Infectious Diseases
A 13-day-old former 35-week gestational age baby presents to the emergency room with a temperature of 102°F. The mother reports the baby has been feeding less, is constipated, and is very irritable. The emergency physician is unable to obtain CSF fluid after multiple attempts. Based on clinical findings, the team believes that the 13-day-old former 35-week gestational age baby may have meningitis. What is the best therapy to begin in this baby before sending her to a pediatric hospital? A. Ampicillin and gentamicin B. Ceftriaxone and gentamicin C. Vancomycin and cefotaxime D. Ampicillin and ceftriaxone
(The correct answer is A)
A 58-year-old febrile woman in the surgical intensive care unit has one out of two blood culture bottles growing yeast. A urine sample collected 2 days ago is growing C. glabrata. What is the best empiric decision for this patient? A. Start fluconazole 400 mg daily B. Wait for a susceptibility report and then start with a sensitive antifungal agent C. The one out of two blood bottles and the urine culture do not require therapy D. Initiate caspofungin 70 mg x 1 dose, then 50 mg daily
(The correct answer is A)
A 70-year-old man presents with fever, nausea, vomiting, severe headache, and extreme photophobia. CSF results: WBC 2500 cells/mm3, 87% neutrophils, glucose 37 mg/dL and protein 240 mg/dL. What type of CNS infection is his clinical picture most consistent with? A. Bacterial meningitis B. Aseptic meningitis C. Viral encephalitis D. Any of the above
(The correct answer is A)
A patient with a health care-associated pneumonia infection is found to have a multidrug resistant organism (this was found by the culture and susceptibility and the pathogen Pseudomonas aeruginosa exhibits a high MIC to all antibiotics). Since the pathogen exhibits a high level resistance, modifications to the dose or interval will be required to achieve successful outcomes. Currently the patient is receiving the beta lactam piperacillin/tazobactam 4.5 g intravenously every 6 hours infused over 30 minutes. Select the factor that may be done to piperacillin/tazobactam that could optimize the pharmacodynamic property. A. Increase the infusion time B. Increase the dose C. Add combination therapy with another beta lactam D. All of the above
(The correct answer is A)
A patient with a histoplasmosis infection is to be discharged from the hospital and started on oral itraconazole capsules. Which one of the following statements would you tell the patient about his medication to maximize the oral absorption? A. Take with food and avoid concomitant use of antacids B. Take on an empty stomach C. Food will not affect the oral absorption D. Do not take this with cola
(The correct answer is A)
A patient with hypotension secondary to sepsis has a history of congestive heart failure and fluid overload. Select the appropriate colloid therapy for this patient. A. 5% albumin 500 mL B. 5% dextrose 500 mL C. 0.9% sodium chloride 500 mL D. 0.45% sodium chloride 500 mL
(The correct answer is A)
A treatment experienced patient receiving atazanavir therapy should avoid the addition of which of the following medications: A. Omeprazole B. Metronidazole C. Pravastatin D. Metoprolol
(The correct answer is A)
Adamantanes have activity against which influenza types? A. Influenza A B. Influenza B C. Influenza C D. All of the above
(The correct answer is A)
BK is a 40-year-old HIV-positive patient. He develops CSF culture-positive cryptococcal meningitis. He has no hepatic or renal insufficiency and his complete blood count is within normal limits. Select the preferred antifungal regimen for a patient with cryptococcal meningitis? A. Amphotericin B desoxycholate + flucytosine B. Amphotericin B desoxycholate C. Liposomal amphotericin B D. Fluconazole E. Micafungin
(The correct answer is A)
HF is a 29-year-old woman who was diagnosed with genital herpes 6 years ago. She reports approximately one to two recurrences each year since diagnosis. Recently she has experienced an increase in outbreaks, having three in a 6-month period. The decision is made to start HF on daily suppressive therapy. Select the most appropriate therapy for HF. A. Valacyclovir po B. Erythromycin ointment C. Tetracycline po D. Acyclovir ointment
(The correct answer is A)
High-dose amoxicillin (1 g every 8 hours) and amoxicillin/clavulanate XR (2 g every 12 hours) are recommended in CAP treatment. The increase in dose of the two antimicrobials is recommended because of bacterial resistance. Select the pathogen that requires an increase in the dose of amoxicillin. A. Drug-resistant Streptococcus pneumoniae (DRSP) B. Methicillin-resistant Staphylococcus aureus (MRSA) C. Extended-spectrum beta-lactamase (ESBL) Klebsiella pneumoniae D. All of the above
(The correct answer is A)
IO is an 11-year-old patient with a diagnosis of acute bacterial sinusitis. IO has been prescribed 10 mg/kg of trimethoprim/sulfamethoxazole. Which component(s) of the antibiotic should the dose is based upon? A. Trimethoprim B. Sulfamethoxazole C. Sulfonamide D. All of the above
(The correct answer is A)
In a patient with a history of acute on chronic pancreatitis, which of the following medications should be avoided? A. Didanosine B. Darunavir C. Tenofovir D. Enfuvirtide
(The correct answer is A)
JK is a 32-year-old HIV-negative new patient at the clinic you work at. He receives a Mantoux skin test that returns positive 2 days later. He was born in the United States and works as a prison guard. He injects heroin on a regular basis. His chest x-ray comes back normal, he has no symptoms of tuberculosis, and his smear culture is negative. What type of drug therapy would be appropriate for this patient? A. Isoniazid 300 mg daily x 9 months B. Rifampin 100 mg daily x 4 months C. No drug therapy needed D. Isoniazid 300 mg and rifampin 600 mg x 6 months E. Isoniazid, rifampin, ethambutol, and pyrazinamide
(The correct answer is A)
NK is a 62-year-old man presenting to urgent care today with dysuria, increased urinating frequency, and flank pain. His past medical history includes hyperlipidemia and migraines. He is allergic to penicillin and sulfa drugs. NK has classic symptoms of pyelonephritis. Pyelonephritis is characterized as cystitis plus fever, flank pain, nausea, and vomiting. Ciprofloxacin is the appropriate therapy because NK is allergic to penicillin and sulfa drugs. Fourteen days is the appropriate duration of therapy for men with pyelonephritis. NK completes his therapy and feels better. Two weeks later he returns to the emergency department (ED) with general malaise, a temperature of 101.7°F, pelvic pain, dysuria, and increased urination. What is the probable diagnosis? A. Acute bacterial prostatitis B. Benign prostatic hyperplasia C. Cystitis D. Epididymitis
(The correct answer is A)
SA is a 33-year-old man with no known drug allergies who presents to the local STD clinic with complaints of extreme pain on urination and urethral discharge for two days. A diagnosis of gonococcal urethritis is made. Select the most appropriate therapy for SA. A. Ceftriaxone B. Benzathine penicillin C. Azithromycin D. Levofloxacin
(The correct answer is A)
Select the SSTI that may be treated with topical antimicrobials. A. Impetigo B. Cellulitis C. Diabetic foot ulcers D. a and c E. All of the above
(The correct answer is A)
