Written PP Flashcards
When choosing the proper antibiotic, one must consider:
a. the number of the patients stool per day
b. the site of infection and distribution of the antimicrobials.
c. the length of the infection
d. body temperature
b. the site of infection and distribution of the antimicrobials.
Narrow spectrum antibiotics are recommended in the case of:
a. wide spectrum pathogens.
b. critical clinical spectrum.
c. known mixed infection.
d. isolated pathogens with known sensitivity.
d. isolated pathogens with known sensitivity.
True is about MIC:
a. It shows the minimum bactericidal concentration in mg/L
b. In vitro parameter, which must be exceeded by the concentration of the effective antibiotic at the site of infection.
c. In vivo parameter
d. The effective antibiotic has to achieve a concentration higher then MIC in the whole body.
b. In vitro parameter, which must be exceeded by the concentration of the effective antibiotic at the site of infection.
Poorly penetrated anatomical sites, except for (sign the incorrect answer):
a. central nervous system
b. prostate gland
c. artificial valve in mitral position
d. bone tissue
e. gall bladder
e. gall bladder
Choose the antibiotic, which is safe during pregnancy:
a. ciprofloxacin
b. ceftriaxon
c. trimethoprim sulfomethaxazole
d. clindamycin
e. chloramphenicol
d. clindamycin
contamination is:
a. the access of bacteria, without pathogenic role into the sample taken from microbe test.
b. the coexistence of humans organism with microbes
c. the invasion of pathogens that induces host response
d. the non-infectious systemic inflammatory response syndrome
a. the access of bacteria,without pathogenic role into the sample taken from microbe test.
which disease has the lowest mortality rate?
a. pneumonia
b. osteomyelitis
c. meningitis
d. endocarditis
e. peritonitis
b. osteomyelitis
Combined antibiotic treatment is not necessary:
a. in the case of severe infection with unknown etiology
b. in the case of infectious neutropenic patients
c. in the case of nosocomial pneumonia
d. in the case of simple urinary tract infection
e. in the cade of infections of poorly penetratable anatomical sites.
d. in the case of simple urinary tract infection
Features of community acquired pneumonia (CAP), except for (sign the incorrect answer):
a. The most common pathogen in CAP except for young age (18-40yrs) group is S.pneumoniae.
b. Alcoholism and impaired immunity are risk factors
c. Viral infections has a role only in nosocomial pneumonia
d. The most common pathogens in young adults are M.pneumoniae and C. pneumoniae
e. The “atypical!” pneumonia has lower mortality rate than the “classical” bacterial one.
c. Viral infections has a role only in nosocomial pneumonia
Features of pneumonia caused by S. pneumoniae, except for (sign the incorrect answer):
a. Clinical signs and symptoms of the disease are negligible.
b. Amoxycillin/ciavulanic acid is a proper choice for the treatment in a patient under 65 yrs of age.
c. High mortality rate.
d. Vaccination is an effective option in he most endangered population.
e. The most common type of pneumonia in the population over 65 yrs of age.
a. Clinical signs and symptoms of the disease are negligible.
Features of “atypical” pneumonia are except for (sign the incorrect answer):
a. Mostly young patients are affected
b. High mortality rate
c. Good general condition
d. Clinical signs are gradual onset, dry coughing, lower fever
e. Usually, multinodular infiltration can be seen on X-ray.
b. High mortality rate
The PORT scoring system contains:
a. age + former pneumonia in the patient’s history.
b. age (only in men)+ former pneumonia in the patient’s history + coexisting illnesses.
c. days in Intensive care unit
d. age +coexisting illnesses + the length of antibiotic treatment
e. age + coexisting illnesses + physical examination and laboratory and radiographic findings.
e. age + coexisting illnesses + physical examination and laboratory and radiographic findings.
Possible antibiotic treatment in community acquired pneumonia under 65 yrs of age, without comorbidity, except for (sign the incorrect answer):
a. Amoxycillin/Clavulanic acid
b. Macrolides
c. Cefuroxim
d. Pefloxacin
e. Clarythromycin
d. Pefloxacin
A 78 year old woman was admitted to your hospital, with known diabetes mellitus, hypertension and coronary heart disease. She had fever (38,5 degrees celcius) and complained shaking chill and productive coughing. Physical examination and chest X-ray prove lobar pneumonia. The most probable pathogen is:
a. M. pneumoniae
b. S.pyogenes
c. S. Pneumonia
d. P. aeruginosa
e. C. pneumoniae
c. S. Pneumonia
What type of empiric antibiotic treatment would you recommend in this case:
a. ofloxacin + ampicillin
b. clarythromycin + ceftriaxon
c. amoxycillin/clavulanic acid monotherapy
d. clarythromycin monotherapy
e. imimpenem + moxifloxacin
e. imimpenem + moxifloxacin
(b. clarythromycin + ceftriaxon ??)
