Final Exam

Question 1

Staph aureus

Answer 1

Gram positive

Question 2

MRSA

Answer 2

Gram positive

Question 3

MSSA

Answer 3

Methicillin susceptible, gram positive

Question 4

Strep pneumonia

Answer 4

CAP, gram positive

Question 5

Strep pyogenes

Answer 5

Group A strep, strep throat, necrotizing fasciitis, gram positive

Question 6

Enterococcus faecalis

Answer 6

Gram positive

Question 7

Enterococcus faecium

Answer 7

Gram positive

Question 8

Cdiff

Answer 8

Gram positive, anaerobic

Question 9

Gram positive organisms are what color?

Answer 9

Purple

Question 10

Gram negative organisms are what color?

Answer 10

Pink

Question 11

E. Coli

Answer 11

Gram negative

Question 12

Klebsiella pneumonia

Answer 12

Gram negative

Question 13

Pseudomonas aeruginosa

Answer 13

Gram negative

Question 14

Bacteroides fragiles

Answer 14

Gram negative; anaerobic

Question 15

MIC

Answer 15

Minimum inhibitory concentration, lowest amount of drug that will inhibit growth of organism

Question 16

Time dependent

Answer 16

Greater bactericidal activity as drug concentration remains above the MIC (in time)

Question 17

Concentration dependent

Answer 17

Greater bactericidal activity as drug concentration Cmax exceeds MIC

Question 18

MOA PCN

Answer 18

Inhibits cell wall synthesis

Question 19

HX of PCN

Answer 19

Belongs to beta lactam family, PCN V PO, PCN G IV/IM; as time went on…increasing spectrum of gram- organisms added to PCN. Originally only gram + susceptible

Question 20

PCN origination

Answer 20

1928 discovered, Staph aureus, streptococcus spp., syphilis. Initially great for skin infxn - until resistance. Rx of choice for syphilis.

Question 21

Pen G

Answer 21

IV penicillin

Question 22

Pen G benzathine

Answer 22

IM

Question 23

Pen V

Answer 23

PO PCN - low absorption, limiting its use

Question 24

Oxacillin, Nafcillin, Dicloxacillin

Answer 24

Anti-Staphylococcal PCNs… Tx for PCN-resistant staph aureus (d/c methicillin d/t hepatotoxicity)

Question 25

Drug of choice for MSSA infections (blood stream)

Answer 25

Anti-staphylococcal PCNs - oxacillin, nafcillin, dicloxacillin

Question 26

Oxacillin, nafcillin, dicloxacillin metabolism

Answer 26

Cleared by liver - no renal adjustments (unique); short half life - dosed q4h

Question 27

PO anti-staph PCN

Answer 27

Dicloxacillin - not common; req freq dosing

Question 28

GPC in chains

Answer 28

Strep (chained down when you have strep)

Question 29

GPC in clusters

Answer 29

Staph (cluster the MRSA)

Question 30

What does an antibiogram show?

Answer 30

Number listed is percent of organisms susceptible to antibiotic listed

Question 31

Reasons for drug resistance

Answer 31

1. Broader coverage than needed 2. Frequently recurring infections 3. Patient doesn’t complete antbx 4. Inappropriate dose 5. Overused antbx in animals 6. Duration of therapy

Question 32

Antimicrobial stewardship program

Answer 32

Required in all hospitals - shown to decrease Cdiff, antbx resistance, improve pt outcomes, reduce cost. 30-50% all antbx unnecessary/inappropriate

Question 33

Pseudomonas mnemonic

Answer 33

Zosyn Forts Maximize the Cipro Levo Penem … Zosyn, Fortaz, Maxipime, Ciprofloxacin, Levofloxacin, carbaPENEM (not ertapenem)

Question 34

MRSA mnemonic

Answer 34

Very Tall Zebras Drink Before Tests… Vancomycin, Teflaro, Zyvox, Daptomycin, Bactrim, Tetracyclines