Select the agent that is administered via intramuscular injection for influenza prevention or postexposure prophylaxis. A. TIV B. LAIV C. Zanamivir D. Amantadine E. All of the above
(The correct answer is A)
Select the antibiotic that may cause an abnormal taste. A. Biaxin B. Zithromax C. Doxycycline D. Amoxil
(The correct answer is A)
Select the antibiotic used in combination treatment of necrotizing fasciitis. This antibiotic is used to decrease bacterial toxin production, thereby limiting tissue damage. A. Cleocin B. Primaxin C. Augmentin D. Zosyn
(The correct answer is A)
Select the antimicrobial that can alter glucose levels (hyper- or hypoglycemia). A. Levofloxacin B. Clindamycin C. Vancomycin D. Daptomycin
(The correct answer is A)
Select the antimicrobial that has the same oral and IV dose. A. Doxycycline B. Amoxicillin/clavulanate C. Piperacillin/tazobactam D. Ceftriaxone E. Ciprofloxacin
(The correct answer is A)
Select the bacterial pathogen that is a common cause of lower respiratory tract infections. A. Haemophilus influenza B. Influenza C. Parainfluenza D. b and c E. All of the above
(The correct answer is A)
Select the brand name for zanamivir. A. Relenza B. Tamiflu C. FluMist D. Flumadine E. Symmetrel
(The correct answer is A)
Select the cephalosporin that may be used in the treatment of acute otitis media that has a bitter tasting suspension and has differing bioavailability rates depending upon the oral formulation used. A. Ceftin B. Vantin C. Zithromax D. Cleocin
(The correct answer is A)
Select the most common adverse reaction of TIV. A. Injection site soreness B. Birth defects C. Bronchospasm D. Guillain-Barre syndrome E. Autism
(The correct answer is A)
Select the pathogen(s) that is part of the normal (endogenous) flora of the large intestine. A. Escherichia coli B. Viridans streptococci C. Neisseria meningitidis D. All of the above
(The correct answer is A)
Select the primary method for transmission of seasonal influenza. A. Inhalation B. Exposure to blood and/or bodily fluids C. Exposure to dead birds D. All of the above
(The correct answer is A)
Select the primary method for transmission of tuberculosis. A. Inhalation B. Exposure to blood and/or bodily fluids C. Exposure to dead birds D. Hospitalization
(The correct answer is A)
Select the upper respiratory tract condition that would be defined as the presence of fluid in the middle ear without symptoms of acute illness. A. Otitis media with effusion B. Sinusitis C. Pharyngitis D. All of the above
(The correct answer is A)
Skin and soft tissue infections (SSTIs) may involve all layers of the skin, fascia, and muscle. Select the part of the skin that represents the outermost nonvascular layer. A. Epidermis B. Dermis C. Subcutaneous fat D. Fascia E. All of the above
(The correct answer is A)
The addition of the beta-lactamase inhibitor sulbactam to ampicillin is done to: A. Increase bacterial coverage B. Decrease side effects C. Improve bioavailability D. All of the above
(The correct answer is A)
What is the recommended route of administration for ampicillin for the treatment of bacterial meningitis? A. IV B. Oral C. Intramuscular D. Any of the above are reasonable
(The correct answer is A)
What therapy should be administered within 1 hour of the recognition of sepsis? A. Broad-spectrum antimicrobial therapy B. Corticosteroids in patients with documented adrenal insufficiency C. Drotrecogin alfa therapy D. Vasopressor therapy
(The correct answer is A)
When is a person living with HIV classified as having an AIDS diagnosis? A. Diagnosis of Pneumocystis jiroveci pneumonia B. CD4 count decreases to 350 mcL C. HIV viral load of > 100,000 copies/mL D. a and b only E. All of the above
(The correct answer is A)
Which of the following are targets for currently available HIV medications? A. Reverse transcriptase, protease, and integrase B. Reverse transcriptase, protease, and proviral DNA C. Reverse transcriptase, mRNA, protease, and integrase D. Reverse transcriptase, protease, mRNA, and proviral DNA
(The correct answer is A)
Which of the following carbapenem antibiotics does not have coverage against P. aeruginosa? A. Ertapenem B. Doripenem C. Imipenem-cilastatin D. Meropenem
(The correct answer is A)
Which of the following combinations of antiretrovirals should be avoided? A. Didanosine and stavudine B. Tenofovir and efavirenz C. Lamivudine and zidovudine D. Fosamprenavir and ritonavir
(The correct answer is A)
Which of the following does not describe a current goal of therapy for genital herpes infection? A. Disease eradication B. Viral suppression C. Transmission prevention D. Decrease recurrence frequency
(The correct answer is A)
Which of the following is a contraindication to doxycycline therapy? A. Age less than 8 years B. Concomitant use of QTc interval-prolonging drugs C. Diabetes mellitus D. Documented penicillin allergy
(The correct answer is A)
Which of the following is a contraindication to pyrazinamide therapy? A. Acute gout attacks B. Chronic obstructive pulmonary disease C. Rheumatoid arthritis D. Asthma
(The correct answer is A)
Which of the following is correct regarding bacterial meningitis? A. A bacteria will be identified in majority of the cases. B. The likelihood of a bacteria being identified is unchanged if a patient receives antibiotics prior to CSF cultures. C. CSF cultures are not reliable for diagnosis. D. There is no role for blood cultures in the diagnosis of bacterial meningitis.
(The correct answer is A)
Which of the following is true regarding the treatment of STDs in special populations? A. The treatment of STDs in pregnancy can decrease pregnancy complications and prevent disease transmission to the child. B. Children diagnosed with congenital or acquired STDs should not be treated until they reach 2 years of age due to antimicrobial toxicities. C. In general, adolescent patients require lower doses of recommended antimicrobials for the treatment of STDs. D. Management of genital herpes in patients with HIV infection is the same as the management in patient who are HIV-negative.
(The correct answer is A)
Which of the following nutrition regimens is (are) appropriate in a patient with severe sepsis secondary to pneumonia? A. Continuous tube feeding via a nasoduodenal tube B. Parenteral nutrition via a central IV catheter C. Parenteral nutrition via a peripheral IV catheter D. a and b E. b and c
(The correct answer is A)
Which of the following persons should receive the MPSV4 vaccine? A. A 60-year-old who just had his spleen removed after a traumatic car accident B. A 5-year-old with sickle cell disease C. A 25-year-old microbiologist that works with N. meningitidis D. A 33-year-old traveling to the meningitis belt
(The correct answer is A)
A patient presents to your pharmacy to ask a question about influenza symptom resolution. She was diagnosed with influenza B. She still has cough and malaise. What should you discuss with the patient? A. Influenza symptoms will disappear within 48 hours. If you are still having symptoms, see your provider. B. Influenza symptoms typically last 3 to 7 days. Cough and malaise may last up to 2 weeks. If your symptoms have increased/worsened, you may need to see your provider. C. Influenza does not cause a cough. Patient should be counseled to see provider. D. As long as a patient does not have a fever, there is no need to worry. Cough and malaise symptoms will go away.
