Multiple Choice Questions (MCQ)

Quiz Categories Click to expand

Category: Critical Care Medicine-Infections and Immunologic Disease--->Immune Suppression: Congenital, Acquired, Drugs
Page: 2

Question 6# Print Question

A 53-year-old man with history of chronic hepatitis C and acquired immune deficiency syndrome (history of cryptococcal meningitis, last CD4 count 250 cells/µL on antiretroviral therapy with undetectable viral load) presents for open liver resection after he was diagnosed with liver cancer. Following an uncomplicated operation, he is recovering on surgical floor. On postoperative day 3, he develops fever (temperature, 38.9°C). Other vitals are notable for:

  • blood pressure of 85/52 mm Hg
  • heart rate of 110 beats/min
  • respiratory rate of 26 breaths/min
  • oxygen saturation of 92% on 4 L nasal cannula

Abdominal examination is benign. Chest x-ray reveals likely infiltrate and/or atelectasis in the right lower lobe. Lactate level is 3 mmol/L.

Which of the following is the MOST appropriate initial antibiotic regimen for this patient? 

A. Vancomycin, cefepime, azithromycin
B. Levofloxacin
C. Trimethoprim and sulfamethoxazole (TMP-SMX)
D. Meropenem

Question 7# Print Question

A 45-year-old female is admitted to the surgical ICU following liver transplantation. On postoperative day (POD) 3, she develops a tonic-clonic seizure which is terminated by intravenous midazolam. However, she requires intubation for persistently poor mental status. CT scan of the head is obtained immediately and is negative for bleeding or mass lesion. Lumbar puncture is deferred due to coagulopathy (INR 1.9, Plt 50). A brain MRI performed 6 hours later shows left temporal increased signal intensity in T2 and FLAIR weighted images. 

Which of the following treatment is most effective to decrease patient mortality?

A. Intravenous acyclovir
B. Gancyclovir
C. Levetiracetam
D. Corticosteroids

Question 8# Print Question

A 52-year-old female with severe COPD is admitted to the ICU for hypercarbic respiratory failure. She requires mechanical ventilation and is treated with methylprednisolone and azithromycin. She is extubated on ICU day 4. After extubation, she complains of leftsided flank pain, but her examination and labs are normal. On day 6, a vesicular rash with erythematous base develops diffusely across her abdomen, and additional lesions are noted on her face and arms.

Which of the following is the next best step to diagnose her condition?

A. Full ophthalmologic examination
B. Unroofing vesicle and sending varicella-zoster virus and herpes virus direct fluorescence antibody stain (DFA) and reflex culture
C. Punch biopsy for dermatopathology
D. Skin testing for latex allergy

Category: Critical Care Medicine-Infections and Immunologic Disease--->Immune Suppression: Congenital, Acquired, Drugs
Page: 2 of 2