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R2 MCQ pretest
Quiz by Natapong Manomaiwong
Tag the questions with any skills you have. Your dashboard will track each student's mastery of each skill.
A 29-year-old man was first diagnosed with HIV infection. He was healthy and no history of contact TB. PE was unremarkable. The laboratory showed CD4 225 cells/mm3 (17%) others were within normal limits including CXR. Other than TDF/FTC/DTG administration, what is the proper management about TB prophylaxis?
A 30-year-old man presented with penile ulcer for 2 weeks. He had unprotected sexual intercourse 4 weeks ago. PE showed painless, irregular border ulcer with bleeding tendency, impalpable inguinal lymph nodes. During the pending results of swab, what is the treatment course for the disease.
A 32-year-old man presented with fever, chills and oral painful ulcers causing unable to eat anything for 3 days. He had underlying disease of DLBCL and received 1stcourse chemotherapy (R-CHOP) 2 weeks ago. He had no history of infection before or receiving any antibiotics for prophylaxis.
Physical examination :
V/S : T 39 C, BP120/80 mmHg, PR 120/min, RR 20/min, SpO2 100% (RA)
GA : fatigue,well-cooperative
HEENT : mildly pale,no jaundice, dry lip, multiple painful oral ulcers, no dental caries
CVS, RS, Abdomen :within normal limits
Investigation :
CBC : Hb 8 g/dL, WBC3500 cells/mm3 (N20%, L70%), Platelets 90,000 cells/mm3
Others are withinnormal limits
What is(are) therecommended empirical antibiotics for the patient’s condition ?
A 67-year-old man was admitted with recurrent UTI. After hospitalization for 3 days, he developed fever, abdominal pain and mucous diarrhea. Last admission, he had history of C. difficile diarrhea and treated with oral vancomycin 125 mg QID for 10 days.
Physical examination
V/S :T 39 C, BP 120/80 mmHg, PR 120 bpm, RR 20 bpm
Abdomen: no distension, hyperactive bowel sound, mild tender at LLQ, no rebound tenderness
PR and proctoscope : seen pseudomembrane
Investigation
Stool GDH positive and EIA positive for toxin A
CBC :WBC 16,000 and Cr 1.6
What is the proper management for this patient?
A 58 year-old nurse visit OPD for HIV PEP. The event was 1 hour ago. She got needle stick injury with overt bleeding from the HIV patient who were on ART for 3 years. His recent CD4 729 cells/mm3 and HIV VL not detected. The nurse's anti-HIV was non-reactive and other labs were normal. What would you recommend ?
Who should not receive chemoprophylaxis for invasive meningococcal disease ?
A 29-year old Thai man with U/D HIV infection. His recent CD4 320 cells/mm3. He presented with generalized skin lesions involved face, his both arms and genitalia. He had history of SI with foreigner. What is the recommendation for his disease ?
A 70-year-old man with COPD asked you for appropriate vaccination. He experienced HZV at L3 dermatome 3 months ago. He got influenza vaccine and PPSV23 for 9 months. What is the proper vaccine for him at this visit ?
Who has the least necessity for IE ATB prophylaxis?
A 37-year-old woman who was kidney transplant recipient presented with non-productive cough for 3 weeks. CT chest found multiple pulmonary nodules. After bronchoscope, cell block of BAL showed pauci-septate, right angle branching hyphae. Her GFR was 25 mL/min, other labs were normal. What is the recommended treatment?