MKSAP ID ACTUAL UPDATED Exam
Questions and CORRECT Answers
Patients undergoing cardiothoracic or orthopedic surgery should be screened for --- --- if
positive, should have preoperative decolonization. - CORRECT ANSWER - MRSA nares
Patients undergoing cardiothoracic or orthopedic surgery should be screened for nasal carriage of
Staphylococcus aureus and, if positive, should have preoperative decolonization.
Mupirocin ointment for 5 days with or without chlorhexidine gluconate body wash) to decrease
the risk of developing S. aureus-related SSI.
ab for atypicals - CORRECT ANSWER - levoflox, moxiflox, azithro, doxy
he is an atypical LAD.
ab for MRSA - CORRECT ANSWER - ceftaroline, vanc, dapto, linezolid,
bactrim, clinda, doxy
ab for enterococcus - CORRECT ANSWER - unasyn, zosyn,
vanc, dapto, linzeolid
dapto wont cover - CORRECT ANSWER - lungs
G+ cocci ab - CORRECT ANSWER - PCN, unasyn, zosyn,
cefazolin, cefotetan, ceftriaxone, cefepime (all cephalosporins)
all carbapenems erta and imi meropenam)levoflox moxiflox, vanc, dapto, linezm clindaazithro
ab for G- rods - CORRECT ANSWER - aztreonam, aminoglycoside
FQs
,carbapenems, cephalosporins, not cefazolin, unasyn, zosyn
psuedomonas ab - CORRECT ANSWER - zosyn, ceftaz, cefepime, imi meropenem, FQs,
aztreonam, aminoglycoside
rx esbls ab - CORRECT ANSWER - imipenem, meropenem
oral anaerobes ab - CORRECT ANSWER - pcn, augmentin, zosyn
ertapenem imi meropenem
moxiflox, bactrim, flagyl
gut anaerobe ab - CORRECT ANSWER - augmentin, zosyn, ertapenem, imi meropenem
Duke's criteria - CORRECT ANSWER - infective endocarditis diagnostic criteria
Major - sustained bacteremia, endocardial involvement by echo, new valvular regurgitation
Minor - predisposing condition, fever,
septic or pulm emboli, mycotic aneurysm, intracranial hemorrhage, janeway lesions
immune phenomenon - glomerulonephritis, osler's nodes, roth spots, rheumatoid factor
non major blood culture/echo
dukes BE FIVE PM - inf endocard - CORRECT ANSWER - 2 major
+ blood cx
evidence endocardial involvement
1 major 3 min
5 minor
-predisposing heart cond
, -IVDA
-vasc phen
-fever
-micro evidence of echo evidence not meeting major
Major BE (blood cx+, endocardial involvement)
Minor FIVE PM
1. Fever
2. immunologic phen (GN osler roth spots)
3. vasc phen (aneurysm, emboli hemorrhage lesions).
4. echo proof
5. P predisposition (IVDA, heart murmur)
M (microevidence that doesnt meet major criteria)
--- is the return of a robust immune response resulting from treatment of HIV that may "unmask"
a pre-existing infection; when this occurs, the underlying infection should be treated while
antiretroviral therapy is continued. - CORRECT ANSWER - Immune reconstitution
inflammatory syndrome is the return of a robust immune response resulting from treatment of
HIV that may "unmask" a pre-existing infection; when this occurs, the underlying infection
should be treated while antiretroviral therapy is continued.
The most appropriate management for this patient is to start rifabutin, isoniazid, ethambutol, and
pyrazinamide therapy for tuberculosis. He began antiretroviral therapy 1 month ago and has
responded well, with a significant decrease in viral load and increased CD4 cell count. The
timing of his presentation is consistent with the immune reconstitution inflammatory syndrome
(IRIS) (median 48 days), the return of a robust immune response resulting from treatment of the
HIV that "unmasks" a pre-existing infection that appears like a new acute infection. This
presentation is common with tuberculosis, which may present as a much more acute pulmonary
illness resembling bacterial pneumonia. He had an indeterminate result on interferon-γ release
assay (IGRA) because of an inadequate response to the positive control, which was the result of
immunocompromise at the time of presentation; additionally, the results of IGRA testing are a
Questions and CORRECT Answers
Patients undergoing cardiothoracic or orthopedic surgery should be screened for --- --- if
positive, should have preoperative decolonization. - CORRECT ANSWER - MRSA nares
Patients undergoing cardiothoracic or orthopedic surgery should be screened for nasal carriage of
Staphylococcus aureus and, if positive, should have preoperative decolonization.
