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Multiple Choice Questions (MCQ)

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

A 67-year-old man has been intubated and sedated in the intensive care unit (ICU) for 6 days. He has a central venous catheter and an indwelling urinary catheter in place. He develops a fever to 38.4°C, and blood, urine, and sputum samples are sent for analysis. His urinalysis is notable for <10 white blood cells, negative for leukocyte esterase and nitrites. Urine culture grows >100,000 Candida glabrata after 2 days, susceptible to micafungin, caspofungin, and fluconazole.

What is the MOST appropriate way to manage the yeast growing in urine culture?

A. Give micafungin
B. Give fluconazole
C. No change in management
D. Remove the existing urinary catheter and replace with a new catheter


Question 2#Print Question

A 28-year-old pregnant woman is admitted to the ICU, requiring norepinephrine to treat hypotension due to pyelonephritis from highly susceptible, pan sensitive Escherichia coli. Ultrasound imaging of the kidneys and bladder on admission was normal. She is treated with ceftriaxone for 2 days, with improvement in her pain, fever, and hypotension. However, on day 3 she develops a fever to 38.4 while still receiving intravenous antibiotic therapy. She has no new symptoms, and no costovertebral angle tenderness to palpation.

What is the MOST likely cause of her recrudescent fever?

A. Emerging antibiotic resistance to ceftriaxone
B. Drug fever
C. Perinephric abscess
D. Renal abscess


Question 3#Print Question

A 78-year-old woman with diabetes and hypertension presents to the emergency department with confusion and hypotension. A urinalysis is notable for a white blood cell count of >100,000 and is positive for leukocyte esterase. Urine culture subsequently grows >100,000 Pseudomonas aeruginosa, resistant to ciprofloxacin. You begin appropriate antibiotic therapy with a beta-lactam antibiotic.

For how long should she be treated?

A. 3 to 5 days
B. 5 to 10 days
C. 10 to 14 days
D. Until her confusion resolves


Question 4#Print Question

What diagnostic test is MOST appropriate to evaluate for perinephric abscess?

A. Abdominal ultrasound
B. Computed tomography (CT) of the abdomen and pelvis
C. Magnetic resonance imaging (MRI) of the abdomen and pelvis
D. All of the above are appropriate depending on the clinical situation


Question 5#Print Question

Which indication below is NOT an appropriate indication for indwelling bladder catheterization in the ICU?

A. Management of urinary incontinence
B. Management of immobilized patients
C. Management of patients with neurogenic bladder
D. Hourly urine output measurement in critically ill patients




Category: Critical Care Medicine-Infections and Immunologic Disease--->Genitourinary Infection
Page: 1 of 1