(The correct answer is B)
For which of the following agents is nephrotoxicity not one of the more common side effects that are monitored? A. IV gentamicin B. IV ceftriaxone C. IV vancomycin D. IV acyclovir
(The correct answer is B)
GB is a 28-year-old woman with a chief complaint of dysuria. The physician orders a urinalysis and a urine culture. Pseudomonas aeruginosa is a nosocomial organism and causes <20% of UTIs. TMP-SMX is appropriate empiric therapy for GB. If the local E. coli resistance rate for TMP-SMX is high, ciprofloxacin would be an appropriate choice. What is the appropriate duration of therapy for GB? A. 1 day B. 3 days C. 7 days D. 14 days
(The correct answer is B)
GB is a 28-year-old woman with a chief complaint of dysuria. The physician orders a urinalysis and a urine culture. What is the most likely cause of the UTI? A. Acinetobacter baumannii B. Escherichia coli C. Pseudomonas aeruginosa D. Staphylococcus saprophyticus
(The correct answer is B)
Genetic variability in Cytochrome P-450 CYP 2C19 has been linked to significant interpatient pharmacokinetic differences for which antifungal agent? A. Fluconazole B. Voriconazole C. Micafungin D. Flucytosine
(The correct answer is B)
Identify the type of patient who is the best candidate for therapy with drotrecogin alfa. A. Severe sepsis and a low risk of death B. Severe sepsis and a high risk of death C. a and b D. None of the above
(The correct answer is B)
In a patient receiving zidovudine therapy, which of the following could you expect to be elevated on laboratory evaluation? A. Blood urea nitrogen (BUN) B. Mean corpuscular volume (MCV) C. Serum creatinine D. Potassium
(The correct answer is B)
JM is a 23-year-old woman who is 28 weeks pregnant. She presents to her primary care physician (PCP) with symptoms of dysuria and unusual vaginal discharge. A diagnosis of chlamydia is made. Assuming no drug allergies, select the most appropriate therapy for JM. A. Doxycycline B. Amoxicillin C. Cefixime D. Levofloxacin
(The correct answer is B)
LA is 30-year-old pregnant woman. She is 16 weeks pregnant and reports dysuria at her appointment today. Urinalysis and urine culture are conducted, and she is started on TMP-SMX 1 DS tablet po bid. What is the appropriate duration of therapy? A. 3 days B. 7 days C. 14 days D. 28 days
(The correct answer is B)
SL is a 32-year-old man with sepsis secondary to an intra-abdominal abscess. He has no significant past medical history and currently has been fluid resuscitated with a mean arterial pressure (MAP) of 70 mm Hg. What is the best treatment plan for SL? A. Ampicillin/sulbactam 3 g IV every 6 hours and transfer to the intensive care unit B. Ampicillin/sulbactam 3 g IV every 6 hours and surgical drainage of the abscess C. Amoxicillin/clavulanic acid 875 mg po every 12 hours and transfer to the intensive care unit D. Amoxicillin/clavulanic acid 875 mg po every 12 hours and surgical drainage of the abscess
(The correct answer is B)
Select the anti-infective that exhibits the pharmacodynamic property of time-dependent activity. A. Levofloxacin B. Doripenem C. Amikacin D. Metronidazole
(The correct answer is B)
Select the antimicrobial that is utilized for community-acquired pneumonia, inhibits protein synthesis, and is a strong inhibitor of the CYP-450 3A4 hepatic enzyme. A. Azithromycin B. Clarithromycin C. Amoxicillin D. Cefpodoxime
(The correct answer is B)
Select the antimicrobial that may cause thrombocytopenia, especially with more than 2 weeks of therapy. A. Cleocin B. Zyvox C. Cubicin D. Tygacil
(The correct answer is B)
Select the brand name for drotrecogin alfa. A. Activated protein C B. Xigris C. Levophed D. Solu-Medrol
(The correct answer is B)
Select the factor that may affect the bioavailability of an oral anti-infective. A. A medication that is a substrate of the CYP-450 system B. Dosage formulation of the anti-infective C. A patient that has peripheral vascular disease D. A patient that has renal dysfunction
(The correct answer is B)
Select the mechanism of action for cephalosporin antibiotics. A. Bind to the 30S bacterial ribosomal subunit, ultimately inhibiting bacterial protein synthesis B. Bind and inactivate a family of enzymes required for bacterial cell wall synthesis, causing cell death C. Bind and stabilize DNA complexes with topoisomerase II and topoisomerase IV enzymes, causing DNA-strand breakage and cell death D. Bind to the 23S component of the 50S ribosomal subunit, inhibiting RNA-dependent protein synthesis
(The correct answer is B)
Select the salt formation of piperacillin/tazobactam. A. Potassium B. Hydrochloride C. Sodium D. All of the above
(The correct answer is B)
Select the side effect that a high percentage of patients with infectious mononucleosis develop when they receive penicillin antimicrobials (amoxicillin, ampicillin, or piperacillin). A. Bone marrow suppression (BMS) B. Rash C. Clostridium difficile D. Thrombocytopenia
(The correct answer is B)
TD is 27-year-old man who presents to a local STD clinic with complaints of painful urination and urethral discharge over the past 4 days. He is sexually active, reporting three partners within the past 30 days. He has no known drug allergies. A diagnosis of chlamydia is made. Select the most appropriate therapy for TD. A. Doxycycline B. Azithromycin +cefixime C. Ceftizoxime D. Acyclovir + ofloxacin
(The correct answer is B)
TK is a 32-year-old woman admitted to the intensive care unit with possible sepsis secondary to pneumonia. Her vitals signs are temperature 38.1°C, heart rate 80 beats per minute, and respiratory rate 16 breaths per minute. She also has a white blood cell count of 15,500 cells/mm3. Based on this information, does TK have sepsis? A. Yes, TK has sepsis because she has an infection source but meets no SIRS criteria. B. Yes, TK has sepsis because she has an infection source and meets two SIRS criteria. C. No, TK does not have sepsis because she has an infection source but does not have any organ failures. D. No, TK does not have sepsis because she does not have positive cultures.
