BCACP Infectious Disease and Immunization Management 4

Question 1

A patient with HIV on antiretroviral therapy has a CD4 count of 150 cells/μL. Which opportunistic infection prophylaxis is MOST indicated?

Accepted Answer

Trimethoprim-sulfamethoxazole for Pneumocystis jirovecii pneumonia

Answer

TMP-SMX prophylaxis for PCP is indicated when CD4 count falls below 200 cells/μL.

Question 2

Which hepatitis B vaccine schedule is recommended for adults with diabetes mellitus aged 60 years or older?

Accepted Answer

Vaccination should be at the clinician's discretion based on risk

Answer

ACIP recommends hepatitis B vaccination for adults 19–59 with diabetes and at the clinician's discretion for those ≥60 years.

Question 3

A patient is prescribed rifampin for latent TB. Which drug interaction requires the most urgent counseling?

Accepted Answer

Warfarin — reduced anticoagulant effect

Answer

Rifampin is a potent CYP450 inducer that significantly reduces warfarin levels, increasing thromboembolism risk.

Question 4

Which statement best describes the role of oseltamivir in outpatient influenza management?

Accepted Answer

Most beneficial when initiated within 48 hours of symptom onset

Answer

Oseltamivir reduces duration and severity of influenza most effectively when started within 48 hours of symptom onset.

Question 5

A 35-year-old pregnant woman at 28 weeks asks about Tdap vaccination. What is the correct guidance?

Accepted Answer

Administer Tdap during each pregnancy, preferably between 27–36 weeks gestation

Answer

ACIP recommends Tdap during every pregnancy, ideally at 27–36 weeks, to provide neonatal pertussis protection via maternal antibody transfer.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test