Mupirocin ointment for 5 days with or without chlorhexidine gluconate body wash) to decrease
the risk of developing S. aureus-related SSI.
ab for atypicals - CORRECT ANSWER - levoflox, moxiflox, azithro, doxy
he is an atypical LAD.
ab for MRSA - CORRECT ANSWER - ceftaroline, vanc, dapto, linezolid,
bactrim, clinda, doxy
ab for enterococcus - CORRECT ANSWER - unasyn, zosyn,
vanc, dapto, linzeolid
dapto wont cover - CORRECT ANSWER - lungs
G+ cocci ab - CORRECT ANSWER - PCN, unasyn, zosyn,
cefazolin, cefotetan, ceftriaxone, cefepime (all cephalosporins)
all carbapenems erta and imi meropenam)levoflox moxiflox, vanc, dapto, linezm clindaazithro
ab for G- rods - CORRECT ANSWER - aztreonam, aminoglycoside
FQs
,carbapenems, cephalosporins, not cefazolin, unasyn, zosyn
psuedomonas ab - CORRECT ANSWER - zosyn, ceftaz, cefepime, imi meropenem, FQs,
aztreonam, aminoglycoside
rx esbls ab - CORRECT ANSWER - imipenem, meropenem
oral anaerobes ab - CORRECT ANSWER - pcn, augmentin, zosyn
ertapenem imi meropenem
moxiflox, bactrim, flagyl
gut anaerobe ab - CORRECT ANSWER - augmentin, zosyn, ertapenem, imi meropenem
Duke's criteria - CORRECT ANSWER - infective endocarditis diagnostic criteria
Major - sustained bacteremia, endocardial involvement by echo, new valvular regurgitation
Minor - predisposing condition, fever,
septic or pulm emboli, mycotic aneurysm, intracranial hemorrhage, janeway lesions
immune phenomenon - glomerulonephritis, osler's nodes, roth spots, rheumatoid factor
non major blood culture/echo
dukes BE FIVE PM - inf endocard - CORRECT ANSWER - 2 major
+ blood cx
evidence endocardial involvement
1 major 3 min
5 minor
-predisposing heart cond
, -IVDA
-vasc phen
-fever
-micro evidence of echo evidence not meeting major
Major BE (blood cx+, endocardial involvement)
Minor FIVE PM
1. Fever
2. immunologic phen (GN osler roth spots)
3. vasc phen (aneurysm, emboli hemorrhage lesions).
4. echo proof
5. P predisposition (IVDA, heart murmur)
M (microevidence that doesnt meet major criteria)
--- is the return of a robust immune response resulting from treatment of HIV that may "unmask"
a pre-existing infection; when this occurs, the underlying infection should be treated while
antiretroviral therapy is continued. - CORRECT ANSWER - Immune reconstitution
inflammatory syndrome is the return of a robust immune response resulting from treatment of
HIV that may "unmask" a pre-existing infection; when this occurs, the underlying infection
should be treated while antiretroviral therapy is continued.
The most appropriate management for this patient is to start rifabutin, isoniazid, ethambutol, and
pyrazinamide therapy for tuberculosis. He began antiretroviral therapy 1 month ago and has
responded well, with a significant decrease in viral load and increased CD4 cell count. The
timing of his presentation is consistent with the immune reconstitution inflammatory syndrome
(IRIS) (median 48 days), the return of a robust immune response resulting from treatment of the
HIV that "unmasks" a pre-existing infection that appears like a new acute infection. This
presentation is common with tuberculosis, which may present as a much more acute pulmonary
illness resembling bacterial pneumonia. He had an indeterminate result on interferon-γ release
assay (IGRA) because of an inadequate response to the positive control, which was the result of
immunocompromise at the time of presentation; additionally, the results of IGRA testing are a
