For which of the following patients would you recommend prophylaxis against mycobacterium avium-intracellulare?
A30-year old HIV positive male with CD4 count of 20 cells/microliter and a viral load of < 50 copies/mL
B22-year old HIV positive female with CD4 count of 750 cells/microliter and a viral load of 500,000 copies/mL
C45-year old HIV positive female with CD4 count of 250 cells/microliter and a viral load of 100,000 copies/mL
D50-year old HIV positive female with CD4 count of 150 cells/microliter and a viral load of < 50 copies/mL
E36-year old HIV positive male with CD4 count of 75 cells/microliter and an undetectable viral load
Two hours after admission to the intensive care unit, a 56-year-old man with necrotizing pancreatitis develops profound hypotension. His blood pressure is 80/50 mm Hg and he is started on vasopressors. A central venous access line is placed. Which of the following is most likely to decrease the risk of complications from this procedure?
APlacement of the central venous line in the femoral vein
BReplacement of the central venous line every 7-10 days
CInitiation of anticoagulation after placement
DPreparation of the skin with chlorhexidine and alcohol
EInitiation of periprocedural systemic antibiotic prophylaxis
A 65-year-old female patient with a past medical history of diabetes mellitus and an allergy to penicillin develops an infected abscess positive for MRSA on the third day of her hospital stay. She is started on an IV infusion of vancomycin at a dose of 1000 mg every 12 hours. Vancomycin is eliminated by first-order kinetics and has a half life of 6 hours. The volume of distribution of vancomycin is 0.5 L/kg. Assuming no loading dose is given, how long will it take for the drug to reach 94% of its plasma steady state concentration?
A30 hours
B12 hours
C6 hours
D18 hours
E24 hours
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