ALL THE COMSAE EXAM QUESTIONS
WITH COMPLETE SOLUTIONS
Encephalitis due to Borrelia burgdorferi - ANSWER-Ceftriaxone
Meningitis in neonate, child, or adult - ANSWER-ampicillin + cefotaxime +
gentamicin + ceftriaxone or cefotaxime + dexamethasone + vacomycin
Meningitis in alcoholics, people >50, people with severe comorbid diseases, or
anyone who is immunocompromised - ANSWER-ceftriaxone or cefotaxime +
dexamethasone + vacomycin + ampcillin
Meningitis prophylaxis if hemophilus influenzae - ANSWER-rifampin
Meningitis prophylaxis if neisseria meningitidis - ANSWER-rifampin or ceftriaxone or
ciprofloxacin
Otitis externa - ANSWER-acetic acid + propylene glycol + hydrocortisone drops
or
Cirpofloxacin + hydrocortisone drops
Otitis media - ANSWER--amoxicillin if <2 y/o
-analgesics if >2 with no pain or fever
Viral conjunctivitis - ANSWER-nothing or chilled artificial tears
Bacterial conjunctivitis - ANSWER-fluoroquinolone drops
Neonatal conjunctivitis with onset within 1st day of life - ANSWER-nothing
Neonatal conjunctivitis with onset within 2-4 days of life - ANSWER-IV ceftriaxone +
PO erythromycin
Neonatal conjunctivitis with onset within 3-10 days of life - ANSWER-PO
erythromycin
Neonatal conjunctivitis with onset within 2-16 days of life - ANSWER-topical
antivirals + IV acyclovir
Ophthalmia neonatorum prophylaxis - ANSWER-tetracycline ointment or
erythromycin ointment
Post-antibiotic diarrhea - ANSWER-Metronidazole
Travel associated diarrhea - ANSWER-fluoroquinolone or rifaximin
-if a child or pregnant: azithromycin
, Diarrhea prophylaxis during travel - ANSWER-fluoroquinolone + loperamide with first
loose stool
Mild-moderate diarrhea - ANSWER-fluids + lactose and caffeine free diet
-may add anti-diarrheal agents if >4 loose stools/day
Severe diarrhea - ANSWER-ciprofloxacin or levofloxacin + metronidazole + lactose
and caffeine free diet
-Children: trimethoprim-sulfamethoxazole
Acute bronchitis - ANSWER-antitussives +/- inhaled beta-2 agonists
Anthrax prophylaxis post-exposure - ANSWER-ciprofloxacin or doxycycline +
biothrax vaccine
Pneumonia <1 months old - ANSWER-ampicillin + gentamicin +/- cefotaxime (+
vancomycin if MRSA)
Pneumonia 1-3 months old - ANSWER--erythromycin or azithromycin
-febrile: cefotaxime or ceftriaxone
Pneumonia >3 months old - 18 years old - ANSWER-ampicillin (if vacc. up to date)
or cefotaxime (if vacc. not up to date) +/- azithromycin +/- vancomycin
Pneumonia >18 years old - ANSWER-ceftriaxone or ceftaroline + azithromycin
Prostatitis <35 years old - ANSWER-ceftriaxone then doxycycline
Prostatitis >35 years old - ANSWER-fluoroquinolone or trimethoprim and
sulfamethoxazole
Sepsis in a neonate - ANSWER-ampcillin + cefotaxime +/- gentamicin
Sepsis in a child - ANSWER-vancomycin + cefotaxime or ceftriaxone
Sepsis in an adult - ANSWER-any carbapenem or piperacillin-tazobactam +
vancomycin
Septic shock - ANSWER-DOC for suspected organism + IV fluids + norepinephrine +
blood glucose control with target of 140-180 +/- low dose steroids
Outpatient UTI - ANSWER-trimethoprim-sulfamthoxazole
-nitrofurantoin if allergic
Inpatient UTI - ANSWER-ciprofloxacin or levofloxacin
Pregnant patient with UTI - ANSWER-nitrofurantoin
Human or animal bite - ANSWER-amoxicillin-clavulanic acid + tetanus prophylaxis
