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36 Cards in this Set
- Front
- Back
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GP is a 44 year old, otherwise healthy female in the ER for possible CAP (community acquired pneumonia). Gram stain results of and induced sputum culture reveals numerous epithelial cells, PMN’s and gram positive cocci growing in lancet shaped pairs and chains. This is most likely?
a. Enterococcus faecalis b. Staphylococcus aureus c. Pneumococcus d. Legionella pneumophilia e. It is most likely A and C |
c. Pneumococcus
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JP is a soldier returning from Afghanistan. Due to a combat injury, JP had his spleen removed and despite having a partial colectomy he is recovering in Tripler Army Hospital and doing well. While on rotations at this hospital you are asked about his infection risk and you correctly respond?
a. Because he had a splenectomy he is at higher risk of developing C. difficile infections b. Because he had a splenectomy he is at higher risk of developing infections from encapsulated organisms like Listeria monocytogenes c. Because he had a splenectomy he is at higher risk of developing infections caused by commonly spread encapsulated bacteria like Haemophilus influenza d. Because the spleen is an important part of the immune system, involved in clearing bacteria from the blood he will need to be vaccinated against organisms like Streptococcus pneumoniae and Haemophilus influenza e. B, C and D are correct |
c. Because he had a splenectomy he is at higher risk of developing infections caused by commonly spread encapsulated bacteria like Haemophilus influenza
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3. A patient is seen today in clinic and has the following orders;HIV DNA and Antibody, VDRL, urinary culture with Giemsa stain and typical gram stain. What is the Giemsa stain for?
a. This is a stain used to diagnose Treponema pallidum b. This is a stain used to diagnose Neisseria gonorrhea c. This is a stain used to diagnose Chlamydia trachomatis d. This is a stain used to diagnose urinary fungal infections |
d. This is a stain used to diagnose Chlamydia trachomatis
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Teichoic acid is?
a. Made by gram positive & gram negative organisms b. Made by gram negative organisms c. Is like an IgA protease d. Is like a beta-lactamase e. B and C |
e. B and C
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5. JC is a newborn who was delivered vaginally at JKL Memorial Medical Center. His mother is a single, homeless female who was never seen for pre-natal care. Today, JC is being admitted to the Pediatric ICU with a high fever, severe restlessness, failure to thrive, and elevated WBC. The ER physician note states that the PE and lab data points towards meningitis. CSF labs and cultures are pending. What bacterial organisms would be part of the differential here?
a. Listeria monocytogenes b. Streptococcus pyogenes c. Ureplasma urealyticum d. A and C e. A, B and C |
d. A and C
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6. Which of the following is true of E. coli?
a. It is one of the bacterial causes of HAP/VAP (hospital or ventilator acquired pneumonia) b. It is a non-lactose fermenter c. It is a member of the Enterococcus genus d. A and B e. A and C |
a. It is one of the bacterial causes of HAP/VAP (hospital or ventilator acquired pneumonia)
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Today we have to worry about ESBL producing bacteria. Which of the following organisms fit(s) the description of an ESBL producer (I list in my notes/lecture the most common ESBL producers)?
a. E. coli & Klebsiella oxytoca b. E. faecalis & Klebsiella pneumoniae c. Pseudomonas aeruginosa & Listeria monocytogenes d. A and B e. A, B and C |
a. E. coli & Klebsiella oxytoca
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A patient with meningitis, caused by the organism Listeria monocytogenes, who is penicillin allergic is being treated with sulfamethoxazole/trimethoprim, which of the following is true?
a. should have a gram stain that reveals gram positive cocci in chains b. should have an India Ink stain result available in his/her chart showing the organism above c. is actually being treated inappropriately with antibiotics as this organism is part of the CNS normal flora d. a and c are both correct e. none of the above are true |
e. none of the above are true
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An adult patient with a fever?
a. could be infected with something b. could be suffering from a new onset DVT c. could be having a drug reaction d. a, b and c e. a and c only |
d. a,b and c
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The best way to obtain an organisms MIC to antimicrobials is?
a. Pubmed has an MIC database b. Stain the organism with KOH, culture it and place a novobiocin disk for MIC evaluation c. Culture the organism and determine the MIC using disk diffusion d. Culture the organism and stain it, the MIC is whispered to you by the bacteria e. Culture the organism and test it against an epsilometer strip |
e. Culture the organism and test it against an epsilometer strip
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Complete the following statement. Bands are?
