Antibiotics Flashcards
Different circumstances lend themselves to use of the different penicillin antibiotics. Select the correct antibiotic to match with each clinical scenario:
A: 28 year old bitten on the hand by a dog
B: A factory worker with shortness of breath, greenish sputum production and fever who presents to the GP.
C: A diabetic with cellulitis of the leg who is allergic to sulfur.
D: A child with prior history of rheumatic fever who presents with a sore throat.
A: Flucloxacillin, B: Amoxicillin, C: Amoxicillin-Clavulanate, D: Penicillin
A: Flucloxacillin, B: Amoxicillin, C: Penicillin, D: Amoxicillin-Clavulanate
A: Amoxicillin-Clavulanate, B: Amoxicillin, C: Flucloxacillin, D: Penicillin
A: Amoxicillin-Clavulanate, B: Amoxicillin, C: Penicillin, D: Amoxicillin
A: Flucloxacillin, B: Amoxicillin-Clavulanate, C: Amoxicillin, D:Penicillin
A: Amoxicillin-Clavulanate
B: Amoxicillin,
C: Flucloxacillin
D: Penicillin
Which antibiotic is “not effective against enterococci or aerobic gram negatives?”
Clindamycin
Ciprofloxacin
Vancomycin
Doxycycline
Co-trimoxazole ( trimethoprim-sulfamethoxazole)
Clindamycin
“Big Don” is a 76 year old male who presents to general practice with muscle pains and weakness over the past day or so. He was recently discharged from hospital for pneumonia and is still taking oral azithromycin. He has a complicated medical past history with moderate coronary artery disease, a GFR of 60 and a past MI 2 years ago for which he is currently on Aspirin, Simvastatin, Propanolol, clopidogrel and Cilazapril. What can you say to him as to the cause of his current presentation of muscle pain?
His impaired renal function has caused the azithromycin toxicity.
The muscle pain is likely due to a severe infection causing myositis
He has overdosed on azithromycin and muscle pain is a common side effect
Muscle pain and weakness is expected in a recovering 74 year old man as he is frail.
The muscle pains are due to the azithromycin interacting with his medications.
The muscle pains are due to the azithromycin interacting with his medications.
Which of these antibiotics is a lincosamide?
Ciprofloxacin
Azithromycin
Clindamycin
Vancomycin
Gentamicin
Clindamycin
You are the house officer on-call in the general medicine wards at Wellington Hospital. The hygiene policeis calling a lot of consultants out on their poor infection control. You get really nervous about it as there is a patient in the wards with ESBL so the infection control nurse is hovering closer in your space. You go to your mind palace to and list out the waysto reduce the risk of ESBLs for the ward patients. Which one of the ideas is most likely to be false?
Contact precautions - avoid touching the patient’s skin even with gloves on
Hand hygiene - wash hands before and after seeing any patient
Clean hospital environment - especially toilets
Isolation policies - adhere to the CCDHB policy
Antibiotic stewardship
Contact precautions - avoid touching the patient’s skin even with gloves on
Which of the following is clindamycin NOT effective against?
Staphylococci aureus
Methicillin resistant staphylococcus aureus
Enterococci
Gram positive anerobes
Enterococci
You assess Jane, a 58 year old women presents to ED. She is breathless and pale with petechial haemorrhages. She also has a fever. You notice her hands are also significantly deformed, with severe ulnar deviation on both hands and boutonniere deformity on 3 fingers. She tells you she has rheumatoid arthritis and takes a few medications for this but can’t remember the names. She also tells you she has been taking a antibiotic for the past week for a bladder infection. Which drug interaction is the likely cause of her symptoms?
