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Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Infections and Immunologic Disease--->Systemic Infections
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Question 1#Print Question

A 26-year-old man presents to the emergency room with fevers and headache for the last 2 days. His temperature is 39.1°C, heart rate 123 beats/min, blood pressure 88/54 mm Hg, and respiratory rate 28 breaths/min. He appears diaphoretic and pale on examination but has no rash and no other abnormal physical findings. His white blood cell count is 3.9 × 10 9 /L, hemoglobin 5.6 g/dL, platelet count 112,000/µL, and creatinine 2.7 mg/dL. He is oliguric. He is a medical student and returned from Uganda 6 days ago, where he has been conducting research for the last year. He reports no sexual contacts within the last six months.

Which of the following is the MOST likely cause of his acute illness?

A. Strongyloides hyperinfection syndrome
B. Zika virus infection
C. Plasmodium falciparum malaria
D. Brucellosis


Question 2#Print Question

Which of the following statements are TRUE about empiric antibiotic selection for patients in septic shock?

A. Selection should account for recently received antibiotics, prior organisms, and susceptibility patterns for each patient, and local antimicrobial resistance patterns
B. The broadest-spectrum antibiotic combination available should be used until microbiologic testing results return
C. Two antipseudomonal antibiotics of the same class should be used when there is concern for Pseudomonas aeruginosa bacteremia
D. A and C


Question 3#Print Question

A 19-year-old woman is admitted to the intensive care unit for massive hemoptysis. Computed tomography (CT) of the chest reveals a large, cavitated lesion in the right middle lobe. The patient has no known past medical history, lives with her family, and recently immigrated from China.

What is the MOST appropriate management strategy?

A. Place the patient in a negative-pressure isolation room, and continue negative-pressure isolation until three sputum samples are negative for acid-fast bacteria and an alternative diagnosis has been established
B. Place the patient in a negative-pressure isolation room, and continue negative-pressure isolation until three sputum samples are negative for acid-fast bacteria
C. Place the patient in a positive-pressure isolation room, and continue positive-pressure isolation until two sputum samples are negative for acid-fast bacteria and an alternative diagnosis has been established
D. Place the patient in a positive-pressure isolation room, and continue positive-pressure isolation until three sputum samples are negative for acid-fast bacteria


Question 4#Print Question

You admit a 61-year-old man to the intensive care unit after a witnessed generalized tonic-clonic seizure at home. He has a history of sarcoidosis and has been treated with prednisone 10 to 60 mg for the last year. Before admission, he had no cough or sputum production and had felt well. CT of the head, chest, abdomen, and pelvis reveals a 2.5 cm pulmonary nodule in the right upper lobe and 3 cm parenchymal brain lesion.

What is the MOST likely diagnosis?

A. Pneumocystis jirovecii (formerly carinii) infection
B. Sarcoidosis
C. Tuberculosis
D. Nocardiosis


Question 5#Print Question

A 71-year-old man with diabetes, obesity, hypertension, and benign prostatic hypertrophy is admitted to the intensive care unit with abrupt-onset groin pain, fever, and a rapidly spreading erythematous groin and lower abdominal rash with ill-defined margins. The rash is exquisitely tender and firm to palpation. He develops hypotension with mean arterial pressure measured at 52 mm Hg, refractory to intravenous fluid resuscitation.

What is the MOST appropriate sequence of events to manage his disease?

A. Insert a central venous catheter, start vasopressors, obtain two sets of blood cultures, and start antibiotic therapy with vancomycin, meropenem, and clindamycin
B. Start antibiotic therapy with vancomycin, meropenem, and clindamycin; obtain two sets of blood cultures, surgical consult for emergent debridement, and start vasopressors
C. Start vasopressors, obtain two sets of blood cultures, start antibiotic therapy with vancomycin, piperacillin-tazobactam, and clindamycin; surgical consult for emergent debridement
D. Start vasopressors, obtain two sets of blood cultures, start antibiotic therapy with vancomycin, piperacillin-tazobactam, and clindamycin; obtain CT or magnetic resonance image (MRI) of pelvis, surgical consult for emergent debridement




Category: Critical Care Medicine-Infections and Immunologic Disease--->Systemic Infections
Page: 1 of 2