Post4 Infect

Serious adverse reactions to the aminoglycoside antibiotics such as gentamicin are:
A. ringing in the ears and metallic taste in the mouth
B. kidney failure and loss of hearing
C. localized pain over the upper cheeks and eyes
D. liver failure

Infections caused by beta-lactamase producing bacteria may be treated with:
A. Use of a broad spectrum antibiotic such as amoxicillin.
B. An antibiotic with minimal oral absorbtion such as neomycin.
C. An antibiotic with a beta-lactam ring, such as penicillin.
D. An antibiotic prepared with an enzyme inhibitor such as clavulonate.

Drugs effective against tuberculosis include:
A. amphotericin B, fluconazole, nystatin
B. lamivudine, indinavir, zidovudine
C. vancomycin, amikacin, cefotaxime
D. rifabutin, ethambutol, isoniazid

Sue is a 19 year old sexually active female being seen in a family planning clinic for birth control. Her routine annual screening for chlamydia was positive despite being asymptomatic. She has no drug allergies. Should she be treated? With what drug(s), dose and for how long?
A. Yes, she should be treated with Zidovudine (x 7days) and Indinavir (x 7days) by mouth.
B. Yes, she should be treated with Mycostatin vaginal cream for 7 days.
C. Yes, she should be treated with Azithromycin (x 1 dose)
D. No, she does not need to be treated.

Michael is a 10-month-old seen in a primary care office with a 4-day history of runny nose. Yesterday he was rubbing his ear and was described by his mother as being "cranky". He looks sick and has a high fever 39.5). Tympanic membranes in his ears are red and swollen. He has not been treated for ear infections in the past and has no known allergies. Should he be treated? What medicine might be appropriate?
A. No, he does not require treatment. He probably has a viral irritation of the ear which will resolve on its own without treatment. Over-prescribing antibiotics lead to resistance.
B. Yes, he should be treated as an outpatient with ampicillin for 10 days.
C. Yes, he should be hospitalized and treated with intravenous vancomycin for 14 days.
D. Yes, he should be treated as an outpatient with oral vancomycin for 7 days.

You are splashed on your intact skin with normal looking, yellow urine from an HIV positive patient. Center for Disease Control Guidelines would advise you to:
A. Take a 4 week course of zidovudine, lamivudine, and indinavir.
B. Take a single dose of fluconazole (DIFLUCAN), and have an HIV test done.
C. Take a 6 month course of metronidazole (FLAGYL).
D. No prophylaxis will be offered.

The main use of metronidazole is in the treatment of:
A. Superficial skin infections.
B. Intestinal amebias and anaerobic infections
C. Viral infections of the throat.
D. Malaria.

A patient insured by Blue Cross has a urinary tract infection and is being considered for therapy with Septra DS (Double Strength Trimethoprim-Sulfamethoxazole) You know that:
A. Urinary tract infections do not usually respond to Septra DS.
B. Prior approval is required to have Blue Cross pay for the Septra DS.
C. Blue Cross prefers this inexpensive, effective drug treatment for urinary tract infections.
D. Patients who have Blue Cross cannot get prescriptions for Septra.

Azithromycin can be useful for treating:
A. Some community-acquired pneumonias and sexually transmitted infections
B. Inflammatory pain in the joints not responsive to NSAIDS
C. Seizures in patients allergic to macrolides
D. Drug resistant strains of HIV

Ototoxicity (ear) and nephrotoxicity (kidney) are serious side effects of which of the following drug classes?
A. aminoglycosides
B. rifampins
C. penicillins
D. sulfonamides

Infections caused by beta-lactamase producing bacteria may be treated with:
A. Simultaneous administration of a corticosteroid such as prednisone.
B. An antibiotic that does not have a beta-lactam ring, such as vancomycin.
C. A broad spectrum antibiotic such as amoxicillin.
D. A bacteriocidal antibiotic such a penicillin.

Robert is a 42-year-old prison guard whose annual TB skin test converted this year, with a 20-mm induration. He does not feel sick. Several of the inmates are receiving treatment for TB. What treatment if any should he receive?
A. A single dose of streptomycin
B. No treatment is needed.
C. 6-9 months of isoniazid
D. 2 weeks of metronidazole

Martha is a 70-year-old female who is brought from home to the emergency department by her daughter with a three-day history of "flu" and a one-day history of coughing purulent sputum. She has no co-morbidities except mild congestive heart failure. Her vital signs are: temp 38.1, pulse 100, respirations 26, BP130/80, 92% oxygen saturation on room air. Chemistries labs are normal. The WBC is 16,000 with left shift indicating new infection. Her chest X-ray shows an abnormal consolidation but no effusion. She is allergic to penicillin, which caused a rash.Should she receive drug treatment for an infection?
A. No treatment is needed. This pneumonia is probably caused by a virus, so she just needs some tike to get better.
B. Yes, a fluroquinolone such as levofloxacin would be effective outpatient treatment.
C. Yes, she should be treated in the hospital with intravenous ampicillin for 2 weeks.
D. Yes, she should receive a single dose of oral vancomycin and followed up as an outpatient.

You go to employee health after being stuck deep into your muscle with a needle containing blood from a patient with end-stage AIDS. Which of the following should happen?
A. You will be placed on broad spectrum antibiotics such as imipenem and taken to the operating room to have the wound thoroughly cleaned out.
B. It will be recommended that you take zidovudine, lamivudine and perhaps indinavir, starting within hours of the needlestick.
C. You will be offered zidovudine as single drug therapy.
D.     Nystatin (MYCOSTATIN) will be applied topically to the wound after it has been thoroughly cleaned.

While making a home visit to a patient, you want to verify that the patient understands his medications. The patient tells you he took his cefuroxime once a day for the first 3 days, then twice a day for 3 days and now he is up to three times a day. Which would be your best response?
A. And were you able to tolerate the side effects alright building up to a therapeutic dose like that?
B. May I see the directions on the bottle? That's a very unusual way to take an antibiotic.
C. You must have had a previous allergy to that medicine. Are you having any rashes or difficulty breathing now?
D. Will you increase the dose again or stay at 3 tablets each day?