Transcript 1-8-2017 PPT

THERAPEUTICS 3:
ANTIBIOTICS TUTORING
By Alaina Darby
GENERAL PRINCIPLES
Morton’s Section
WHICH OF THE FOLLOWING ANTIBIOTICS
WOULD BE MOST LIKELY TO TARGET G(-)
BACTERIA?
a.
Small, nonpolar, lipophilic
b.
Large, nonpolar, lipophilic
c.
Small, polar, hydrophilic
d.
Large, polar, hydrophilic
JH HAS COLITIS. WHICH OF THE
FOLLOWING IS THE MOST LIKELY CAUSE?
a.
S. aureus
b.
S. pneumoniae
c.
E. coli
d.
B. fragillis
WHICH OF THE FOLLOWING WOULD BE
LEAST HELPFUL FOR DETERMINING THE
CAUSATIVE BACTERIA?
a.
Culture of blood
b.
Culture of sputum
c.
Culture of CSF
d.
Culture of biopsied tissue
WHICH OF THE FOLLOWING WOULD MOST
LIKELY BE CONSIDERED BACTERICIDAL?
a.
Kills 98% of bacteria within 12 hours
b.
Kills 98% of bacteria within 24 hours
c.
Kills 99.9% of bacteria within 36 hours
d.
Kills 99.9% of bacteria within 48 hours
WHICH OF THE FOLLOWING IS A
QUALITATIVE WAY TO MEASURE
SUSCEPTIBILITY?
a.
Broth dilution
b.
Kirby-Baur test
c.
Microtubule
d.
E-test
FOR WHICH OF THE FOLLOWING ARE
CONCENTRATIONS REGULARLY TAKEN?
a.
Penicillin
b.
Azithromycin
c.
Zosyn
d.
Vancomycin
WHICH OF THE FOLLOWING WOULD
MOST LIKELY BE SUSCEPTIBLE?
a.
MIC 8, KB 5
b.
MIC 8, KB 20
c.
MIC 2, KB 5
d.
MIC 2, KB 20
IF THE MIC OF THE ORGANISM IS 3, WHICH
OF THE FOLLOWING ANTIBIOTICS WOULD
WORK BEST?
a.
Peak of 2
b.
Peak of 4
c.
Peak of 6
d.
Need more info
IF THE MIC OF THE ORGANISM IS 3, WHICH
OF THE FOLLOWING ANTIBIOTICS WOULD
WORK BEST?
a.
Peak of 4, time above MIC is 9 hours, concentration dependent
b.
Peak of 6, time above MIC is 9 hours, concentration dependent
c.
Peak of 8, time above MIC is 5 hours, time dependent
d.
Need more info
CEFTAZIDIME IS TYPICALLY DOSED 1G IV Q8H.
IF SUSCEPTIBILITY COMES BACK AS “S-DD”
HOW MIGHT IT BE DOSED TO BE EFFECTIVE?
a.
0.5g IV Q4H
b.
1g IV Q4H
c.
1g IV Q8H
d.
2g IV Q8H
GIVEN THE FOLLOWING, DETERMINE
HOW YOU WOULD TREAT THE PATIENT.
a.
IV Tetracycline at a high dose
b.
IV TMP/SMX at a normal dose + AMG
c.
IV Vancomycin at a high dose
d.
IV Nafcillin at a normal dose + AMG
Drug
MIC
SUSC
Tetracycline
>4
R
TMP/SMX
<10
S
Vancomycin
<1
S
Oxacillin
2
I
WHICH OF THE FOLLOWING IS A STATIC
DRUG THAT WORKS AT THE RIBOSOME?
a.
TMP/SMX
b.
Gentamicin
c.
Erythromycin
d.
Rifampin
JK HAS A MRSA INFECTION. WHY SHOULD
HE NOT BE TREATED WITH DICLOXACILLIN?
a.
He needs an IV option
b.
Resistance to dicoxacillin
c.
He needs a cidal agent
d.
He needs G(-) coverage
JK HAS A MRSA INFECTION. WHY SHOULD
HE NOT BE TREATED WITH DICLOXACILLIN?
a.
Altered porin channel
b.
Efflux pump
c.
Absolute change in target
d.
Beta lactamase production
RA (5 YO) HAS A RESPIRATORY INFECTION
THAT HE PICKED UP IN DAYCARE. WHICH
SHOULD HE BE GIVEN?
a.
Penicillin
b.
Amoxicillin
c.
Augmentin
d.
Zosyn
RA (5 YO) IS A ST. JUDE PATIENT THAT HAS
A RESPIRATORY INFECTION. WHICH
SHOULD HE BE GIVEN?
a.
Penicillin
b.
Amoxicillin
c.
Augmentin
d.
Zosyn
RJ IS TO BE GIVEN A CIVI OF AN
ANTIBIOTIC. WHICH OF THE FOLLOWING IS
MOST LIKELY?
a.
Zosyn
b.
Gentamicin
c.
Levofloxacin
d.
Azithromycin
WHICH OF THE FOLLOWING IS A CASE IN
WHICH YOU MIGHT GIVE A STATIC AND
CIDAL AGENT TOGETHER?
a.
TB
b.
CAP
c.
GNR
d.
HIV
TJ HAS RECENTLY HAD SURGERY TO TRANSPLANT A LUNG DUE TO LUNG
CANCER. HE IS A PAST SMOKER. DURING THE SURGERY, HE WAS INTUBATED.
HE WAS ALSO GIVEN ANTI-REJECTION DRUGS BEFORE AND AFTER THE
TRANSPLANT. WHICH COMPROMISED HIS CELLULAR IMMUNE FUNCTION?
a.
Surgery
b.
Intubation
c.
Immunosuppressive drugs
d.
Smoking
WHICH OF THE FOLLOWING WOULD
BE CONSIDERED SIRS?
a.
Oral temp 39 C, HR 85, WBC 10,000
b.
Oral temp 37 C, HR 95, WBC 10,000
c.
Oral temp 39 C, HR 85, WBC 2,000
d.
Oral temp 37 C, HR 85, WBC 2,000
WHICH OF THE FOLLOWING WOULD
REQUIRE THE LONGEST COURSE OF
TREATMENT?
a.
Endocarditis
b.
S. epidermitis bacteremia
c.
E. coli bacteremia
d.
Surgical prophylaxis