Chapter 24 (Infectious Diseases III: Antifungals & Antivirals) Flashcards

A patient presents with vesicular genital lesions and is prescribed a course of valacyclovir 1 gram PO BID x 10 days. Which pathogen is most likely causing the infection?

FR is a 20-year-old female who presented to the university health clinic with fatigue and a sore throat. She was found to have tender, swollen lymph nodes on exam. She was diagnosed with infectious mononucleosis. Which pathogen causes this illness?

Select the correct dose of oseltamivir for the treatment of influenza in an adult:

A 20-year-old male with HIV/AIDS is admitted to the medicine floor. An esophageal culture is performed and reveals germ-tube positive yeast which is identified as Candida albicans. The team wishes to avoid sending him home with an IV line and asks if there is an acceptable agent to treat Candida albicans that is available in both intravenous and oral formulations. Which agent could be recommended?

Which azole antifungal requires an acidic environment for absorption?

DS has just received a prescription for baloxavir marboxil (Xofluza). He has been feeling incredibly weak from the flu for the past 24 hours. DS has asthma and has been wheezing since he became ill. How many days will the patient need to take this medication?

Which of the following medications require patient counseling for risk of photosensitivity?

Which dosing instructions for the use of OTC docosanol are correct?

Which of the following is a boxed warning for ketoconazole?

GP is receiving amphotericin B deoxycholate for the treatment of mucormycosis. Which of the following side effects are most likely to occur with treatment?

LR had a gastric bypass procedure 2 months ago and experienced complications. Since the procedure, she has required parenteral nutrition through a central line. She recently developed a Candida glabrata bloodstream infection and is being treated with micafungin. Which of the statements are correct regarding the use of micafungin in this patient? (Select ALL that apply)

A patient is being discharged home from the hospital. The patient was getting fluconazole 400 mg IV daily for the treatment of his fungal infection. The physician would like to continue with oral fluconazole therapy. What is the equivalent oral dose?

History of Present Illness: IH is a 45-year-old female who was admitted to the hospital 3 days ago with persistent fever, decreased appetite and shortness of breath. Prior to admission, her symptoms had progressively worsened over a 2-3 week period, despite a 5-day course of Levaquin that had been prescribed for presumed pneumonia.

Allergies: NKDA

Past Medical History
Hypertension
Hyperlipidemia
Migraines
Rheumatoid arthritisAdmission Chest X-ray: nodular densities in the right upper and middle lobes, bilateral pleural effusions, concerning for bacterial, viral or fungal infection given history - consider additional diagnostic evaluationDiagnostic Test Results:
CT chest with contrast: pleural thickening, and centrilobular nodules
Pleural fluid culture: Aspergillus niger

Choose the most appropriate treatment for this patient based on the pleural fluid culture.

A healthy 23-year-old woman presents to her OBGYN office complaining of a vaginal yeast infection. The patient prefers an oral treatment option. Which of the following is the most appropriate oral treatment of her yeast infection?

An 85-year-old man is hospitalized with a fungal infection. He has CKD stage 3 and chronic pain (on methadone). Micafungin 100 mg intravenous is given. During the infusion, the man develops a drop in blood pressure, pruritis and flushing. What is the most likely cause of this reaction?

LT is a 37-year-old female who presented to the ED on 10/2 with fever, fatigue and generalized aches. She receives chronic parenteral nutrition due to a non-healing enterocutaneous fistula. Blood cultures x2 were drawn, and she was admitted to the hospital. Her past medical history is significant for Crohn's disease. She is noted to have a Hickman central catheter at the right chest for TPN administration. The site is red and warm.

Tests:10/2 Blood cultures x2 reveal C. glabrata.

Question:Which medication is preferred to treat LT's bloodstream infection?

Which of the following is the mechanism of action of Diflucan?

History of Present Illness: TP is a 52-year-old African American female who was admitted to the hospital 5 days ago for resection of an abdominal mass.

Allergies: Accupril (cough), cefepime (anaphylaxis)

Past Medical History:
Hypertension
Kidney transplant (cadaveric donor) 6 years agoPain: 6/10 around the abdominal incisionGeneral: patient in mild distress, has had a decreased appetite and decreased PO intake in the past 48 hoursAbdominal: decreased bowel sounds, erythema and swelling around the surgical incision site

Assessment/Plan: possible complicated skin and soft tissue infection. CT abdomen to evaluate for abscess, paralytic bowel and/or other abdominal complications.

A culture of an abdominal abscess drainage identifies the presence of bacteria and C. albicans. Which medication will treat the fungal infection and will have the lowest risk of drug interactions with TP's other medications?

Chief Complaint: “I feel weak and exhausted"
History of Present Illness: TN is 67-year-old Vietnamese female. She states that she is very weak, but cannot really elaborate on how her symptoms are different than normal. Her daily activities have declined over the past two months and she is sleeping most of the day. She describes a tingling sensation over the "rash on her back" for the last 48 hours.
Allergies: ibuprofen and morphine "make her vomit"

Based on the subjective and objective information presented, which diagnosis is most likely?

DE is a 61-year-old male who is experiencing a blistery rash that wraps around the right side of his torso. He reports that the rash is tingling with shooting pain. The appearance of the rash is consistent with herpes zoster. Which medication is appropriate to treat this condition?

Antiviral agents active against cytomegalovirus (CMV) include which of the following:

A 32-year-old female who is receiving chemotherapy for acute leukemia is diagnosed with mucormycosis via tissue culture and will begin therapy with IV isavuconazonium. The nurse contacts the pharmacist asking what he needs to know, as he has never administered the drug before. Which of the following is an important point regarding this medication?

The pharmacist is on rounds with the internal medicine team. They are discussing a patient who has oral candidiasis due to a recent chemotherapy treatment. The infection is very painful for the patient and is considered moderate to severe. Which of the following is the best regimen to recommend for this patient?

A 32-year-old critically-ill patient with diabetes is admitted to the intensive care unit with respiratory compromise and acute kidney injury. She is diagnosed with pulmonary Aspergillosis. Which of the following antifungal agents would be most appropriate to initiate?

A 59-year-old male is admitted to the hospital with a CrCl of 35 mL/min and a fungal infection. Which of the following antifungal medications would require a dose adjustment?

Which of the following is a first-line treatment for dermatophytes that cause nail bed infections? (Select ALL that apply.)

Which of the following is the most appropriate administration of nystatin for the treatment of oral candidiasis?

What is a 79-year-old woman receiving intravenous acyclovir most at risk for?

Choose the correct mechanism of action for oseltamivir:

SF was prescribed a Symbicort inhaler for her asthma. One month later, SF reports developing a white film on her tongue and throat. When asked, she stated that she isn't always able to rinse her mouth after each dose. Which of the following is the most appropriate treatment for SF?

Due to the risk of life-threatening arrhythmias, coadministration of dofetilide is contraindicated with which medication?

Which of the following counseling points are correct for Vfend? (Select ALL that apply.)

RS is a 23-year-old male with poorly controlled asthma. He is currently presenting to the ED with a sudden onset of headache, dry cough and fever (temperature 101.9 degrees F). His symptoms started 24 hours ago. A rapid test reveals influenza B. Which antiviral agent would be most useful to initiate?

Which of the following is the most appropriate treatment for postherpetic neuralgia?

Which of the following medications is contraindicated in a patient with heart failure?

All of the following statements regarding amphotericin B are correct EXCEPT: