Free Practice Questions for Adult Infectious Diseases Fellowship
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Sample Adult Infectious Diseases Fellowship Practice Questions
Try these sample questions to review concepts for the Adult Infectious Diseases Fellowship exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 54-year-old man with no prior cardiac history presents with 2 weeks of remittent fever, malaise, and a new holosystolic murmur at the apex radiating to the axilla. Blood cultures grow methicillin-susceptible Staphylococcus aureus (MSSA) in 4 of 4 bottles within 12 hours. Transesophageal echocardiography (TEE) demonstrates a 16-mm mobile vegetation on the anterior leaflet of the mitral valve with severe mitral regurgitation and mild pulmonary venous systolic flow reversal. On hospital day 2, while receiving intravenous cefazolin, he develops sudden-onset left hemiparesis. Brain MRI reveals a 12-mm non-hemorrhagic cortical ischemic infarct in the right middle cerebral artery territory. What is the most appropriate next step in the management of this patient?
2A 48-year-old previously healthy woman is brought to the emergency department with acute high-grade fever, severe headache, photophobia, and altered mental status. On examination, she is somnolent with marked nuchal rigidity and positive Kernig sign. Lumbar puncture demonstrates opening pressure of 290 mm H2O, WBC count of 3,800/mcL (92% neutrophils), glucose 18 mg/dL (serum glucose 110 mg/dL), and protein 240 mg/dL. Gram stain reveals lancet-shaped Gram-positive diplococci. What is the recommended strategy regarding adjunctive corticosteroid therapy in this patient?
3A 62-year-old man presents with persistent dull left shoulder pain and mild stiffness 14 months following a total shoulder arthroplasty. He has no fever or systemic symptoms, and the surgical scar is well-healed without sinus tract. Inflammatory markers show an ESR of 28 mm/hr and CRP of 14 mg/L (normal <5 mg/L). Fluoroscopy-guided glenohumeral joint aspiration yields synovial fluid with 2,400 WBCs/mcL (72% polymorphonuclear cells). Anaerobic cultures from the synovial fluid yield Cutibacterium acnes (formerly Propionibacterium acnes) on day 9 of incubation. What is the most appropriate management plan for this delayed prosthetic joint infection (PJI)?
4A 65-year-old mechanically ventilated patient in the intensive care unit develops new purulent endotracheal secretions, worsening hypoxemia (PaO2/FiO2 ratio 160), and progressive bilateral lower lobe infiltrates on day 10 of hospitalization. Endotracheal aspirate culture yields >10^6 CFU/mL of Pseudomonas aeruginosa. Susceptibility testing reveals resistance to piperacillin-tazobactam, cefepime, meropenem, imipenem, ciprofloxacin, and tobramycin (difficult-to-treat resistance [DTR] phenotype). The isolate remains susceptible to ceftolozane-tazobactam and colistin. What is the preferred definitive antimicrobial therapy according to IDSA guidance on antimicrobial-resistant Gram-negative infections?
5A 71-year-old woman with chronic kidney disease presents with watery diarrhea (6 loose stools daily), lower abdominal cramping, and leukocytosis (WBC 14,200/mcL). Stool nucleic acid amplification test and toxin EIA are positive for Clostridioides difficile. She was treated 4 weeks ago for her initial episode of non-severe C. difficile infection with oral vancomycin 125 mg 4 times daily for 10 days, achieving complete symptom resolution. What is the most appropriate management for this first recurrence of C. difficile infection according to current IDSA/SHEA clinical guidelines?
6A 52-year-old man with decompensated alcohol-related cirrhosis (Child-Pugh class C, MELD-Na 24) presents with worsening abdominal distension, fever (38.4 C), and mild diffuse abdominal tenderness without rigidity. Diagnostic paracentesis yields cloudy ascitic fluid with an absolute neutrophil count of 420 cells/mcL. What is the most appropriate immediate medical management?
7A 59-year-old man with well-controlled type 2 diabetes presents with progressive mid-lumbar back pain and low-grade fever for 3 weeks. Spinal MRI demonstrates T1 hypointensity, T2 hyperintensity, and post-contrast enhancement of the L3-L4 intervertebral disc and adjacent vertebral endplates with minimal non-compressive epidural phlegmon. CT-guided disc biopsy yields methicillin-susceptible Staphylococcus aureus (MSSA). Neurological examination is completely normal. He receives IV cefazolin with rapid defervescence and normalization of pain. What is the evidence-based recommendation regarding total duration and oral step-down therapy according to the OVIVA trial and IDSA guidelines?
8A 36-year-old previously healthy man presents with excruciating right lower extremity pain out of proportion to physical exam findings following a minor skin abrasion sustained 24 hours earlier. Within 4 hours of arrival, the leg develops dusky violaceous bullae, cutaneous anesthesia, and crepitus. Blood pressure drops to 78/46 mmHg and heart rate is 135 bpm. Urgent operative exploration reveals greyish dishwater fluid and lack of bleeding along the deep fascia. Intraoperative Gram stain shows chains of Gram-positive cocci. What antimicrobial regimen should be initiated immediately alongside emergent surgical debridement?
9A 61-year-old woman undergoing induction chemotherapy for acute myeloid leukemia via a tunneled subclavian central venous catheter (Hickman line) develops rigors and fever to 39.2 C. Two sets of blood cultures (one peripheral and one from the catheter hub) turn positive for Staphylococcus aureus at 14 hours and 8 hours of incubation, respectively. She has no erythema or purulence along the subcutaneous tunnel. In addition to initiating IV daptomycin, what is the mandatory recommendation regarding the catheter?
10A 50-year-old man presents with acute perforated appendicitis with a 4-cm retrocecal abscess. Percutaneous drainage is performed, and peritoneal fluid cultures grow Escherichia coli producing an extended-spectrum beta-lactamase (ESBL). The isolate tests susceptible in vitro to piperacillin-tazobactam (MIC 4 mcg/mL), ertapenem (MIC <= 0.25 mcg/mL), and meropenem (MIC <= 0.25 mcg/mL). Blood cultures are negative, and the patient is clinically improving. Based on evidence from randomized clinical trials (e.g., the MERINO trial) and current IDSA guidance, what is the preferred definitive antimicrobial therapy?
About the Adult Infectious Diseases Fellowship Exam
Independent English-language MCQ study adaptation by OpenExamPrep. Independent practice question bank by OpenExamPrep for fellows preparing for the Saudi Fellowship Final Written Examination in Adult Infectious Diseases administered by the Saudi Commission for Health Specialties (SCFHS). This practice resource covers bacterial, viral, fungal, mycobacterial, parasitic, and tropical infections, immunocompromised host care, clinical microbiology, stewardship, and antimicrobial pharmacology. It is an independent MCQ study aid for the written final exam and does not simulate the clinical, OSCE, or structured oral examination.
Exam sponsor: Saudi Commission for Health Specialties (SCFHS). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.
Assessment
One paper of 80–120 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
Time Limit
Not published by SCFHS
Passing Score
70% (lowered to minimum 65% if pass rate under 70%)
Reported exam pass rate: Not published by SCFHS. SCFHS publishes no candidate pass rate. The blueprint instead sets the passing score at 70% and, if fewer than 70% of candidates pass before final approval, lowers that score one mark at a time until a 70% pass rate is reached or the score reaches 65%, whichever comes first; it is never lowered below 65%. Exam sponsor website
Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.
Our practice resources: topics covered
We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.
Bacterial Diseases
Bacteremia, infective endocarditis, CNS infections, bone and joint infections, SSTIs, intra-abdominal infections, and MDR pathogens.
Clinical Microbiology
Diagnostic microbiology, Gram stain and culture interpretation, susceptibility testing methodologies, molecular diagnostics, and mass spectrometry.
Viral Diseases
HIV/AIDS diagnosis and management, viral hepatitis (HBV, HCV, HDV), herpesviruses, respiratory viruses, arboviruses, and emerging viral pathogens.
Mycobacterial Infections
Pulmonary and extrapulmonary tuberculosis, drug-resistant TB (MDR/XDR), latent TB infection, and non-tuberculous mycobacteria (NTM).
Parasites, Tropical and Zoonotic Infections
Malaria, leishmaniasis, schistosomiasis, echinococcosis, brucellosis, MERS-CoV, dengue, rabies, and regional travel/zoonotic infections.
Immunology and Vaccination
Primary and secondary immunodeficiencies, adult immunization schedules, pre-travel vaccines, post-exposure prophylaxis, and vaccine safety.
Immunocompromised Host and Fungal Infections
Infections in solid organ and hematopoietic stem cell transplant recipients, neutropenic fever, candidiasis, invasive aspergillosis, and mucormycosis.
Antimicrobial Stewardship and Infection Control
Stewardship metrics, formulary restriction, antibiograms, healthcare-associated infections (CAUTI, CLABSI, SSI), outbreak response, and isolation precautions.
Pharmacology and Therapeutics
Antimicrobial pharmacokinetics and pharmacodynamics (PK/PD), therapeutic drug monitoring, adverse drug reactions, drug-drug interactions, and organ dose adjustments.
Preparing for the Adult Infectious Diseases Fellowship Exam
What You Need to Know
- Passing score: 70% (lowered to minimum 65% if pass rate under 70%)
- Assessment: One paper of 80–120 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
- Time limit: Not published by SCFHS
- Exam / certification fees: Not published by SCFHS Official sources
Using Our Practice Resources
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
Frequently Asked Questions
What is the structure of the Saudi Fellowship Final Written Examination in Adult Infectious Diseases?
One paper of 80–120 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
What is the passing score for the Saudi Fellowship Adult Infectious Diseases written examination?
The standard passing score is 70%. If the overall candidate pass rate falls below 70%, the passing score is adjusted downward one percentage mark at a time to target a 70% pass rate, but it is never lowered below 65%.
Does this practice bank include clinical or oral exam preparation?
This bank is an independent English-language MCQ study adaptation for the written examination. It does not simulate or replace the separate mandatory final clinical/practical assessment. Consult the specialty clinical blueprint for its station formats and any structured oral or OSCE components.
Is OpenExamPrep affiliated with the Saudi Commission for Health Specialties (SCFHS)?
No. OpenExamPrep is an independent educational platform. This practice resource is not endorsed by, sponsored by, or affiliated with the Saudi Commission for Health Specialties.