(The correct answer is B)
The addition of pyridoxine (vitamin B6) helps protect against which isoniazid-induced toxicity? A. Hepatotoxicity B. Peripheral neuropathy C. Gastrointestinal upset D. Rash
(The correct answer is B)
UQ is a 2-year-old child who attends day care and is diagnosed with severe acute bacterial sinusitis. Because the patient is attending a day care and is 2 years of age, penicillin-resistant S. pneumoniae is highly suspected. Select the antibiotic regimen that would be recommended to treat this acute bacterial sinusitis infection. A. Amoxicillin 45 mg/kg/d in divided doses B. Amoxicillin 90 mg/kg/d in divided doses C. Trimethoprim-sulfamethoxazole (8 mg/kg trimethoprim) in divided doses D. Doxycycline 100 mg in divided doses
(The correct answer is B)
What drug interaction would be exhibited by adding fluconazole to a person's medication regimen that includes warfarin (stabilized at an INR of 2.5)? A. Fluconazole and warfarin concentrations would both be reduced B. An increase in INR would be expected C. Warfarin Cytochrome P-450 metabolism would be induced D. An interaction would not be expected
(The correct answer is B)
What is the preferred regimen for treating latent tuberculosis infection in adults? A. Isoniazid 300 mg daily x 6 months B. Isoniazid 300 mg daily x 9 months C. Rifampin 600 mg daily x 6 months D. Rifampin 600 mg daily x 9 months
(The correct answer is B)
What is the primary mode of HIV acquisition in the United States? A. Heterosexual contact B. Homosexual contact C. Casual contact with an HIV-infected person D. Contaminated blood and tissue products
(The correct answer is B)
What is the purpose of adding vancomycin to empiric therapy for bacterial meningitis in a 4-year-old patient? A. To provide coverage against resistant L. monocytogenes B. To provide coverage against resistant S. pneumoniae C. To provide coverage against resistant N. meningitidis D. Vancomycin is not needed in a 4-year-old with bacterial meningitis because S. aureus is unlikely
(The correct answer is B)
When preparing an IV formulation of amphotericin B deoxycholate (desoxycholate), the lyophilized amphotericin B powder must first be reconstituted with sterile water. What type of IV fluid must the reconstituted amphotericin B be placed in for IV administration? A. 0.9% sodium chloride B. 5% dextrose in water C. Lactated Ringer's solution D. Any of the above solutions
(The correct answer is B)
Which antibiotic is not appropriate for UTI treatment in pregnant women? A. Amoxicillin/clavulanic acid B. Doxycycline C. Nitrofurantoin D. TMP-SMX
(The correct answer is B)
Which antifungal agent has the greatest 24-hour urinary excretion percentage? A. Amphotericin B desoxycholate B. Fluconazole C. Voriconazole D. Caspofungin
(The correct answer is B)
Which antifungal preparation carries a relative contraindication against use in patients with severe renal insufficiency (due to risk of renal complications from a carrier molecule)? A. IV fluconazole B. IV voriconazole C. Oral itraconazole D. IV caspofungin E. Oral voriconazole
(The correct answer is B)
Which corticosteroid should be used to treat patients with septic shock refractory to vasopressor therapy? A. Prednisone B. Hydrocortisone C. Methylprednisolone D. Dexamethasone
(The correct answer is B)
Which of the following agents is not recommended as therapy for invasive aspergillosis? A. Amphotericin B B. Fluconazole C. Voriconazole D. Liposomal amphotericin B
(The correct answer is B)
Which of the following condition(s) would be a contraindication for receiving TIV? A. Diabetes mellitus B. Egg allergy C. Recently received amantadine (within 48 hours) D. Concerned about development of autism from thimerosal in TIV E. All of the above
(The correct answer is B)
Which of the following explains the pharmacokinetic differences between a neonate and an adult with regards to gentamicin? A. Increased volume of distribution and increased clearance B. Increased volume of distribution and decreased clearance C. Decreased volume of distribution and increased clearance D. Decreased volume of distribution and decreased clearance
(The correct answer is B)
Which of the following is consistent with the recommended antibacterial therapy for a 78-year-old patient with bacterial meningitis? A. Vancomycin and ceftriaxone B. Vancomycin, ceftriaxone, and ampicillin C. Ampicillin and ceftriaxone D. Ceftriaxone
(The correct answer is B)
Which of the following is not common with bacterial meningitis? A. CSF WBC 5000 cells/ mm3 B. CSF WBC with 70% lymphocytes C. CSF glucose 23 mg/dL D. CSF protein of 250 mg/dL
(The correct answer is B)
Which of the following is true regarding genital herpes infection? A. Genital herpes is an acute, self-limiting disease. B. Genital lesions are typically vesicular in nature and accompanied by pain, itching, and burning. C. The rate of recurrence increases over time in most patients. D. Transmission risk in a mother with recurrent disease but no visible lesions is high.
(The correct answer is B)
Which of the following is true regarding the diagnosis of syphilis? A. The diagnosis of syphilis is made through direct techniques such as culture. B. Serologic testing is the standard method of detecting primary, secondary, latent, and tertiary syphilis in the United States. C. The VDRL-CSF is the standard serologic test for secondary syphilis. D. Nontreponemal serologic testing alone is sufficient for a definitive diagnosis of syphilis.
(The correct answer is B)
Which of the following properties are true of efavirenz? A. Should be taken with a high-fat meal. B. Is a common cause of vivid dreams and hallucinations. C. Is the NNRTI of choice in pregnancy. D. a and b
(The correct answer is B)
Which of the following statements about HIV prevention is true? A. Condoms are 100% effective in preventing HIV transmission B. All pregnant women should be screened for HIV C. Only pregnant women who engage in high-risk behaviors should be screened for HIV D. IV drug abusers can reuse/share syringe hubs as long as a new needle is used E. None of these statements is true
(The correct answer is B)
Which rifamycin has the least drug interactions? A. Rifampin B. Rifabutin C. Rifapentine D. Rocephin
(The correct answer is B)
XW is a 28-year-old pregnant patient. She is currently receiving amoxicillin for a urinary tract infection caused by Escherichia coli. She comes to your pharmacy wanting an influenza vaccination. She hates shots and prefers not to receive any injection. During last year's influenza season she received treatment with oseltamivir. Select the appropriate agent for influenza vaccination for XW. A. LAIV B. TIV C. Oseltamivir D. Rimantadine
(The correct answer is B)
A 13-day-old former 35-week gestational age baby presents to the emergency room with a temperature of 102°F. The mother reports the baby has been feeding less, is constipated, and is very irritable. The emergency physician is unable to obtain CSF fluid after multiple attempts. Based on clinical findings, the team believes that the 13-day-old former 35-week gestational age baby may have meningitis. When the 13-day-old former 35-week gestational age baby is examined at the pediatric hospital, she is also noted to have some lesions. The team will be sending cultures of the lesions as well as HSV PCR of the CSF. Which of the following is an appropriate pharmacologic approach in this patient? A. Wait for the cultures and PCR results to come back, then modify therapy if needed. B. Change antibiotic therapy to ceftriaxone and vancomycin. C. Add IV acyclovir to the current antibiotic regimen. D. Add oral voriconazole therapy to the current antibiotic regimen.
(The correct answer is C)
A 13-day-old former 35-week gestational age baby presents to the emergency room with a temperature of 102°F. The mother reports the baby has been feeding less, is constipated, and is very irritable. Which symptom is not a common symptom of meningitis in a neonate? A. Temperature of 102°F B. Decreased feeding C. Constipation D. Irritable appearance
(The correct answer is C)
A health care worker has a higher risk of contracting HIV from a HIV-positive patient if: A. The health care worker has a deep needlestick injury and the patient has an undetectable viral load B. The health care worker has a superficial needlestick injury and the patient has an undetectable viral load C. The health care worker has a deep needlestick injury and the patient has a high viral load D. The health care worker has a superficial needlestick injury and the patient has a high viral load
(The correct answer is C)
At the end of a 10-week course of treatment for cryptococcal meningitis (CSF-sterilized) in an HIV-positive patient, what is generally recommended in terms of cryptococcal infection? A. Once weekly doses of azithromycin B. Four weeks of fluconazole oral therapy C. Indefinite low-dose suppressive fluconazole therapy D. No further antifungal therapy is needed
(The correct answer is C)
BC is a 28-month-old child with no significant past medical history. BC has not had a wheezing episode in the last 12 months. Select the best statement as it relates to influenza vaccination. A. BC should be vaccinated with TIV. B. BC should be vaccinated with LAIV. C. BC should be vaccinated with TIV or LAIV. D. BC should be administered oseltamivir for prophylaxis. E. BC does not meet criteria for vaccination.
