Necla Flashcards
4-year-old boy from Somali is adopted by a family in the United States. As part of the adoption process, the boy is given a routine physical exam along with laboratory testing. The boy is healthy and has no complaints. His physical exam is unremarkable.
However, the family is concerned about the laboratory tests below:
• Sputum AFB stain x 3: No AFB seen
• Sputum AFB culture x 3: No growth after 6 weeks
• Interferon-gamma (IFN-y) release assay: Positive
• Tuberculosis (TB) skin test: Positive
Correct: This boy has latent TB infection and should be treated
• Chest X-ray: Normal
What is the most appropriate management for this boy’s condition?
A. This boy has active TB disease and must be treated
This boy has latent TB infection and should betreated
C. This boy is likely infectious and should be inrespiratory isolation
D. This boy likely has active TB and the cultures should be repeated
E. This boy has disseminated TB and CT scan should be ordered
This boy has latent TB infection and should betreated
A 19-year-old woman visits her physician for a routine physical examination.
She has no complaints and her vital signs and physical examination are unremarkable. Blood and urine are collected for routine laboratory tests. The urine culture grows 10° CFU/mL coagulase-negative staphylococci, 10° CFU/ mL lactobacilli, and 10° CFU/mL of diphtheroids (Corynebacterium species).
Which of the following is the most appropriate management for this patient?
A. Collect a catheterized urine specimen to confirmthe results .. Do nothing further; this probably indicates contamination
C. Start antimicrobial therapy with fluconazole
D. Start antimicrobial therapy with metronidazole
E. Start antimicrobial therapy with trimethoprim/sulfamethoxazole
.. Do nothing further; this probably indicates contamination
If the venipuncture site is inadequately disinfected, blood cultures are most often contaminated with which of the following bacteria?
(A) Escherichia coli
(B) Haemophilus influenzae
(C) Pseudomonas aeruginosa
(D) Staphylococcus epidermidis
(E) Streptococcus pneumoniae
(1 Staphylococcus epidermidis
28-year-old primigravida woman at 10-week gestation visits her obstetrician for an initial prenatal appointment. Pregnancy is uncomplicated and she has no complaints. Her physical examination is normal. A routine urine dipstick is negative for ketones, glucose, and proteins but is positive for nitrites.
Clean-catch midstream urine is obtained for culture and reveals 2 105 CFU/mL of Escherichia coli. An additional urine culture 2 days later demonstrates 2 105 CFU/mL of E. coli. Which of the following is the most appropriate management for this patient?
A. Administration of cephalexin
B. Administration of ciprofloxacin
C. Administration of tetracycline
D. Administration of trimethoprim/sulfamethoxazole
E. No antibiotic therapy should be administered
Administration of cephalexin
The main purpose of performing a throat culture is to detect the presence of which of the following bacteria?
(A) Neisseria meningitidis
(B) Staphylococcus aureus
(C) Staphylococcus epidermidis
(D) Streptococcus pneumoniae
(E) Streptococcus pyogenes
Streptococcus pyogenes
23-year-old man visits his physician because of a sore on his penis. He states the sore does not hurt, but he is concerned because it has been present for about 2 weeks. His temperature is 37.1°C (98.8°F) and his pulse is 85 beats per minute. Physical examination reveals a single, indurated ulcer with well-demarcated edges on the penile shaft. No urethral discharge is noted. Mild inguinal lymphadenopathy is observed, and the lymph nodes are firm and nontender. Which of the following tests is the best next step in diagnosing this patient’s infection?
A. Chlamydia PCR
B. Fluorescent treponemal antibody-absorbed assay(FTA-ABS)
C. Routine bacterial culture
D. Gram staining
E. Viral culture
B. Fluorescent treponemal antibody-absorbed assay(FTA-ABS)
A sputum culture will be rejected (i.e., it will not be stained or cultured) by the clinical laboratory if:
(A) it is streaked with blood.
(B) it contains IgA antibody.
(C) it contains many more epithelial cells than neutrophils.
(D) it contains pus.
(E) it contains sulfur granules.
(C) it contains many more epithelial cells than neutrophils.
An 18-year-old woman has symptoms of a lower urinary tract infection.
Which of the following statements about the nitrate test is true?
A. Detects the presence of bacterial nitrate reductase
B. Specificity is below 80% for indicating a urinary tract infection
C. Sensitivity is above 90% for detecting a urinary tract infection
D. False positives arise with Enterococcus spp.
E. False positives arise when urine has been in the bladder for less than 4 hours
Detects the presence of bacterial nitrate reductase
A 36-year-old nurse suffered a needlestick with blood from an HIV-positive patient. Six months later, the nurse’s serum was positive in an ElA test, gave negative results in a repeat ElA test, and was negative by Western blot. The nurse
(A) Is probably infected with HIV
(B) Is in the window between acute infection with HIV and seroconversion
(C) Is probably not infected with HIV
(D) May be infected with a drug-resistant strain of HIV
(E) May be a long-term nonprogressor
(C) Is probably not infected with HIV
An 18-year-old woman has symptoms of a lower urinary tract infection.
Which of the following statements about specimen collection is true?
A. Unpreserved urine should be processed in less than 4 hours from collection time
B. Preservatives such as iodine stabilise bacterial counts for 24-72 hours from collection
-C. A suprapubic aspirate should be obtained
D. The first void urine of the day should be collected
E. A pure growth of an organism in a mid-stream urine is indicative of a pathogen
A. Unpreserved urine should be processed in less than 4 hours from collection time
You can use fluoroquinolones for the treatment of diseases to the following microorganisms except:
A. Salmonellae,
B. Shigellae
C. Escherichia coli
D. Haemophilus influenzae
E. Treponema pallidum
Treponema pallidum
After 3 days of aminoglikozid therapy, the supervising nurse leaves you voice mail indicating that the patient you just began treating has begun to exhibit signs of drug toxicity. As you return to the hospital, you reflect on the drugs side effect profile. Which of the following would your patient most likely be experiencing?
A. Color blindness
B. Disulfiram reaction
C.Elevated blood creatinin & protein in the urine
D.Orange colored tears & urine
F.Yellowing of the teeth
Elevated blood creatinin & protein in the urine
A 55-year-old male develops malaise, fever up to 103.5°F, nonproductive cough, headache, and shortness of breath a few days after he repaired the cooling system of an old hotel. A chest x-ray reveals fluid in his lungs . From a sputum sample, a gram-negative rod grew slowly on a buffered cys teine containing charcoal -yeast agar. Which of the following antibiotic therapies is most appropriate for treating this patient?
a . Ampicillin
b. Ceftriaxone
C. Clarithromycin
d. Penicillin
e. Vancomycin
C. Clarithromycin
Amongst those antibiotics that act by inhibiting protein synthesis, several members this drug class are known to produce side effects related to both drug interactions caused by inhibition of P-450 and cardiac effects (QT prolongation/Torsade de pointes). Which drug class is this?
Aminoglycosides
Fluoroquinolones
Macrolides
Rifamycins
Tetracyclines
Macrolides
Ali is a 15 year old boy hospitalized for a severe infection who has been treated with a parenteral antibiotic having bactericidal properties. Two days after the onset of therapy he complains of
“ringing in the ears”, and appears to have difficulty walking normally.
Which of the following antibiotics was Ali most likely given?
a macrolide (e.g. azithromycin)
a tetracycline (e.g. minocycline)
an aminoglycoside (e.g. tobramycin)
an oxazolidinone (linezolid)
clindamycin
an aminoglycoside (e.g. tobramycin)
