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1. Which of the following is the most appropriate use of galactomannan testing in the management of invasive pulmonary aspergillosis (IPA)?

A. Monitoring of serum levels as a trigger for pre-emptive therapy in asymptomatic patients B. Single serum level as trigger for starting Aspergillus spp. therapy in a patient receiving prophylactic posaconazole C. BAL GM level in a high-risk, untreated patient to rule out IPA D. BAL level in a high-risk patient with sepsis who has been on piperacillin-tazobactam

2. True or false. In the landmark study by Morrell and colleagues in invasive candidiasis, the majority of patients received antifungal therapy within 12 hours from the time the first blood culture containing Candida spp. was drawn.

A. True B. False

3. In the clinical trial by Mylonakis and colleagues that led to approval of the T2MR Candida spp. test:

A. The test was found to have a sensitivity of approximately 95% for C. glabrata when spiked blood cultures were evaluated B. Consistently yielded positive results only in patients with diagnosed candidemia by blood culture C. Had a limit of detection of a few CFUs/mL D. Had a low negative predictive value

4. If all tests were available and valid, which would be most helpful in diagnosing a suspected intra-abdominal candidiasis with resistant C glabrata and defining the resistance mechanism present?

A. Traditional blood culture B. T2MR Candida C. Beta glucan D. PCR

5. Which of the following tests for IA functions in a manner similar to a pregnancy test?

A. Lateral flow B. Galactomannan C. PCR D. Beta-D-Glucan

6. The antifungal that has extensive clinical data in invasive candidiasis but lacks an FDA indication for this condition is:

A. Caspofungin B. Anidulafungin C. Fluconazole D. Ampotericin B

7. Which of the following statements are TRUE regarding antifungal agents used in the management of mucormycosis?

A. Most are FDA-approved based on direct, head-to-head studies with amphotericin B B. Agents that have good coverage for invasive aspergillosis can be expected to have similar activity against mucormycosis C. Isavuconazole recently received an FDA indication for mucormycosis D. The body of literature is strongest for first-line use (vs salvage) of posaconazole in the setting of mucormycosis

8. Which of the following antifungals is NOT considered an appropriate first-line therapy for IA?

A. Liposomal amphotericin B B. Voriconazole C. Fluconazole D. Isavuconazole

9. Which of the following is true about TDM for isavuconazole and the newer formulations of posaconazole?

A. The target range for isavuconazole is ≥1-2 mcg/mL and <5-6 mcg/mL B. Posaconazole DR tablets frequently yield plasma levels above the minimum trough level recommended for treatment and prophylaxis C. Patients receiving posaconazole suspension are >25% more likely to achieve target levels than patients receiving the delayed-release tablet formulation D. There is a clear relationship between exposure parameters and clinical trial efficacy outcomes for isavuconazole

10. In a hospital with a high incidence of non-Aspergillus mold infections, which antifungal agent with an FDA-indication for prophylaxis would be most reasonable to prevent fungal infections in a HSCT patient with GVHD?

A. Voriconazole B. Isavuconazole C. Posaconazole D. Micafungin

11. Which of the following antifungals has the highest degree of CSF penetration?

A. Liposomal amphotericin B B. Anidulafungin C. Caspofungin D. Fluconazole

12. If you were administering an azole in a solid-organ transplant patient receiving immunosuppressants, which of the following agent would have the highest propensity for drug-drug interactions through the CYP3A4 pathway?

A. Voriconazole B. Posaconazole C. Isavuconazole D. All of these agents would have a similar propensity

13. You have a series of patients who are receiving posaconazole delayed-release tablets. Based on the study by Miceli and colleagues, which type of patient is most likely to have an issue obtaining a target level of 1 ug/mL with this formulation?

A. The patient on an H2RA B. The patient with diarrhea C. The patient with a BMI <30 D. The patient with a body weight <90 kg

14. True or false. As reported in a recent study, 30%-50% of bloodstream samples sent to UTHSC reference laboratory for therapeutic drug monitoring of mold-active azoles from 2001-2013 had subtherapeutic concentrations.