(The correct answer is C)
CX is a 46-year-old patient diagnosed with lymphangitis. CX has a penicillin allergy, the allergy is a rash. Select the best antimicrobial to treat the lymphangitis in CX. A. Penicillin G (IV) B. Penicillin VK (oral) C. Clindamycin (IV) D. Trimethoprim-sulfamethoxazole (IV) E. Vancomycin (oral)
(The correct answer is C)
Complications of chlamydia genital infection include which of the following? A. Granulomatous and cardiovascular diseases B. Vesicular lesions on the external genitalia C. Pelvic inflammatory disease and infertility D. General paresis, dementia, and sensory ataxia
(The correct answer is C)
Dosing of Selzentry (maraviroc) should be increased to 600 mg twice daily when combined with which of the following medications? A. Ketoconazole B. Clarithromycin C. Rifampin D. Warfarin
(The correct answer is C)
Health care-associated pneumonia is divided up into two subsets, early and late onset. Select the factor that is the major difference in early versus late onset. A. Severity of illness B. Pneumonia severity index score C. Time of onset/diagnosis D. All of the above
(The correct answer is C)
How long after a Mantoux skin test for TB infection is placed should it be read? A. 12 hours B. 24 hours C. 48 hours D. 96 hours E. 120 hours
(The correct answer is C)
KT is a 65-year-old man with a history of end-state renal disease on hemodialysis admitted with severe sepsis likely secondary to an infected dialysis catheter. Which of the following represents the best order of events to manage KT sepsis? A. Drotrecogin alfa, fluids, microbiologic cultures, antimicrobial therapy B. Drotrecogin alfa, antimicrobial therapy, microbiologic cultures, fluids C. Fluids, microbiologic cultures, antimicrobial therapy, drotrecogin alfa D. Fluids, antimicrobial therapy, microbiologic cultures, drotrecogin alfa
(The correct answer is C)
LA is 30-year-old pregnant woman. She is 16 weeks pregnant and reports dysuria at her appointment today. Urinalysis and urine culture are conducted, and she is started on TMP-SMX 1 DS tablet po bid. Initial therapy for pregnant women should be 7 days, and a follow-up urine culture 1 to 2 weeks post therapy and then monthly until birth is recommended. Three days later the clinic calls LA to tell her the culture results are back and she needs to change therapy. The culture was positive for E. coli, and it is resistant to TMP-SMX. What would be the new appropriate therapy for LA? A. Amoxicillin 500 mg po tid for 3 days B. Ciprofloxacin 500 mg po bid for 7 days C. Nitrofurantoin 100 mg po bid for 7 days D. TMP-SMX 2 DS tablets po bid for 7 days
(The correct answer is C)
Lipid-based or liposomal amphotericin B formulations have what advantage over conventional amphotericin B (desoxycholate)? A. Less expensive than conventional amphotericin B B. Decreased mortality C. Decreased rates of nephrotoxicity D. More efficacious than conventional amphotericin B
(The correct answer is C)
NK is a 62-year-old man presenting to urgent care today with dysuria, increased urinating frequency, and flank pain. His past medical history includes hyperlipidemia and migraines. He is allergic to penicillin and sulfa drugs. NK has classic symptoms of pyelonephritis. Pyelonephritis is characterized as cystitis plus fever, flank pain, nausea, and vomiting. Ciprofloxacin is the appropriate therapy because NK is allergic to penicillin and sulfa drugs. Fourteen days is the appropriate duration of therapy for men with pyelonephritis. NK completes his therapy and feels better. Two weeks later he returns to the emergency department (ED) with general malaise, a temperature of 101.7°F, pelvic pain, dysuria, and increased urination. NK's initial therapy resolved his pyelonephritis. The prostate is a common site of bacteria persistence. Two weeks later he displays symptoms of acute bacterial prostatitis. NK is admitted to the hospital. Blood and urine cultures are collected. He is started on ceftriaxone 1 g IV daily. On day three, blood cultures are negative, and the urine culture is positive for E. coli. The isolate is resistant to amoxicillin. On day four, NK is ready for discharge. What is the most appropriate outpatient therapy for NK? A. Ciprofloxacin 500 mg po bid for 3 days B. Ciprofloxacin 500 mg po bid for 14 days C. Ciprofloxacin 500 mg po bid for 28 days D. Nitrofurantoin 100 mg po bid for 28 days
(The correct answer is C)
NK is a 62-year-old man presenting to urgent care today with dysuria, increased urinating frequency, and flank pain. His past medical history includes hyperlipidemia and migraines. He is allergic to penicillin and sulfa drugs. NK has classic symptoms of pyelonephritis. Pyelonephritis is characterized as cystitis plus fever, flank pain, nausea, and vomiting. What is the most appropriate therapy for NK? A. Amoxicillin 500 mg po tid for 7 days B. Ciprofloxacin 500 mg po bid for 3 days C. Ciprofloxacin 500 mg po bid for 14 days D. TMP-SMX 1 DS tablet po bid for 14 days
(The correct answer is C)
One of the primary goals of HIV therapy is: A. Complete eradication of the virus B. Maintain CD4 count at the level it was when treatment began C. Durable and maximal suppression of HIV replication D. None of the above
(The correct answer is C)
Select the answer that is defined as a superficial skin infection caused by beta-hemolytic Streptococcus and S. aureus. Treatment consists of soaking the lesions with soap and water, use of skin emollients to dry areas, and antimicrobials. Topical mupirocin may be used alone when there are few lesions. A. Erysipelas B. Lymphangitis C. Impetigo D. Necrotizing fasciitis E. All of the above
(The correct answer is C)
Select the anti-infective that exhibits the pharmacodynamic property of concentration dependent activity. A. Ceftriaxone B. Amoxicillin C. Ciprofloxacin D. Meropenem
(The correct answer is C)
Select the anti-infective that may be used to treat pediatric community-acquired pneumonia. A. Levofloxacin B. Doxycycline C. Ceftriaxone D. All of the above
(The correct answer is C)
Select the beta-lactam antimicrobial that does not require dose or interval reductions in patients with renal dysfunction. A. Amoxicillin B. Azithromycin C. Ceftriaxone D. Moxifloxacin E. Cefepime
(The correct answer is C)
Select the brand name for benzathine penicillin. A. Bicillin C-R B. Wycillin C. Bicillin L-A D. Pen-VK
(The correct answer is C)
Select the brand name of cefuroxime axetil. A. Vantin B. Rocephin C. Ceftin D. Augmentin
(The correct answer is C)
Select the correct statement regarding nitrofurantoin. A. Does not have a renal dosing adjustment B. Appropriate throughout pregnancy C. Is not indicated for the treatment of pyelonephritis D. Is an antifungal
(The correct answer is C)
Select the information that is revealed by a gram stain. A. Minimum inhibitory concentration B. Genre and species of the bacteria C. Morphologic characteristics of the bacteria D. All of the above
(The correct answer is C)
Select the most appropriate duration of antimicrobial therapy in a patient with sepsis. A. 1 to 3 days B. 3 to 5 days C. 7 to 10 days D. 24 to 28 days
(The correct answer is C)
Select the pathogen(s) that is classified as an atypical organism. A. Escherichia coli B. Klebsiella pneumoniae C. Mycoplasma pneumoniae D. All of the above
(The correct answer is C)
Select the phrase that most accurately describes severe sepsis. A. Bacteremia with a high colony count B. Bacteremia with the systemic inflammatory response syndrome (SIRS) C. Bacteremia with the systemic inflammatory response syndrome (SIRS) and organ dysfunction D. Bacteremia with the systemic inflammatory response syndrome (SIRS), organ dysfunction, and immune failure
(The correct answer is C)
Select the statement that most accurately describes HIV. A. A DNA virus B. An RNA virus C. An RNA retrovirus D. A parasite
(The correct answer is C)
TC is a 19-year-old woman diagnosed with a UTI. She is allergic to sulfa drugs. What is an appropriate empiric regimen for her? A. Ciprofloxacin 250 mg po bid for 3 days B. Trimethoprim 100 mg po bid for 3 days C. Both regimens are appropriate D. Neither regimen is appropriate
(The correct answer is C)