Prednisone + Gentamicin
Augmentin + diclofenac
Methotrexate + Trimethoprim
Doxycyline + paracetamol
Methotrexate + Trimethoprim
Mark is a 22 year old barbecue enthusiast who has an extensive burn injury to his right arm. After two weeks he is noted to have increasing erythema and purulent discharge on part of the wound. Culture of debrided tissue grows Pseudomonas aeruginosa. A grant of skin from his thigh to cover the burn is planned, once the infection is treated. Which antibiotic would be most appropriate to treat this infection, from the list below;
IV Ceftriaxone
IV Flucloxacillin
Doxycycline
Oral Augmentin
IV Piperacillin-tazobactam
IV Piperacillin-tazobactam
Which antibiotic is NOT effective against MRSA in New Zealand, where most MRSA is non multi resistant?
Clindamycin
Amoxicilin
Cotrimoxazole
Doxycycline
Vancomycin
Amoxicilin
Sheryl a 68 year old woman was bitten by one of her 37 pet cats. Three days later you see there are deep puncture marks and surrounding swelling and erythema. What antibiotic will you prescribe?
Penicillin
Amoxicillin Clavulanate
Amoxicillin
Flucloxacillin
Amoxicillin Clavulanate
Mrs P is a 72 year old woman who lives in a rest home in Wellington. She presents with a red, swollen bump on her left leg. You initially give her flucloxacillin. You then check her past cultures and find that she has had previous infection with methicillin resistant Staphylococcus aureus. Which of the following would most likely be UNHELPFUL in treating Mrs P’s infection?
Erythromycin
Cotrimoxazole
Vancomycin
Cephalexin
Cephalexin
Which of the following antibiotics is NOT effective against Methicillin Resistant Staphylococcus Aureus (MRSA)?
Vancomycin
Ceftriaxone
Clindamycin
Doxycyline
Cotrimoxazole
Ceftriaxone
Which of the following is true of the antibiotic Clindamycin?
It readily crosses the blood-brain barrier
It is in the macrolide class of antibiotics, along with erythromycin and vancomycin
It has poor antimicrobial effects on aerobic gram negative organisms
It has poor antimicrobial effects on anaerobic organisms
It has poor antimicrobial effects on aerobic gram negative organisms
On your general medicine rotation you see a 78 year old man with cough, fever and bilateral patchy opacities on chest x-ray following prolonged ventilation in the Intensive Care Unit. A sputum sample has cultured Pseudomonas aeruginosa. What antibiotic you would use in this situation?
Augmentin
Cefuroxime
Amoxicillin
Ceftazidime
Ceftazidime
Maria is a 34 year old Italian plumber who has presented recently with cystitis. Urine culture during previous episodes grew a Klebsiella pneumoniae with extended spectrum beta lactamase (ESBL). Which antibiotic is likely to be effective against her current UTI?
Augmentin
Ertapenem
Ceftriaxone
Amoxicillin
Terbinafine
Ertapenem
Mrs Hunter, a lovely 79 year old women has unfortunately developed a stubborn case of otitis externa, this is treated by her GP with a 2 week course of flucloxacillin 250 mg BD. Following the end of her 2 week course, Mrs Hunter finds some spare flucloxacillin in her medication cabinet and decides that it’s a good idea to continue taking the antibiotics for another week “just to make sure”. When you look up Mrs Hunter’s file you see she has a eGFR of 30mL/min and was admitted to hospital in 2014 with alcohol hepatitis. Which of the following adverse drug reactions is LEAST likely to occur in this scenario?
CNS toxicity
Cholestatic jaundice and hepatitis
Diarrhoea
Osteonecrosis of the jaw
Osteonecrosis of the jaw
Mr RB has been admitted to the ward for pyelonephritis caused by ESBL-producing E. coli. You decide to propose some ideas to the nurse manager to reduce the risk of ESBL transmission for ward patients. Which of the following actions could limit transmission of ESBL-producing E. coli in your ward.
Select one:
Cleanse hands before and after touching patient
Environmental cleaning especially toilets
Minimise use of broad spectrum antibiotics through following hospital protocols
Staff vaccination
Staff vaccination