A. True B. False

15. Which of the following would be a reasonable strategy to optimize PK/PD of antifungals?

A. Increase the frequency of dosing of a mold-active azole in a patient who is a hypermetabolizer B. Consider an alternative formulation of the agent C. With high levels, consider holding the dose if necessary, restarting at a lower dose D. All of the above

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1. Which of the following is the most appropriate use of galactomannan testing in the management of invasive pulmonary aspergillosis (IPA)?

2. True or false. In the landmark study by Morrell and colleagues in invasive candidiasis, the majority of patients received antifungal therapy within 12 hours from the time the first blood culture containing Candida spp. was drawn.

3. In the clinical trial by Mylonakis and colleagues that led to approval of the T2MR Candida spp. test:

4. If all tests were available and valid, which would be most helpful in diagnosing a suspected intra-abdominal candidiasis with resistant C glabrata and defining the resistance mechanism present?

5. Which of the following tests for IA functions in a manner similar to a pregnancy test?

6. The antifungal that has extensive clinical data in invasive candidiasis but lacks an FDA indication for this condition is:

7. Which of the following statements are TRUE regarding antifungal agents used in the management of mucormycosis?

8. Which of the following antifungals is NOT considered an appropriate first-line therapy for IA?

9. Which of the following is true about TDM for isavuconazole and the newer formulations of posaconazole?

10. In a hospital with a high incidence of non-Aspergillus mold infections, which antifungal agent with an FDA-indication for prophylaxis would be most reasonable to prevent fungal infections in a HSCT patient with GVHD?

11. Which of the following antifungals has the highest degree of CSF penetration?

12. If you were administering an azole in a solid-organ transplant patient receiving immunosuppressants, which of the following agent would have the highest propensity for drug-drug interactions through the CYP3A4 pathway?

13. You have a series of patients who are receiving posaconazole delayed-release tablets. Based on the study by Miceli and colleagues, which type of patient is most likely to have an issue obtaining a target level of 1 ug/mL with this formulation?

14. True or false. As reported in a recent study, 30%-50% of bloodstream samples sent to UTHSC reference laboratory for therapeutic drug monitoring of mold-active azoles from 2001-2013 had subtherapeutic concentrations.

15. Which of the following would be a reasonable strategy to optimize PK/PD of antifungals?

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1. Which of the following is the most appropriate use of galactomannan testing in the management of invasive pulmonary aspergillosis (IPA)?

2. True or false. In the landmark study by Morrell and colleagues in invasive candidiasis, the majority of patients received antifungal therapy within 12 hours from the time the first blood culture containing Candida spp. was drawn.

3. In the clinical trial by Mylonakis and colleagues that led to approval of the T2MR Candida spp. test:

4. If all tests were available and valid, which would be most helpful in diagnosing a suspected intra-abdominal candidiasis with resistant C glabrata and defining the resistance mechanism present?

5. Which of the following tests for IA functions in a manner similar to a pregnancy test?

6. The antifungal that has extensive clinical data in invasive candidiasis but lacks an FDA indication for this condition is:

7. Which of the following statements are TRUE regarding antifungal agents used in the management of mucormycosis?

8. Which of the following antifungals is NOT considered an appropriate first-line therapy for IA?

9. Which of the following is true about TDM for isavuconazole and the newer formulations of posaconazole?

10. In a hospital with a high incidence of non-Aspergillus mold infections, which antifungal agent with an FDA-indication for prophylaxis would be most reasonable to prevent fungal infections in a HSCT patient with GVHD?

11. Which of the following antifungals has the highest degree of CSF penetration?

12. If you were administering an azole in a solid-organ transplant patient receiving immunosuppressants, which of the following agent would have the highest propensity for drug-drug interactions through the CYP3A4 pathway?

13. You have a series of patients who are receiving posaconazole delayed-release tablets. Based on the study by Miceli and colleagues, which type of patient is most likely to have an issue obtaining a target level of 1 ug/mL with this formulation?

14. True or false. As reported in a recent study, 30%-50% of bloodstream samples sent to UTHSC reference laboratory for therapeutic drug monitoring of mold-active azoles from 2001-2013 had subtherapeutic concentrations.

15. Which of the following would be a reasonable strategy to optimize PK/PD of antifungals?

« Return to Activity

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