TK is a 32-year-old HIV-positive patient. He does not want influenza to develop and would like to be vaccinated since he is immunocompromised. Select the appropriate vaccination for TK. A. LAIV B. Oseltamivir C. TIV D. Amantadine E. Immunocompromised patients should not be vaccinated
(The correct answer is C)
The fungal cell wall component (1, 3) beta-D-glucan is not a key structure in C. neoformans and therefore explains the poor activity of what class of antifungal agents for Cryptococcus? A. Triazoles B. Amphotericin B C. Echinocandins D. 5-Flucytosine E. None of the above
(The correct answer is C)
What is the goal blood glucose for patients with sepsis? A. 80 to 110 mg/dL B. <120 mg/dL C. <150 mg/dL D. <200 mg/dL
(The correct answer is C)
What is the most common gram-positive cause of a UTI? A. Staphylococcus aureus B. Staphylococcus epidermidis C. Staphylococcus saprophyticus D. Streptococcus pneumoniae
(The correct answer is C)
Which antifungal agent is only available as an oral formulation? A. Amphotericin B lipid-complex B. Voriconazole C. Posaconazole D. Anidulafungin E. None of the above
(The correct answer is C)
Which meningococcal vaccine would be suggested for outbreak control of A, C, Y, or W135? A. MCV4 B. MPSV4 C. Either MCV4 or MPSV4 can be used D. Neither MCV4 or MPSV4 are used for outbreak control
(The correct answer is C)
Which of the following groups has dexamethasone demonstrated a mortality benefit? A. A 2-week-old with group B Streptococcus meningitis B. A 17-year-old with N. meningitidisi> meningitis C. A 35-year-old with S. pneumoniae meningitis D. It has not demonstrated clear benefit for any type of bacterial meningitis
(The correct answer is C)
Which of the following is an appropriate test of monitoring ethambutol toxicity? A. Creatinine B. Foot examination C. Snellen visual chart examination D. Complete blood count E. Triglycerides
(The correct answer is C)
Which of the following is consistent with the recommended empiric antibiotic therapy for a 7-year-old with bacterial meningitis. A. Ceftriaxone B. Ceftriaxone and ampicillin C. Cefotaxime and vancomycin D. Ampicillin and gentamicin
(The correct answer is C)
Which of the following is not a counseling point on rifampin? A. This medication can cause your body secretions to be an orange-red color. B. This medication can decrease the effectiveness of your oral contraceptives. C. This medication can cause you to need a decrease in your warfarin dose. D. This medication may cause gastrointestinal upset. E. This medication can cause your phenytoin concentrations to go down.
(The correct answer is C)
Which of the following is not a second-line agent for treatment of active TB disease? A. Streptomycin B. Ciprofloxacin C. Amoxicillin D. Capreomycin E. Ethionamide
(The correct answer is C)
Which of the following is not a sign/symptom of pulmonary tuberculosis? A. Weight loss B. Productive cough C. Headache D. Fever E. Night sweats
(The correct answer is C)
Which of the following is true regarding genital herpes infection and pregnancy? A. The risk of herpes transmission is lowest in mothers who have the initial outbreak at the time of delivery. B. Acyclovir, famciclovir, and valacyclovir are classified in pregnancy category D. C. Use of antiviral therapy late in pregnancy decreases herpes transmission to the neonate. D. Herpes disease in the neonate commonly manifests as a scalp abscess or ophthalmic infection.
(The correct answer is C)
Which of the following is true regarding gonococcal urethritis and/or cervicitis? A. Women older than 25 years are at the highest risk of infection. B. Men are typically asymptomatic or have minor symptoms. C. Increased transmission of HIV infection is associated with gonococcal infection. D. Antibiotic susceptibility data can be obtained using nonculture diagnostic tests for gonorrhea.
(The correct answer is C)
Which of the following patients are not recommended to receive a vaccine against Streptococcus pneumoniae. A. Healthy infants B. A 40-year-old with chronic obstructive pulmonary disease (COPD) C. A healthy 55-year-old D. A 35-year-old asplenic patient
(The correct answer is C)
Which of the following represents an adverse effect associated with fluoroquinolone use? A. Permanent tooth darkening B. Neurologic toxicity C. Dysglycemia D. Jarisch-Herxheimer reaction
(The correct answer is C)
Which of the following vaccines is recommended to be given as part of routine child-care to otherwise healthy infants? A. MCV4 B. MPSV4 C. PCV13 D. PPSV23
(The correct answer is C)
Which one of the following adjunctive measures is used to lessen the occurrence of nephrotoxicity associated with amphotericin B? A. Test dose of amphotericin B B. Diphenhydramine premedication C. Normal saline boluses D. Furosemide E. All of the above
(The correct answer is C)
Which patient group should get drug-susceptibility testing? A. All latent tuberculosis patients B. Latent tuberculosis patients over age 35 C. All active tuberculosis disease patients D. Active tuberculosis patients over age 35 E. Foreign-born cases of latent and active tuberculosis
(The correct answer is C)
XJ is a 29-year-old woman who presents with severe sepsis including hypotension and decreased urine output. She has no significant past medical history. Select the appropriate initial regimen for early fluid resuscitation in XJ. A. 5% dextrose 500 mL B. 5% albumin 1000 mL C. 0.9% sodium chloride 1000 mL D. 0.45% sodium chloride 1000 mL
(The correct answer is C)
YQ is a 59-year-old man with a past medical history significant for chronic obstructive pulmonary disease, diabetes mellitus, hypertension, and hyperlipidemia. YQ wanted to receive influenza vaccination, but the United States has a short supply of TIV. YQ's physician recommended postexposure prophylaxis if he is exposed to influenza. If YQ is exposed to influenza, which agent should be used as postexposure prophylaxis? A. Amantadine B. Rimantadine C. Oseltamivir D. Zanamivir E. LAIV
(The correct answer is C)
A 55-year-old man is to be treated for invasive aspergillosis. He weighs 100 kg. What amphotericin B formulation dose(s) would be appropriate for this patient? A. Amphotericin B desoxycholate 80 mg B. Amphotericin B desoxycholate 400 mg C. Liposomal Amphotericin B 400 mg D. a and c E. None of the above
(The correct answer is D)
A 7-year-old patient with no significant past medical history presents to your hospital with fever, severe headache, photophobia, and neck pain. The physician does a lumbar puncture and sends the CSF collections to the laboratory. Based upon clinical diagnosis the patient is suspected to have bacterial meningitis. Which of the following are likely pathogens associated with bacterial meningitis in this patient? A. Streptococcus pneumoniae and H. influenzae B. Neisseria. meningitidis and L. monocytogenes C. Listeria monocytogenes and group B Streptococcus D. Streptococcus pneumoniae and N. meningitidis
(The correct answer is D)
A patient is to receive home infusion therapy with liposomal amphotericin B. What laboratory values should be monitored? A. Serum creatinine B. Serum potassium C. Serum magnesium D. All of the above
(The correct answer is D)
A patient presents to the hospital with a 2-week history of a mono-like illness. All of her laboratory tests are within normal limits or are negative including her ELISA. The patient reports being sexually active with multiple partners. The most appropriate course of action is: A. Inform her that she does not have HIV and discharge home B. Inform her that she does not have HIV, but counsel her on HIV and STD prevention C. Inform her that she will need to complete a follow-up ELISA in 1 month D. Inform her that she will need to complete a follow-up ELISA in 1 month, and counsel her on HIV and STD prevention
(The correct answer is D)
AF is a 19-year-old college student who is considering becoming sexually active. During her annual Pap smear she asks her gynecologist for information on STD and pregnancy prevention. Which of the following statements is true regarding STD prevention? A. Vaccines are currently available for chlamydia, gonorrhea, and syphilis. B. Diaphragm use is a reliable method of STD prevention. C. Hormonal contraception is effective in preventing pregnancy and STDs. D. Condom use reduces the acquisition and transmission of STDs.
