Devita, Hellman, and Rosenberg's Cancer

LWBK1006-43 LWW-Govindan-Review December 14, 2011 15:38

Chapter 43•Infections in the Cancer Patient 543

Question 43.17. A 62-year-old man with squamous cell carcinoma of the oral cavity in

remission presents with headaches, diplopia, and low-grade fevers. Brain

magnetic resonance imaging (MRI) reveals a ring-enhancing lesion within

the brain parenchyma. You suspect a brain abscess and call the neuro-

surgeon for needle aspiration. Pending cultures, which of the following

empiric regimens should be recommended?

A. Ceftriaxone

B. Vancomycin and metronidazole

C. Ceftriaxone and metronidazole

D. Voriconazole

Question 43.18. A 45-year-old woman with hepatocellular carcinoma undergoes

chemoembolization. What is the rate of infection associated with this

procedure?

A. 1%

B. 10%

C. 20%

D. 30%

Question 43.19. Vancomycin-resistant enterococcus (VRE) faecium is isolated from blood

culture in a patient with cancer and normal hepatic and renal function.

Which of the following choices is acceptable first-line antibiotic therapy?

A. Linezolid

B. Daptomycin

C. Quinupristin-dalfopristin

D. Any of the above

Question 43.20. A 44-year-old man with refractory AML has multiple painful sores in

his mouth, and oral swab culture is positive for HSV. He has lost 15 lbs

with decreased food intake because of his painful lesions. He also has

lightheadedness on standing but denies other symptoms. What is the pre-

ferred treatment?

A. Oral acyclovir 400 mg three times daily

B. Intravenous acyclovir 5 mg/kg every 8 hours

C. Intravenous acyclovir 10 mg/kg every 8 hours

D. Oral valacyclovir 1 g twice daily

Question 43.21. Posttransplant lymphoproliferative disorder (PTLD) is induced by which

pathogen?

A. Epstein-Barr virus (EBV)

B. Human herpes virus-6

C. CMV

D. Varicella-zoster virus