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Category: Critical Care Medicine-Infections and Immunologic Disease--->Bioterrorism
Page: 1

Question 1# Print Question

A 28-year-old male presents with fever, severe headache, shortness of breath, and altered mental status. While in the emergency room, he develops a seizure and is subsequently intubated and placed on mechanical ventilation. Recent medical history is significant for nonspecific complaints of fever, cough, and malaise. His chest radiograph shows mediastinal widening and pleural effusions. A lumbar puncture reveals grossly bloody CSF with low glucose and elevated white blood cell count. Blood and CSF cultures are growing Bacillus anthracis.

Which of the following antibiotic combinations should be started?

A. Ciprofloxacin, Meropenem, and Vancomycin
B. Doxycycline, Meropenem, and Vancomycin
C. Ceftriaxone, Ciprofloxacin, and Clindamycin
D. Trimethoprim-sulfamethoxazole, Meropenem, and Vancomycin


Question 2# Print Question

A 53-year-old female presents with mydriasis, ptosis, diplopia, dysphagia, dysarthria, and a progressive, symmetric descending flaccid paralysis. She is conscious and has no cardiovascular perturbations. Colleagues at other area hospitals are reporting several similar cases. You recommend to:

A. Start plasmapheresis or intravenous immunoglobulin and admit her to an intensive care unit (ICU) for close respiratory and cardiovascular monitoring
B. Administer atropine, pralidoxime, anticonvulsants if seizures occur and admit her to an ICU for close monitoring for respiratory failure and risk of aspiration
C. Administer antitoxin, supportive care, and admit her to an ICU for close monitoring for respiratory failure and risk of aspiration
D. Administer edrophonium 2 mg


Question 3# Print Question

The emergency department calls to inform you that there are multiple patients with symptoms of fever, altered mental status, respiratory failure, and shock that will be transferred to the ICU. Features that the patients may be victims of a biologic attack include all of the following EXCEPT:

A. Reports of similar cases at other hospitals and clinics
B. Large numbers of rapidly fatal cases
C. A rise in a number of patients with similar symptoms over a few hours to days and then a drop off in patients with the symptoms
D. Patients arriving from a disperse area


Question 4# Print Question

A 54-year-old postal worker presents with symptoms of chest tightness, cough, dyspnea, and fever. Chest radiograph shows pulmonary edema. He is intubated secondary to severe hypoxia and transferred to the ICU. Per report, he was handling a broken vial containing a white powder, and the post office is currently being decontaminated. Management of this patient includes: 

A. Respiratory isolation in negative pressure room
B. Gut decontamination with activated charcoal
C. Supportive treatment with mechanical ventilation
D. Administration of an antitoxin




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