+/- rabies prophylaxis
WITH COMPLETE SOLUTIONS
Encephalitis due to Borrelia burgdorferi - ANSWER-Ceftriaxone
Meningitis in neonate, child, or adult - ANSWER-ampicillin + cefotaxime +
gentamicin + ceftriaxone or cefotaxime + dexamethasone + vacomycin
Meningitis in alcoholics, people >50, people with severe comorbid diseases, or
anyone who is immunocompromised - ANSWER-ceftriaxone or cefotaxime +
dexamethasone + vacomycin + ampcillin
Meningitis prophylaxis if hemophilus influenzae - ANSWER-rifampin
Meningitis prophylaxis if neisseria meningitidis - ANSWER-rifampin or ceftriaxone or
ciprofloxacin
Otitis externa - ANSWER-acetic acid + propylene glycol + hydrocortisone drops
or
Cirpofloxacin + hydrocortisone drops
Otitis media - ANSWER--amoxicillin if <2 y/o
-analgesics if >2 with no pain or fever
Viral conjunctivitis - ANSWER-nothing or chilled artificial tears
Bacterial conjunctivitis - ANSWER-fluoroquinolone drops
Neonatal conjunctivitis with onset within 1st day of life - ANSWER-nothing
Neonatal conjunctivitis with onset within 2-4 days of life - ANSWER-IV ceftriaxone +
PO erythromycin
Neonatal conjunctivitis with onset within 3-10 days of life - ANSWER-PO
erythromycin
Neonatal conjunctivitis with onset within 2-16 days of life - ANSWER-topical
antivirals + IV acyclovir
Ophthalmia neonatorum prophylaxis - ANSWER-tetracycline ointment or
erythromycin ointment
Post-antibiotic diarrhea - ANSWER-Metronidazole
Travel associated diarrhea - ANSWER-fluoroquinolone or rifaximin
-if a child or pregnant: azithromycin
, Diarrhea prophylaxis during travel - ANSWER-fluoroquinolone + loperamide with first
loose stool
Mild-moderate diarrhea - ANSWER-fluids + lactose and caffeine free diet
-may add anti-diarrheal agents if >4 loose stools/day
Severe diarrhea - ANSWER-ciprofloxacin or levofloxacin + metronidazole + lactose
and caffeine free diet
-Children: trimethoprim-sulfamethoxazole
Acute bronchitis - ANSWER-antitussives +/- inhaled beta-2 agonists
Anthrax prophylaxis post-exposure - ANSWER-ciprofloxacin or doxycycline +
biothrax vaccine
Pneumonia <1 months old - ANSWER-ampicillin + gentamicin +/- cefotaxime (+
vancomycin if MRSA)
Pneumonia 1-3 months old - ANSWER--erythromycin or azithromycin
-febrile: cefotaxime or ceftriaxone
Pneumonia >3 months old - 18 years old - ANSWER-ampicillin (if vacc. up to date)
or cefotaxime (if vacc. not up to date) +/- azithromycin +/- vancomycin
Pneumonia >18 years old - ANSWER-ceftriaxone or ceftaroline + azithromycin
Prostatitis <35 years old - ANSWER-ceftriaxone then doxycycline
Prostatitis >35 years old - ANSWER-fluoroquinolone or trimethoprim and
sulfamethoxazole
Sepsis in a neonate - ANSWER-ampcillin + cefotaxime +/- gentamicin
Sepsis in a child - ANSWER-vancomycin + cefotaxime or ceftriaxone
Sepsis in an adult - ANSWER-any carbapenem or piperacillin-tazobactam +
vancomycin
Septic shock - ANSWER-DOC for suspected organism + IV fluids + norepinephrine +
blood glucose control with target of 140-180 +/- low dose steroids
Outpatient UTI - ANSWER-trimethoprim-sulfamthoxazole
-nitrofurantoin if allergic
Inpatient UTI - ANSWER-ciprofloxacin or levofloxacin
Pregnant patient with UTI - ANSWER-nitrofurantoin
Human or animal bite - ANSWER-amoxicillin-clavulanic acid + tetanus prophylaxis
+/- rabies prophylaxis