(The correct answer is D)
Aminoglycoside antimicrobials may be dosed via conventional (1-2.5 mg/kg every 8-12 hours) or extended interval (4-7 mg/kg every 24, 36, or 48 hours) methods. Select the therapeutic drug monitoring parameter(s) associated with conventional dosing of aminoglycosides. A. Peak (Cmax) 8 to 10 mcg/mL for serious infections B. Trough (Cmin) less than 2 mg/L C. Random level (between 6-14 hours) of 5 mg/L D. a and b E. All of the above
(The correct answer is D)
Approximately what percent of uncomplicated UTIs are caused by Escherichia coli? A. <10 B. 25 C. 50 D. >70
(The correct answer is D)
BD is a 24-year-old man with no known drug allergies who was initially treated with vancomycin for his cellulitis. His abscess culture after appropriate incision/drainage revealed caMRSA. He has clinically improved enough to receive oral antibiotics. Which of the following is an appropriate step-down antibiotic for BD? A. Cephalexin B. Amoxicillin-clavulanate C. Ceftriaxone D. Trimethoprim-sulfamethoxazole
(The correct answer is D)
Central nervous system (CNS) side effects (seizures and mental status changes) are associated with beta lactam and quinolone anti-infectives. A risk factor for development of the central nervous system reactions is: A. Duration of therapy B. Infusion interval C. Bioavailability D. Renal dysfunction
(The correct answer is D)
GB is a 28-year-old woman with a chief complaint of dysuria. The physician orders a urinalysis and a urine culture. Pseudomonas aeruginosa is a nosocomial organism and causes <20% of UTIs. What is appropriate empiric therapy for GB? A. Cefdinir B. Linezolid C. Penicillin D. TMP-SMX
(The correct answer is D)
If a 7-year-old is determined to have S. pneumoniae meningitis, what chemoprophylaxis is suggested for close contacts? A. Ceftriaxone B. Rifampin C. Ciprofloxacin D. No chemoprophylaxis is indicated
(The correct answer is D)
If a neonate is begun on acyclovir for herpes simplex virus associated encephalitis, which of the following should be monitored? A. Serum creatinine B. Neutrophil count C. Urine output D. All should be routinely monitored
(The correct answer is D)
Influenza vaccination emphasis should be placed upon: A. Patients at high risk of complications B. Children 6 months to 18 years C. People more than 50 years of age D. All of the above
(The correct answer is D)
JG is a patient with an immediate allergic reaction to ticarcillin/clavulanate (Timentin). Select the antimicrobial that JG may take in relation to his allergy. A. Piperacillin/tazobactam B. Amoxicillin/clavulanate C. Ceftriaxone D. Aztreonam
(The correct answer is D)
LA is 30-year-old pregnant woman. She is 16 weeks pregnant and reports dysuria at her appointment today. Urinalysis and urine culture are conducted, and she is started on TMP-SMX 1 DS tablet po bid. Initial therapy for pregnant women should be 7 days, and a follow-up urine culture 1 to 2 weeks post therapy and then monthly until birth is recommended. Three days later the clinic calls LA to tell her the culture results are back and she needs to change therapy. The culture was positive for E. coli, and it is resistant to TMP-SMX. Initial therapy for pregnant women should be 7 days, and a follow-up urine culture 1 to 2 weeks post therapy and then monthly until birth is recommended. Nitrofurantoin is contraindicated in pregnant patients at term (38-42 weeks gestation) and during labor and delivery. LA is only 16 weeks pregnant; so she can take nitrofurantoin. Does LA need a follow-up culture? If so, when? A. No follow-up culture is needed B. Yes, in 2 days C. Yes, a day after the therapy is complete D. Yes, 7 to 14 days after the therapy is complete
(The correct answer is D)
LWS is a 28-year-old man returning home from a military tour of duty from overseas. LWS is an OEF (operation enduring freedom) veteran. He received LAIV 7 days ago. Today he presents with symptoms of influenza. Select the reason LWS could develop influenza symptoms, even if he received the appropriate vaccine. A. LAIV is a live virus and can cause influenza. B. LWS was not a candidate for influenza vaccination; therefore, he should not have received LAIV. C. LWS does not have influenza. He has the common cold. D. Influenza vaccines are not 100% effective.
