MKSAP ID UPDATED ACTUAL Exam
Questions and CORRECT Answers
Non purulent vs purulent antibiotics choice - CORRECT ANSWER - Empiric treatment of
moderate severity nonpurulent cellulitis (fever, tachycardia, leukocytosis) includes intravenous
penicillin, ceftriaxone, cefazolin, or clindamycin.
Empiric antibiotic treatment of moderate severity purulent cellulitis (with systemic signs of
infection) includes oral doxycycline or trimethoprim-sulfamethoxazole.
What are risk factors for candidemia ? - CORRECT ANSWER - Commonly encountered
risk factors for candidemia include central venous or hemodialysis-associated catheters,
gastrointestinal surgery, and broad-spectrum antimicrobial agents.
If we suspect candidemia what should we do ? - CORRECT ANSWER - The T2 magnetic
resonance assay of whole blood and the β-D-glucan assay for invasive candidiasis should be
obtained when a patient at high risk receiving antimicrobial agents is not responding to therapy.
Sweet syndrome ? - CORRECT ANSWER - Sweet syndrome is a reactive febrile skin
eruption often following upper respiratory or gastrointestinal viral infections; it is characterized
by tender edematous ("juicy") red-to-violaceous papules and plaques.
Rapid resolution of Sweet syndrome with systemic glucocorticoids is characteristic.
Severe malaria in return travelers from Africa ? - CORRECT ANSWER - Malaria
falciparum
Endemic area for malaria vs bavesios ? - CORRECT ANSWER - Africa vs America
Acute epydidimitus empiric treatment? - CORRECT ANSWER - Ceftriaxone +
levofloxacin
Epidydimitus tx? - CORRECT ANSWER - Ceftriaxone+ levofloxacin
, Chlamydia treatment ? - CORRECT ANSWER - Doxy . If pregnancy - azythro
Gonorrhea testing ? - CORRECT ANSWER - NAAT. Do not pick cervical gram stain
Always if gonorea positive - test for HIV and syphilis
Diagnostic tricks for herpes ? - CORRECT ANSWER - 1. Do not use HSV antibody test ,
it will showedpeevious infection
2. Don't order a Tzanck test to diagnose HSV infection; it is neither sensitive nor specific.
Recurrent erythema multiforme is most commonly caused by HSV recurrences.
Treatment trick for herpes ? - CORRECT ANSWER - Use acyclovir or famciclovir, or
valacyclovir for 7 to 10 days.
Do not treat herpetic keratitis with topical glucocorticoid drops.
Topical acyclovir is not effective for treating genital herpes.
HIV diagnosis trick ? - CORRECT ANSWER - If a test is positive on the initial
antigen/antibody combination immunoassay but negative on the antibody differentiation
immunoassay and NAAT testing, the initial test result was a false positive.
Vaccination in HIV ? - CORRECT ANSWER - Live vaccines are contraindicated in
immunocompromised patients, but the MMR, varicella, and recombinant zoster vaccines can be
given to patients with HIV with CD4 cell counts >200/μL.
The most common cause of pneumothorax in pt with AIDS ? - CORRECT ANSWER -
The most common cause of a pneumothorax in a patient with AIDS is P. jirovecii pneumonia.
Patient is not improving on antibiotics . Cultures are negative . We expect candida infection .
What to do ? - CORRECT ANSWER - Obtain b-D Glucan test of T2 magnetic resonance
assay of whole blood provides rapid diagnosis of culture-negative invasive candidal infections
Questions and CORRECT Answers
Non purulent vs purulent antibiotics choice - CORRECT ANSWER - Empiric treatment of
moderate severity nonpurulent cellulitis (fever, tachycardia, leukocytosis) includes intravenous
penicillin, ceftriaxone, cefazolin, or clindamycin.
Empiric antibiotic treatment of moderate severity purulent cellulitis (with systemic signs of
infection) includes oral doxycycline or trimethoprim-sulfamethoxazole.
What are risk factors for candidemia ? - CORRECT ANSWER - Commonly encountered
risk factors for candidemia include central venous or hemodialysis-associated catheters,
gastrointestinal surgery, and broad-spectrum antimicrobial agents.
If we suspect candidemia what should we do ? - CORRECT ANSWER - The T2 magnetic
resonance assay of whole blood and the β-D-glucan assay for invasive candidiasis should be
obtained when a patient at high risk receiving antimicrobial agents is not responding to therapy.
Sweet syndrome ? - CORRECT ANSWER - Sweet syndrome is a reactive febrile skin
eruption often following upper respiratory or gastrointestinal viral infections; it is characterized
by tender edematous ("juicy") red-to-violaceous papules and plaques.
Rapid resolution of Sweet syndrome with systemic glucocorticoids is characteristic.
Severe malaria in return travelers from Africa ? - CORRECT ANSWER - Malaria
falciparum
Endemic area for malaria vs bavesios ? - CORRECT ANSWER - Africa vs America
Acute epydidimitus empiric treatment? - CORRECT ANSWER - Ceftriaxone +
levofloxacin
Epidydimitus tx? - CORRECT ANSWER - Ceftriaxone+ levofloxacin
, Chlamydia treatment ? - CORRECT ANSWER - Doxy . If pregnancy - azythro
Gonorrhea testing ? - CORRECT ANSWER - NAAT. Do not pick cervical gram stain
Always if gonorea positive - test for HIV and syphilis
Diagnostic tricks for herpes ? - CORRECT ANSWER - 1. Do not use HSV antibody test ,
it will showedpeevious infection
2. Don't order a Tzanck test to diagnose HSV infection; it is neither sensitive nor specific.
Recurrent erythema multiforme is most commonly caused by HSV recurrences.
Treatment trick for herpes ? - CORRECT ANSWER - Use acyclovir or famciclovir, or
valacyclovir for 7 to 10 days.
Do not treat herpetic keratitis with topical glucocorticoid drops.
Topical acyclovir is not effective for treating genital herpes.
HIV diagnosis trick ? - CORRECT ANSWER - If a test is positive on the initial
antigen/antibody combination immunoassay but negative on the antibody differentiation
immunoassay and NAAT testing, the initial test result was a false positive.
Vaccination in HIV ? - CORRECT ANSWER - Live vaccines are contraindicated in
immunocompromised patients, but the MMR, varicella, and recombinant zoster vaccines can be
given to patients with HIV with CD4 cell counts >200/μL.
The most common cause of pneumothorax in pt with AIDS ? - CORRECT ANSWER -
The most common cause of a pneumothorax in a patient with AIDS is P. jirovecii pneumonia.
Patient is not improving on antibiotics . Cultures are negative . We expect candida infection .
What to do ? - CORRECT ANSWER - Obtain b-D Glucan test of T2 magnetic resonance
assay of whole blood provides rapid diagnosis of culture-negative invasive candidal infections
