1. Which one of the following statements regarding the use of voriconazole is INCORRECT?
A. Adverse reactions associated with voriconazole include transient visual disturbances.
B. The recommended loading dose is 4 milligrams per kilogram intravenously every 12 hours on day 1.
C. Toxicities have been observed with trough levels >5.5 mcg/mL.
D. Voriconazole dose adjustment is recommended in patients with mild-to-moderate hepatic impairment (Child Pugh A/B).
2. Which one of the following statements regarding the use of diagnostics for invasive aspergillosis (IA) is CORRECT?
A. The beta-D-glucan assay is not specific for Aspergillus species and can be positive in patients with a variety of invasive fungal infections.
B. Beta-D-glucan can interfere with galactomannan assessment.
C. Any Aspergillus infection in the body will produce a positive galactomannan serum assay.
D. GMA assay values can be falsely elevated in patients on concurrent aminoglycoside therapy.
3. Which one of the following statements regarding antifungal therapy for invasive aspergillosis is CORRECT?
A. Non-inferiority trials demonstrated that isavuconazole is superior to voriconazole in patients with proven or probable I
B. Posaconazole is FDA-approved for primary treatment of invasive aspergillosis.
C. Combination therapy with voriconazole and an echinocandin is an emerging trend in the treatment of invasive aspergillosis
4. Which one of the following factors is NOT typically a major consideration when choosing empiric antifungal therapy?
A. A history of prolonged exposure to antifungal agents.
B. Typical antifungal susceptibility patterns at the medical center or community.
C. A history and assessment of degree of immunosuppression.
D. A history of chronic kidney disease.
E. A history of cardiovascular disease.
5. Which one of the following factors is NOT a common risk factor associated with invasive Candida infections?
A. Total parenteral nutrition.
B. Broad spectrum antibiotic therapy.
C. Disruption of the GI mucosa.
D. Anemia with hemoglobin <8 g/dL.
E. Prolonged neutropenia.
6. Which one of the following statements regarding the use of echinocandins for the treatment of candidemia is INCORRECT?
A. Echinocandins are appropriate for empiric therapy in neutropenic hosts.
B. A lower than customary daily dose of caspofungin (35 mg daily) should be used in patients with Child-Pugh score 7-9.
C. Echinocandins are a recommended choice for empiric antifungal therapy in non-neutropenic hosts with severe illness or recent azole exposure.
D. Candida krusei is intrinsically resistant to echinocandins.
7. Which one of the following epidemiologic and historic factors is not a major consideration when selecting antifungal therapy for candidemia?
A. History of recent azole exposure.
B. Prevalence of different Candida species and current antifungal susceptibility data in the clinical unit and medical center.
C. Severity of illness.
D. Evidence of involvement of the central nervous system, cardiac valves, eyes, and/or visceral organs.
E. Use of a proton pump inhibitor.
8. Which one of the following statements regarding the management of Cryptococcus meningoencephalitis is true?
A. The use of flucytosine during induction therapy is only recommended for patients with HIV infection.
B. Careful management of intracranial pressures has been shown to improve patient outcomes.
C. The transition to consolidation therapy must always begin on week 2 to limit the toxicities of amphotericin B.
D. Antifungal doses should be reduced in patients who develop Immune Reconstitution Syndrome.
9. Which one of the following statements regarding cryptococcal infections is INCORRECT?
A. The leading risk factor for cryptococcal infection is HIV/AIDS.
B. C. neoformans is only isolated from patients with documented immunodeficiencies.
C. C. gattii has been associated with a recent outbreak of cryptococcal infections in the northwest United States.
D. C. gattii infections can be more aggressive and progress more rapidly than infections with C. neoformans.
10. Which one of the following statements regarding Cryptococcus infections is INCORRECT?
A. Severe C. gattii have been observed in persons with no identified immunodeficiency or immunosuppression.
B. CSF cryptococcal antigen assays can routinely detect C. gattii .
C. CSF fungal cultures routinely grow Cryptococcus if present.
D. C. neoformans cryptococcal infections are more resistant to azole therapies such as fluconazole compared to C. gattii .
Evaluation Questions
11. To what extent did the program meet objective #1?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
12. To what extent did the program meet objective #2?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
13. To what extent did the program meet objective #3?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
14. To what extent did the program meet objective #4?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
15. To what extent did the program meet objective #5?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
16. To what extent did the program meet objective #6?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
17. Rate the effectiveness of how well the program related to your educational needs:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
18. Rate how well the active learning strategies (questions, cases, discussions) were appropriate and effective learning tools:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
19. Rate the quality of the faculty:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
20. Rate the effectiveness and the overall usefulness of the material presented:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
21. Rate the appropriateness of the examination for this activity:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
22. Rate the effectiveness of how well the activity related to your practice needs:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
23. Rate the effectiveness of how well the activity will help you improve patient care:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
24. Will the information presented cause you to change your practice?
A. Yes
B. No
25. Are you committed to making these changes?
A. Yes
B. No
26. As a result of this activity, did you learn something new?
A. Yes
B. No
27. What is your practice setting or area of practice?
A. Community Pharmacy/Independent
B. Community Pharmacy/Chain
C. Hospital/Health Systems
D. Administrative/Pharmacy Director
E. Critical Care Pharmacy
F. Long-term Care
G. Managed Care/PBM
H. Oncology
I. Specialty Pharmacy
J. Industry/Manufacturing
28. How many years have you been in practice?
A. <5
B. 5 – 10
C. 11 – 20
D. >20
29. In your practice, do you follow the current guidelines from the Infections Diseases Society of America for management of patients with invasive aspergillosis?
A. Yes
B. No
C. I am not aware of these specific guideline recommendations
30. In your practice, do you routinely monitor voriconazole troughs on all patients on this antifungal agent?
A. Yes
B. No
31. In your practice, do you follow the current guidelines from the Infectious Diseases Society of America for management of patients with candidiasis?
A. Yes
B. No
C. I am not aware of these specific guideline recommendations
32. In your practice, do you follow the current guideline from the Infectious Diseases Society of America for management of patients with cryptococcal disease?
A. Yes
B. No
C. I am not aware of these specific guideline recommendations