Choose the true statement:
a. In CAP etiological diagnosis is possible in 80-90% of the cases.
b. Radiology features can be pathogenomic in CAP.
c. The activity against S. pneumoniae among the macrolide derivatives is different, which has a great impact on the treatment of CAP requiring ICU admittance.
d. Beta-lactams are effective against the atypical pathogens.
e. 2.generation fluoroquinolones exhibit poor activity to S. pneumonia, while 3. and 4. generation derivatives are highly active.
e. 2.generation fluoroquinolones exhibit poor activity to S. pneumonia, while 3. and 4. generation derivatives are highly active.
Common nosocomial pathogens, except for (sign the incorrect answer):
a. Staphylococcus aureus
b. Candida spp.
c. Leptospira interrogans
d. Pseudomonas aeruginosa
e. Enterococcus spp.
c. Leptospira interrogans
The most dangerous nosocomial infection with the highest mortality rate is:
a. osteomyelitis
b. pneumonia
c. cystitis acute
d. cholecystitis acuta
e. tonsillitis follicularis
b. pneumonia
A characteristic feature of severe nosocomial pneumonia:
a. two forms can be differentiated: early and late onset
b. no specific risk factors can be indentified
c. 2. and 3. generation cephalosporins should be the therapy of choice without antipseudomonas activity
d. rapid progression, multilobal infilatration or abscess may occur
e. usually anaerobes are involved
d. rapid progression, multilobal infilatration or abscess may occur
Characteristics of catheter sepsis, except for (sign the incorrect answer):
a. the incidence of catheter infections increases with time
b. the eradication of the bacteria is successful in the majority of cases.
c. the value of antibiotic treatment is limited because of the biofilm production of bacteria.
d. the catheters sooner or later should be removed, except for S. epidermidis infection.
e. isolation of identical pathogens from peripheral blood and catheter.
b. the eradication of the bacteria is successful in the majority of cases.
We present the case of 60 year old man with colon cancer and pulmonary metastasis. Due to his condition, he recieved parenteral potassium substituition through a peripheral intravenous catheter. Chemotherapy has not been introduced yet. The iv. line became infected and the patient developed fever. Four blood samples were taken, and one of them became positive with S. Epidermidis (MSSE). The following therapeutic approach is recommended:
a. the catheter should be removed immediately and local desinfection should be performed
b. parenteral vancomycin therapy for 10-14 days
c. admission to the intensive care unit.
d. prophylactic antimycotic and antibacterial treatment
c. admission to the intensive care unit.
Prophylaxis of catheter infections is possible by:
a. routine changes of the catheter
b. desinfection of the sterile catheter before the introduction
c. prophylactic antibiotics
d. use of moisturing creams
e. rigorous adherence to asepsis
e. rigorous adherence to asepsis
A 38 year old woman received high dose steroid and cyclophosphamid therapy due to systemic vasculitis (Churg-Strauss syndrome) through a central venous catheter. She received broad spectrum antibiotics because of suggested pneumonia from the 5th day of treatment. On the 12th day the patient developed hypothermia, oliguria and hypotonia and became leukopenic. The central venous catheter was changed, multiple blood cultures were taken. Both the result of the blood cultures and the culture of the tip of the catheter show candida spp. infection. Treatment options, except for (sign the incorrect answer):
a. parenteral fluconazole
b. the cessation of the immunosuppressive treatment
c. monitoring in the intensive care unit
d. fluid substituition
b. the cessation of the immunosuppressive treatment
Goals of antimicrobial treatment, except for (sign the incorrect answer):
a. clinical cure
b. antipyretic effect
c. shortening the duration of the illness
d. prevention of complications
b. antipyretic effect
The effect of antibiotic treatment depends:
a. only on the minimum inhibitory concentration (MIC) of the durg
b. only on the number of the microbes
c. on the relationship of one of the kinetic parameters and the MIC
d. only on the kinetic parameter (AUC, Cmaz, etc.)
c. on the relationship of one of the kinetic parameters and the MIC
The following statements are true, except one:
a. Headache, fever and vomiting are the three most important signs of acute bacterial meningitis.
b. Age, immunological condition of the patient and preceeding antibiotic treatment may modify the presenting signs and symptoms of acute bacterial meningitis.
c. Clinical signs of meningeal involvemnet (Kernig, Brudzinski) are present in all cases of acute bacterial meningitis.
d. Skin lesions are often seen in patients with meningococcal meningitis.
c. Clinical signs of meningeal involvemnet (Kernig, Brudzinski) are present in all cases of acute bacterial meningitis.
