C. difficile Colonization 2 patients have a C. difficile PCR test and toxin EIA. 1: has cirrhosis, takes lactulose, normal WBC, no changes in diarrhea 2: febrile, took ciprofloxacin last week, having diarrhea Which patient(s) should be treated for C. difficile? How did others respond? Reveal the answer Best Answer: Patient 2 👨🏻🦰 Explanation: This …
Leukocytosis is admitted to the with lupus nephritis. She is started on therapy including a corticosteroid The next day, leukocytosis is noted. What is the MOST LIKELY explanation? A. New infectionB. Medication side effectC. MalignancyD. Lab error How did others respond? Reveal the answer Best Answer: Medication side effect Explanation: When corticosteroids are started, they …
Non-Purulent Cellulitis is admitted to the for cellulitis. NO purulence is noted on exam and she has no relevant past medical history Which antibiotic is NOT recommended per IDSA guidelines for non-purulent cellulitis? A. CefazolinB. DicloxacillinC. NafcillinD. Vancomycin How did others respond? Reveal the answer Best Answer: Vancomycin Explanation: IDSA skin/soft tissue guidelines state that …
C. difficile Prevention with lymphoma is admitted to the ICU for sepsis from an unknown source. He has a history of C. difficile. Which intervention will DECREASE his risk of C. difficile? How did others respond? Reveal the answer Best Answer: Narrow antibiotics when able Explanation: Limiting antibiotic spectrum is an excellent way to prevent …
Understanding Urinalyses presents to clinic for routine prenatal care and is feeling well. A urinalysis is positive for nitrites, leukocyte esterase and bacteria. Empiric antibiotics are prescribed. Is this APPROPRIATE? How did others respond? Reveal the answer Best Answer: Yes ✅ Explanation: The patient’s urinalysis is abnormal. In most cases, asymptomatic bacteriuria SHOULD NOT be …
Cystitis vs. Pyelonephritis presents to clinic with dysuria, flank pain & fever They are prescribed nitrofurantoin. Is this APPROPRIATE? How did others respond? Reveal the answer Best Answer: No 🚫 Explanation: Our patient has flank pain & fever, consistent with pyelonephritis. Nitrofurantoin is ONLY recommended in the treatment of cystitis. We should also consider …
Clostridioides difficile Prophylaxis A 70 year old with leukemia is admitted to the for febrile neutropenia. She was treated for C. difficile colitis last month. She is started on cefepime. She is not currently having diarrhea. Which is the BEST option? A. Test for C. difficileB. Start fidaxomicinC. Start oral vancomycin prophylaxis How did others respond? …
Empiric Pip-Tazo in Intra-Abdominal Infections 2 patients are admitted & started on empiric piperacillin/tazobactam. Patient 1: with community-onset appendicitis Patient 2: with pancreatic cancer s/p recent Whipple with anastomotic leak & peritonitis In which patient is it REASONABLE to narrow antibiotics? How did others respond? Reveal the answer Best Answer: Patient 1 👨🏾 Explanation: 2017 …
The Clinically Non-Responding Patient has a history of heart failure and is admitted for respiratory distress. He is diagnosed with pneumonia After 2 days, his oxygen requirements are but he is afebrile. Which is the MOST APPROPRIATE next action? How did others respond? Reveal the answer Best Answer: Evaluate fluid status Explanation: 👴🏼 has a …
MRSA Nasal Screening After Vancomycin has pneumonia and is on day 5 of vancomycin. He has a history of MRSA No respiratory cultures have been collected. Should a MRSA swab be collected now? How did others respond? Reveal the answer Best Answer: No Explanation: The utility of MRSA 👃 swabs after anti-MRSA therapy is questionable …