a. immature lymphocytes that are released early from the bone marrow b. observed to have a segmented nucleus c. a sign of grade 3 neutropenia d. observed at >5% when a left shift is present e. a, b and d are correct |
a. immature lymphocytes that are released early from the bone marrow
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Patients who are placed on medications with high anti-cholinergic activity are at risk for infections. This increased risk is due to?
a. decreased production of IgA b. decreased coughing reflex c. decreased gastric pH and motility d. decreased lysozyme production e. c and d |
d. decreased lysozyme production
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Gram negative versus Gram positive organisms. Which of the following is true?
a. gram negatives make beta-lactamase in the periplasmic space, gram positives have a lipid rich cell wall b. gram negatives have teichoic acid, gram positives have a thick peptidoglycan layer c. gram positive cell wall has low lipid solubility, gram negatives make endotoxin d. a and b e. b and c |
a. gram negatives make beta-lactamase in the periplasmic space, gram positives have a lipid rich cell wall
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Antibody titers are used as diagnostic markers for which of the following?
a. Haemophilus influenzae b. Mycoplasma pneumoniae c. Chlamydia pneumoniae d. a, b and c e. b and c |
e. b and c
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Common flora of the skin includes?
a. Staphylococcus aureus b. Propionibacterium acnes c. Streptococcus mutans d. a, and b e. b and c |
d. a and b
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Which of the following is a synergistic combination?
a. dicloxacillin + gentamicin b. dicloxacillin + ciprofloxacin c. dicloxacillin + nafcillin d. dicloxacillin + fluconazole (the antifungal known as Diflucan) e. all of the above are synergistic combinations |
a. dicloxacillin + gentamicin
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A patient with meningitis, caused by the organism Staphylococcus aureus, who is penicillin allergic is being treated with vancomycin, which of the following is true?
a. should have a gram stain that reveals gram positive cocci in clusters b. should have an India Ink stain result available in his/her chart showing the organism above c. is actually being treated inappropriately with antibiotics as this organism is part of the CNS normal flora d. a and c are both correct e. none of the above are true |
a. should have a gram stain that reveals gram positive cocci in clusters
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An adult patient with a fever?
a. could infected with something b. could be suffering from an embolic stroke c. could have cancer d. a, b and c e. a and c only |
d. a,b and c
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The best way to obtain an organisms MIC to antimicrobials is?
a. Google Scholar has the largest MIC database b. Stain the organism, culture it under anaerobic conditions and check antibody titers c. Culture the organism and determine the MIC using the Kirby Bauer method d. Culture the organism and stain it, the MIC is whispered to you by the bacteria e. Culture the organism and test it using broth dilution methods |
e. Culture the organism and test it using broth dilution methods
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Complete the following statement. Bands are?
a. immature granulocytes that are released early from the bone marrow b. also called Reed Sternberg cells c. a sign of grade 3 neutropenia d. observed at <5% when a left shift is present e. a, b and d are correct |
a. immature granulocytes that are released early from the bone marrow
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Patients who are placed on medications with high anti-cholinergic activity are at risk for infections. This increased risk is due to?
a. decreased production of IgA b. decreased coughing reflex c. decreased gastric pH and motility d. decreased plasma cell activation production e. none of the above are correct |
e. none of the above are correct
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Your patient has 15% eosinophils on CBC with differential. This is?
a. normal in a patient with a viral infection b. normal in a patient with a parasitic infection c. normal in a patient with Hodgkin’s Lymphoma d. a, b and c are true e. b and c are true |
e. b and c are true
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Gram negative versus Gram positive organisms. Which of the following is true?
a. gram negatives make beta-lactamase in the periplasmic space, gram positives have low lipid solubility cell walls b. gram negatives have teichoic acid, gram positives have a thick peptidoglycan layer c. gram positive cell wall has high lipid solubility, gram negatives make endotoxin d. a and b e. b and c |
c. gram positive cell wall has high lipid solubility, gram negatives make endotoxin
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Antibody titers are used as diagnostic markers for which of the following?
a. Flaviviridae – (Hepatitis C virus) b. Mycoplasma pneumoniae c. Chlamydia pneumoniae d. a, b and c e. a and b |
d. a, b and c
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Common flora of the skin includes?
