Amphotericin B + immediate surgical debridement + correction of predisposing factors (DKA)
Caspofungin monotherapy
Itraconazole + observation
A 19-year-old student living in a dormitory comes with fever, chills, and petechial rash. LP: high neutrophils, low glucose, high protein. After culture is taken, initial therapy is given. What is the most appropriate public health action for close contacts?
Influenza vaccine for all contacts
Rifampicin prophylaxis (or ciprofloxacin/ceftriaxone) for close contacts
Amoxicillin prophylaxis for 10 days
No prophylaxis needed if the patient has been treated
TMP-SMX prophylaxis
A 22-year-old sexually active woman experiences dysuria and frequent urination. Urinalysis: leukocyte esterase positive, nitrite negative. Culture: clustered gram-positive cocci; catalase positive. Which test best helps distinguish the cause from Staphylococcus aureus?
Coagulase
Novobiocin susceptibility
Urease
Oxidase
Hemolysis on blood agar
