ACCS ACCS Infection Control and Sepsis Management 2

Question 1

In a patient with septic shock refractory to fluid resuscitation, which vasopressor is recommended as the first-line agent?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor for septic shock due to its potent vasoconstrictive effect with limited tachycardia.

Question 2

Which isolation precaution is required for a patient with confirmed Clostridioides difficile infection in the ICU?

Accepted Answer

Contact precautions with soap and water handwashing

Answer

C. difficile requires contact precautions, and soap and water must be used for hand hygiene because alcohol-based sanitizers do not kill spores.

Question 3

A patient develops fever, purulent tracheal secretions, and a new infiltrate on CXR after 5 days of mechanical ventilation. What is the most appropriate next step?

Accepted Answer

Obtain a bronchoalveolar lavage (BAL) and start empiric antibiotics for VAP

Answer

BAL sampling followed by empiric broad-spectrum antibiotics targeting VAP pathogens is the recommended approach for suspected VAP.

Question 4

Which serum lactate level is used to define occult tissue hypoperfusion (cryptic shock) in sepsis?

Accepted Answer

≥2 mmol/L

Answer

A lactate ≥2 mmol/L despite normal blood pressure defines occult or cryptic septic shock and warrants aggressive resuscitation.

Question 5

Which antifungal agent is recommended as first-line empiric therapy for suspected candidemia in a critically ill ICU patient?

Accepted Answer

An echinocandin (caspofungin, micafungin, or anidulafungin)

Answer

Echinocandins are first-line for suspected candidemia because they cover fluconazole-resistant Candida species with excellent tolerability.

(ACCS) Adult Critical Care Specialty Practice Test

(ACCS) Adult Critical Care Specialty Practice Test

ACCS ACCS Infection Control and Sepsis Management 2