ABIM Infectious Disease

Question 1

A healthy 28-year-old non-pregnant woman has dysuria and urinary frequency with no fever or flank pain. Which is an appropriate first-line treatment for her uncomplicated cystitis?

Accepted Answer

Nitrofurantoin for 5 days

Answer

IDSA guidelines list nitrofurantoin for 5 days as a first-line choice for acute uncomplicated cystitis. Fluoroquinolones are saved for other uses because of resistance and adverse effects. Amoxicillin alone works poorly because of high resistance rates, and IV therapy is not needed.

Question 2

A 40-year-old man with no comorbidities and no recent antibiotic use has outpatient community-acquired pneumonia. Per the 2019 ATS/IDSA guideline, which is a recommended empiric regimen?

Accepted Answer

Amoxicillin

Answer

For healthy outpatients without comorbidities, the 2019 ATS/IDSA guideline recommends high-dose amoxicillin, with doxycycline or a macrolide as alternatives where local resistance allows. Broad-spectrum or IV regimens are for patients with comorbidities or those who are hospitalized.

Question 3

Which of the following is a CDC-recommended treatment regimen for latent tuberculosis infection?

Accepted Answer

Rifampin daily for 4 months

Answer

The CDC's preferred short-course options for latent TB are 4 months of daily rifampin, 3 months of weekly isoniazid plus rifapentine, and 3 months of daily isoniazid plus rifampin. Rifampin plus pyrazinamide is not recommended because of severe hepatotoxicity.

Question 4

A 55-year-old has a first episode of non-severe Clostridioides difficile infection. According to the 2021 IDSA/SHEA update, which treatment is preferred?

Accepted Answer

Oral fidaxomicin

Answer

The 2021 IDSA/SHEA update prefers fidaxomicin for an initial episode because it lowers the recurrence rate. Oral vancomycin is an acceptable alternative. IV vancomycin does not reach the colon, and metronidazole is reserved for when the other options are unavailable.

Question 5

A 67-year-old presents with fever, neck stiffness, and confusion. Besides dexamethasone, which is the most appropriate empiric antibiotic regimen for suspected bacterial meningitis?

Accepted Answer

Vancomycin plus ceftriaxone plus ampicillin

Answer

Adults over 50 need ampicillin added to vancomycin and ceftriaxone to cover Listeria monocytogenes, in addition to resistant pneumococcus and meningococcus.

ABIM - American Board of Internal Medicine Practice Test

ABIM - American Board of Internal Medicine Practice Test

ABIM Infectious Disease