AHN 577 MAIN EXAM SET 2025/2026 QUESTIONS AND
SOLUTIONS GRADED A+ TIP
✔✔Diagnosing meningitis - ✔✔Lumbar puncture - CSF for gram stain, culture, & AFB
✔✔Empiric bacterial meningitis treatment - ✔✔Ceftriaxone and vancomycin
(add ampicillin if Listeria is suspected)
✔✔Decadron in meningitis - ✔✔Most beneficial for S. pneumonia
Unknown benefit for N. meningitides
✔✔Prophylactic treatment for intimate contact with meningitis - ✔✔If meningococcal
meningitis is source
✔✔Treatment for viral meningitis - ✔✔Usually self-limiting; treatment toward specific
virus
✔✔Endocarditis characteristics - ✔✔Infection of valvular/endocardial surface of heart
✔✔Etiology of endocarditis - ✔✔-Native/prosthetic valve disease
-Transient bacteremia following invasive procedures
-IV drug use
✔✔Common causative organisms of endocarditis - ✔✔S. aereus (most common)
Streptococci
Enterococci
Coag negative staphylococci
HACEK organisms <- normal oral-pharyngeal flora
Fungi
✔✔S/S of endocarditis - ✔✔- Persistent fever/malaise
- Anorexia
- New/worsening murmur
- Embolic manifestations (petechiae, Osler/Janeway nodes, splinter hemorrhages)
- Roth spots
- Splenomegaly
✔✔Diagnosis of endocarditis - ✔✔TTE/TEE
Blood cultures
Modified Duke criteria
✔✔Modified Duke criteria - ✔✔- Confirmed microorganisms by any method except
blood culture OR
2 major; 1 major + 3 minor; or 5 minor symptoms:
, - Major: blood cx positive for organisms; echocardiographic ID of valve-related abscess,
separation, etc.; new valve regurg
- All other sx are minor
✔✔Empiric treatment for endocarditis - ✔✔Ceftriaxone + Vanc
✔✔Treatment for Streptococci endocarditis - ✔✔PCN or Ceftriaxone
✔✔Treatment for Enterococci endocarditis - ✔✔PCN/Ampicillin + Gentamycin
✔✔Treatment for MSSA/MRSA endocarditis - ✔✔Nafcillin/Oxacillin or Cefazolin +
Vanco/Daptomycin
✔✔Treatment for coag negative staph endocarditis - ✔✔Vanco, Rifampin, or
Gentamicin
✔✔Treatment for HASEK endocarditis - ✔✔Ceftriaxone
✔✔Dental prophylaxis to prevent endocarditis - ✔✔-Preferred: Amoxicillin
-With PCN allergy: Clinda, Cephalexin, Azithro
✔✔When should surgical intervention be considered for endocarditis? - ✔✔-After tx
failure x 1 week
-Acute HF
✔✔potential complications of endocarditis - ✔✔-myocardial abscess
-rhythm disturbances
-embolization
-septic pulmonary emboli (2/2 tricuspid valve endocarditis with IVD use)
✔✔Most common cause of CLABSI - ✔✔Coag negative staph
✔✔Empiric treatment for CLABSIs - ✔✔Ceftazidime/Cefepime + Vancomycin
✔✔Most common causative agent of CAP - ✔✔S. pneumoniae
✔✔Most common causative agent of VAP/HAP/HCAP - ✔✔MRSA
✔✔Gold standard for PNA diagnosis - ✔✔CXR
✔✔CXR findings with pneumonia - ✔✔- Airspace opacities
- Lobar consolidation
- Diffuse interstitial opacities
- Pleural effusion
SOLUTIONS GRADED A+ TIP
✔✔Diagnosing meningitis - ✔✔Lumbar puncture - CSF for gram stain, culture, & AFB
✔✔Empiric bacterial meningitis treatment - ✔✔Ceftriaxone and vancomycin
(add ampicillin if Listeria is suspected)
✔✔Decadron in meningitis - ✔✔Most beneficial for S. pneumonia
Unknown benefit for N. meningitides
✔✔Prophylactic treatment for intimate contact with meningitis - ✔✔If meningococcal
meningitis is source
✔✔Treatment for viral meningitis - ✔✔Usually self-limiting; treatment toward specific
virus
✔✔Endocarditis characteristics - ✔✔Infection of valvular/endocardial surface of heart
✔✔Etiology of endocarditis - ✔✔-Native/prosthetic valve disease
-Transient bacteremia following invasive procedures
-IV drug use
✔✔Common causative organisms of endocarditis - ✔✔S. aereus (most common)
Streptococci
Enterococci
Coag negative staphylococci
HACEK organisms <- normal oral-pharyngeal flora
Fungi
✔✔S/S of endocarditis - ✔✔- Persistent fever/malaise
- Anorexia
- New/worsening murmur
- Embolic manifestations (petechiae, Osler/Janeway nodes, splinter hemorrhages)
- Roth spots
- Splenomegaly
✔✔Diagnosis of endocarditis - ✔✔TTE/TEE
Blood cultures
Modified Duke criteria
✔✔Modified Duke criteria - ✔✔- Confirmed microorganisms by any method except
blood culture OR
2 major; 1 major + 3 minor; or 5 minor symptoms:
, - Major: blood cx positive for organisms; echocardiographic ID of valve-related abscess,
separation, etc.; new valve regurg
- All other sx are minor
✔✔Empiric treatment for endocarditis - ✔✔Ceftriaxone + Vanc
✔✔Treatment for Streptococci endocarditis - ✔✔PCN or Ceftriaxone
✔✔Treatment for Enterococci endocarditis - ✔✔PCN/Ampicillin + Gentamycin
✔✔Treatment for MSSA/MRSA endocarditis - ✔✔Nafcillin/Oxacillin or Cefazolin +
Vanco/Daptomycin
✔✔Treatment for coag negative staph endocarditis - ✔✔Vanco, Rifampin, or
Gentamicin
✔✔Treatment for HASEK endocarditis - ✔✔Ceftriaxone
✔✔Dental prophylaxis to prevent endocarditis - ✔✔-Preferred: Amoxicillin
-With PCN allergy: Clinda, Cephalexin, Azithro
✔✔When should surgical intervention be considered for endocarditis? - ✔✔-After tx
failure x 1 week
-Acute HF
✔✔potential complications of endocarditis - ✔✔-myocardial abscess
-rhythm disturbances
-embolization
-septic pulmonary emboli (2/2 tricuspid valve endocarditis with IVD use)
✔✔Most common cause of CLABSI - ✔✔Coag negative staph
✔✔Empiric treatment for CLABSIs - ✔✔Ceftazidime/Cefepime + Vancomycin
✔✔Most common causative agent of CAP - ✔✔S. pneumoniae
✔✔Most common causative agent of VAP/HAP/HCAP - ✔✔MRSA
✔✔Gold standard for PNA diagnosis - ✔✔CXR
✔✔CXR findings with pneumonia - ✔✔- Airspace opacities
- Lobar consolidation
- Diffuse interstitial opacities
- Pleural effusion
