Antibiotics Flashcards

1
Q

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

A: Amoxicillin-Clavulanate
B: Amoxicillin,
C: Flucloxacillin
D: Penicillin

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2
Q

Which antibiotic is “not effective against enterococci or aerobic gram negatives?”

Clindamycin

Ciprofloxacin

Vancomycin

Doxycycline

Co-trimoxazole ( trimethoprim-sulfamethoxazole)

A

Clindamycin

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3
Q

“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.

A

The muscle pains are due to the azithromycin interacting with his medications.

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4
Q

Which of these antibiotics is a lincosamide?

Ciprofloxacin

Azithromycin

Clindamycin

Vancomycin

Gentamicin

A

Clindamycin

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5
Q

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

A

Contact precautions - avoid touching the patient’s skin even with gloves on

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6
Q

Which of the following is clindamycin NOT effective against?
Staphylococci aureus

Methicillin resistant staphylococcus aureus

Enterococci

Gram positive anerobes

A

Enterococci

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7
Q

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

A

Methotrexate + Trimethoprim

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8
Q

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

A

IV Piperacillin-tazobactam

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9
Q

Which antibiotic is NOT effective against MRSA in New Zealand, where most MRSA is non multi resistant?

Clindamycin

Amoxicilin

Cotrimoxazole

Doxycycline

Vancomycin

A

Amoxicilin

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10
Q

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

A

Amoxicillin Clavulanate

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11
Q

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

A

Cephalexin

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12
Q

Which of the following antibiotics is NOT effective against Methicillin Resistant Staphylococcus Aureus (MRSA)?
Vancomycin

Ceftriaxone

Clindamycin

Doxycyline

Cotrimoxazole

A

Ceftriaxone

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13
Q

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

A

It has poor antimicrobial effects on aerobic gram negative organisms

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14
Q

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

A

Ceftazidime

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15
Q

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

A

Ertapenem

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16
Q

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

A

Osteonecrosis of the jaw

17
Q

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

A

Staff vaccination