E02_09 CAP Flashcards
2017, 2018_CAP
True statement about the use of penicillins for CAP in adults:
A. High incidence of penicillin resistant pneumococci decreases its utility
B. Amoxicillin covers for Stretococcus pneumonia and H. influenza
C. It may be used to cover mycoplasma, chlamydia, and legionella
D. it is considered highly toxic to humans and is not recommended
B. Amoxicillin covers for Stretococcus pneumonia and H. influenza
2017, 2018_CAP
Which of the following is the least recommended drug for low-risk CAP?
A. Azithromycin
B. Cefuroxime
C. Levofloxacin
D. Amoxicillin
C. Levofloxacin
Low-Risk CAP
> If prev. healthy: Amoxicillin OR extended macrolides
> If with stable comorbids: BLIC OR 2nd gen ceph +/- extended macrolides
> alternative: 3rd gen ceph +/- ext. macrolides
A. Azithromycin - macrolide
B. Cefuroxime - 2nd gen ceph
C. Levofloxacin - respiratory fluoroquinoline
D. Amoxicillin - aminopenicllin
2017, 2018_CAP
Factors which are included in the risk classification of CAP include the following except:
A. Vital signs
B. Presence of pleural effusion
C. Mental status
D. Age >65
D. Age >65
2017, 2018_CAP
Acceptable therapies for low risk CAP includes the following except: A. Co-amoxiclav B. Cotrimoxazole C. Azithromycin dihydrate D. Cefuroxime axetil
B. Cotrimoxazole
Guidelines report increasing resistance rates for Cotrimoxazole against Strep pneumo and H. influenza (most common etiologic agents for low risk CAP); it’s use for Low Risk CAP is not recommended.
2017, 2018_CAP
The spectrum of activity of azithromycin includes the following except: A. Mycoplasma pneumoniae B. S. pneumoniae C. H. influenzae D. Enterococcus
D. Enterococcus
Think respiratory infections»_space; M. pneumoniae, S. pneumoniae, H. influenzae
2017, 2018_CAP
This compound/salt is added to penicillin- derived antibiotics to extend the spectrum activity of the drug and inhibits beta lactamase by bacteria:
A. Sulfamethoxazole
B. Besylate
C. Clavunate
D. Dihydrate
C. Clavunate
Clavulanate : Beta-Lactamase inhibitor; so adding it to your penicillin-derived antibiotics restores its effect agains beta-lactamase-producing bacteria
Clavulanate + Amoxicillin = Clavulanic Acid
**Sulfamethoxazole + Trimethoprim = Cotrimoxazole
2017, 2018_CAP
Which statement is correct regarding antibiotic resistance pattern of S. pneumoniae in the Philippines?
A. Chloramphenicol has very high resistance and should never be used.
B. Penicillin resistance reflects that of other countries with more than 30% resistance.
C. Has low resistance for Penicillin at 1%.
D. Cotrimoxazole resistance has decreased since 2004
C. Has low resistance for Penicillin at 1%.
> low resistance for penicillin
high resistance for cotrimoxazole
5% resistance for chloramphenicol
2017, 2018_CAP
The most common side effects of macrolides:
A. Vaginitis
B. Flatulence
C. Diarrhea
D. Agitation
C. Diarrhea
2017, 2018_CAP
Which is not a common side effect related to the intake of amoxicillin-clavunate: A. Nausea B. Diarrhea C. Vomiting D. Anemia
D. Anemia
2017, 2018_CAP
The following drug is bactericidal by inhibiting the biosynthesis of bacterial cell wall mucopeptide:
A. Ciprofloxacin
B. Penicillin
C. Azithromycin
D. Aztreonam
B. Penicillin
Ciprofloxacin - Quinolone; inhibits DNA replication
Azithromycin - Macrolide; inhibits 50S ribosome function
Aztreonam - Monobactam»_space; same MOA as Penicillin (?)
2017, 2018_CAP
Which of the following inhibits bacterial DNA gyrase made in high concentrations of its active stereoisomer and has broad spectrum of activity to cover also against penumococcus and even pseudomonas?
A. Minocycline
B. Levofloxacin
C. Aztreonam
D. Neomycin
B. Levofloxacin - Quinolone; inhibits DNA replication (by inhibiting DNA gyrase)
A. Minocycline - Tetracycline; inhibits 30S Ribosome function
C. Aztreonam - Monobactam; inhibits bacterial cell wall synthesis
D. Neomycin - Aminoglycoside; inhibits 30S Ribosome function»_space; also has antipseudomonal activity
2018_CAP
Which is an aminopenicillin?
A. Clindamycin
B. Levofloxacin
C. Amoxicillin
D. Co-amoxiclav
C. Amoxicillin
*Penicillin: B lactam
>Natural: Pen G, Pen VK
>Anti-Staph: Oxacillin, Cloxacillin
>Aminopenicillins: Amoxicillin, Ampicillin
Clindamycin: non-B lactam (50S ribosome function inh)
Levofloxacin: non-B lactam (DNA replication inh)
Co-amoxiclav: BLIC
2018_CAP
Which of the following drugs are used for atypical organisms?
A. Clindamycin
B. Amoxicillin
C. Azithromycin
D. Linezolid
C. Azithromycin
According to the guidelines, extended macrolides are added to cover for atypical pathogens
** Macrolides: A, C, E
> Azithromycin dihydrate, Clarithromycin, Erythromycin
2018_CAP
Among the following drugs, which is the most appropriate for low-risk CAP with a stable co- morbid illness?
A. Cotrimoxazole
B. Ceftazidime
C. Ampicillin-sulbactam
D. Cefipime
C. Ampicillin-Sulbactam
Low-Risk CAP, if with stable comorbids:
> BLIC or 2nd Gen Cephalosporins +/- ext. macrolides
BLIC: Co-amoxiclav, Ampicillin-sulbactam, Sultamicillin
2nd gen: Cefuroxime, Cefaclor
Ext. macrolides: azithryomycin dihydrate, clarithromycin
A. Cotrimoxazole: high resistance rates
B. Ceftazidime: 3rd gen ceph
D. Cefipime: 4th gen ceph