a. Staphylococcus aureus b. Propionibacterium acnes c. Streptococcus mutans d. a, and b e. b and c |
d. a and b
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Which of the following is an additive combination?
a. dicloxacillin + gentamicin b. dicloxacillin + ciprofloxacin c. dicloxacillin + nafcillin d. dicloxacillin + fluconazole (the antifungal known as Diflucan) e. all of the above are synergistic combinations |
c. dicloxacillin + nafcillin
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1. GP is a 44 year old, otherwise healthy female in the ER for possible CAP (community acquired pneumonia). Gram stain results of an induced sputum culture reveals numerous epithelial cells, PMN’s and gram negative cocci/cocci-bacilli. This is most likely?
a. Enterococcus faecalis b. Staphylococcus aureus c. Pneumococcus d. Haemophilus influenzae e. It is most likely A or C |
d. Haemophilus influenzae
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A patient is seen today in clinic and has the following orders; HIV DNA and Antibody, VDRL, urinary culture with Giemsa stain and typical gram stain. What is the VDRL order for?
a. This is a stain used to diagnose Treponema pallidum b. This is a stain used to diagnose Neisseria gonorrhea c. This is a stain used to diagnose Chlamydia trachomatis d. This is a stain used to diagnose urinary fungal infections |
a. This is a stain used to diagnose Treponema pallidum
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4. Teichoic acid is?
a. Made by gram positive & gram negative organisms b. Made by gram negative organisms c. Is form of lysozyme d. Is like a beta-lactamase e. None of the above |
e. none of the above
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5. JC is a newborn who was delivered vaginally at JKL Memorial Medical Center. His mother is a single, homeless female who was never seen for pre-natal care. Today, JC is being admitted to the Pediatric ICU with a high fever, severe restlessness, failure to thrive, and elevated WBC. The ER physician note states that the PE and lab data points towards meningitis. CSF labs and cultures are pending. What bacterial organisms would be part of the differential here?
a. Streptococcus bovis b. Streptococcus pyogenes c. Ureplasma urealyticum d. A and C e. A, B and C |
c. Ureplasma urealyticum
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Which of the following is true of E. coli?
a. It is one of the bacterial causes of CAP (community acquired pneumonia) b. It is a lactose fermenter c. It is a member of the Enterococcus genus d. A and B e. A and C |
b. It is a lactose fermenter
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7. Today we have to worry about beta-lactamase producing bacteria. Which of the following organisms fit(s) the description of a beta-lactamase producer?
a. E. coli & Klebsiella oxytoca b. E. faecalis & Mycoplasma pneumoniae c. Pseudomonas aeruginosa & Legionella pneumophilia d. A and B e. A, B and C |
a. E. coli & Klebsiella oxytoca
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Which of the following constitute(s) the “Big Three” drug interactions with warfarin that would cause a critical elevation in a patient’s INR?
a. Cloxacillin b. Sulfamethoxazole/Trimethoprim c. Rifampin d. Tobramycin e. a, b and c |
b. Sulfamethoxazole/Trimethoprim (the others are amiodarone and metronidazole)
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Which of the following is true of the labeling of antibiotics “static” vs. “cidal”?
a. static antimicrobials eliminate bacteria slowly by killing only rapidly growing isolates b. cidal antimicrobials help prevent bacterial toxin release the result of which is lower sepsis rates c. static antimicrobials are not always considered optimal depending on the bacterial isolate in patients who take immune suppressing agents like infliximab d. cidal antimicrobials are uncommonly capable of bacterial killing effects e. both a and d are true |
e. both a and d are true
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. Which of the following is/are part of the normal GI flora of an adult?
a. Enterococcus, Klebsiella b. Bacteroides, Staphylococcus c. Bacteroides, Acinetobacter d. Acinetobacter, Listeria e. A and C |
c. static antimicrobials are not always considered optimal depending on the bacterial isolate in patients who take immune suppressing agents like infliximab
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Which of the following is/are part of the normal GI flora of an adult?
a. Enterococcus, Klebsiella b. Bacteroides, Staphylococcus c. Bacteroides, Acinetobacter d. Acinetobacter, Listeria e. A and C |
a. Enterococcus, Klebsiella
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