(The correct answer is D)
NK is a 62-year-old man presenting to urgent care today with dysuria, increased urinating frequency, and flank pain. His past medical history includes hyperlipidemia and migraines. He is allergic to penicillin and sulfa drugs. What is the probable diagnosis? A. Benign prostatic hyperplasia (BPH) B. Cystitis C. Prostate cancer D. Pyelonephritis
(The correct answer is D)
PU is a 58-year-old patient diagnosed with cellulitis. It was determined that the most likely pathogens causing the infection were S. aureus and group A streptococci. PU has a history of chronic renal insufficiency and the provider would like to use an antibiotic that does not have to be adjusted for renal dysfunction. Select the antibiotic that is not required to be adjusted for renal function. A. Nafcillin B. Ertapenem C. Ceftriaxone D. a and c E. All of the above
(The correct answer is D)
Patients with chronic indwelling catheters usually have asymptomatic bacteriuria. What should be done if the patient becomes symptomatic? A. Remove the catheter B. Insert new, sterile catheter C. Start therapy D. All of the above
(The correct answer is D)
Prevention of pneumonia may be achieved by: A. Infection control/prevention measures B. Streptococcus pneumoniae vaccine C. Influenza vaccine D. All of the above
(The correct answer is D)
QW is a 35-year-old man with a diagnosis of acute bacterial sinusitis. QW has a penicillin allergy (delayed reaction?rash). Select the antibiotic that may be used to treat acute bacterial sinusitis in patients with a delayed hypersensitivity reaction to penicillin. A. Amoxicillin B. Trimethoprim-sulfamethoxazole C. Clarithromycin D. b and c E. All of the above
(The correct answer is D)
RL is a patient with a past medical history of iron deficiency anemia. He is being treated with ferrous sulfate. Select the antimicrobial(s) that would have a decreased bioavailability when combined with ferrous sulfate. A. Moxifloxacin B. Tetracycline C. Azithromycin D. a and b E. All of the above
(The correct answer is D)
Select the IV antimicrobial used in the empiric treatment of cellulitis that is active/stable against the penicillinase-producing strains of S. aureus and group A streptococci. A. Dicloxacillin B. Cephalexin C. Amoxicillin-clavulanate D. Cefazolin
(The correct answer is D)
Select the anti-infective that is associated with the adverse effects of nephrotoxicity and ototoxicity. A. Amoxicillin / Clavulanate B. Cefpodoxime C. Moxifloxacin D. Gentamicin
(The correct answer is D)
Select the anti-influenza agent that is formulated as a Rotadisk inhaler.$$$C. Rimantadine B. Amantadine C. Oseltamivir D. Zanamivir E. LAIV
(The correct answer is D)
Select the antibiotic that would have activity against caMRSA and haMRSA. A. Vancomycin B. Clindamycin C. Daptomycin D. a and c E. All of the above
(The correct answer is D)
Select the antibiotic to treat strep throat in a 4-year-old child with an immediate penicillin allergy. A. Trimethoprim-sulfamethoxazole B. Amoxicillin C. Cephalexin D. Clindamycin
(The correct answer is D)
Select the antibiotic with the following mechanism of action: binds to components of the cell membrane and causes rapid depolarization, inhibiting intracellular synthesis of DNA, RNA, and protein. A. Piperacillin-tazobactam B. Imipenem-cilastatin C. Clindamycin D. Daptomycin E. Vancomycin
(The correct answer is D)
Select the antimicrobial that a patient with a delayed allergic hypersensitivity reaction to ampicillin/sulbactam may receive. A. Ceftriaxone B. Moxifloxacin C. Piperacillin tazobactam D. a and b E. All of the above
(The correct answer is D)
Select the antimicrobial(s) that is associated with the side effect photosensitivity. A. Doxycycline B. Ciprofloxacin C. Cefepime D. a and b E. All of the above
(The correct answer is D)
Select the antimicrobials that are often associated with a Clostridium difficile infection. A. Ciprofloxacin B. Clindamycin C. Cefotaxime D. All of the above
(The correct answer is D)
Select the atypical pathogen(s) that is a common cause of community-acquired pneumonia (CAP). A. Mycoplasma pneumoniae B. Chlamydia pneumoniae C. Moraxella catarrhalis D. a and b E. All of the above
(The correct answer is D)
Select the best answer that represents part of the normal (endogenous) flora of the lower respiratory tract. A. Enterobacteriaceae B. Streptococcus pneumoniae C. Enterococcus species D. Normally sterile
(The correct answer is D)
Select the brand name of ceftazidime. A. Zyvox B. Rocephin C. Avelox D. Fortaz E. Vibramycin
(The correct answer is D)
Select the common side effect(s) for amoxicillin and amoxicillin-clavulanate. A. Nausea, vomiting, and diarrhea B. Rash C. Allergic reactions D. All of the above
(The correct answer is D)
Select the correct dose of cefepime (Maxipime) for a patient with normal renal function and empirically treated for an infection (at this time the site or source of infection have not been identified). A. 1 g IV every 12 hours B. 2 g IV every 12 hours C. 2 g IV every 8 hours D. All of the above
(The correct answer is D)
Select the factor that would usually necessitate a patient to be given IV anti-infectives. A. Fever of 101.9°F B. Severe cough C. Glucose-6-phosphate dehydrogenase (G6PD) deficiency D. Blood pressure of 91/52 mm Hg with signs of hypoperfusion (Baseline blood pressure for patient is 129/86 mm Hg)
(The correct answer is D)
Select the factor(s) that are involved in diabetic foot infections. A. Angiopathy B. Neuropathy C. Immunopathy D. All of the above
(The correct answer is D)
Select the factor(s) that may reduce the rate of diabetic foot infections. A. Periodic foot examinations B. Optimal glycemic control C. Smoking cessation D. All of the above
(The correct answer is D)
Select the following organism(s) that can cause a UTI. A. Bacteria B. Fungus C. Virus D. All of the above
(The correct answer is D)
Select the infection(s) that represents lower respiratory tract infections. A. Pneumonia B. Sinusitis C. Bronchitis D. a and c E. All of the above
(The correct answer is D)
Select the infectious disease state that requires excellent tissue penetration (distribution). A. Meningitis B. Acute cystitis C. Bronchitis D. a and b E. All of the above
(The correct answer is D)
Select the information that is reported by a gram stain. A. Presence of white blood cells or epithelial cells B. Morphologic characteristic of bacteria C. Genera and species of the bacteria D. a and b E. All of the above
(The correct answer is D)
Select the macrolide antibiotic(s) that has CYP-450 3A4 drug interactions. A. Biaxin B. Bactrim C. Pediazole D. a and c E. All of the above
(The correct answer is D)
Select the most appropriate regimen for glycemic control in a patient with sepsis. A. Metformin 1000 mg po bid B. Sitagliptin 100 mg po daily C. Insulin glargine 50 units qhs D. Insulin infusion
(The correct answer is D)
Select the most common causative organism(s) for the majority of SSTIs. A. Staphylococcus aureus B. Streptococcus pyogenes C. Pseudomonas aeruginosa D. a and b E. All of the above
(The correct answer is D)
Select the parameter(s) that should be monitored with daptomycin. A. CPK B. Muscle weakness C. Serum creatinine D. All of the above
(The correct answer is D)
Select the pathogen that represents an exogenous bacteria flora (ie, acquired from the hospital). Characteristics of this pathogen are nonlactose fermenting gram-negative bacilli. A. Neisseria meningitidis B. Enterobacter cloacae C. Streptococcus pneumoniae D. Pseudomonas aeruginosa
(The correct answer is D)
Select the penicillin antimicrobial that is combined with a beta-lactamase inhibitor. A. Zosyn B. Unasyn C. Augmentin D. All of the above
(The correct answer is D)
Select the phrase that most accurately describes sepsis. A. Presence of bacteria in the bloodstream B. Systemic inflammatory response to a physiologic insult C. Persistent hypotension and altered organ function D. Systemic inflammatory response due to an infection
(The correct answer is D)
Select the risk factor(s) for health care-associated pneumonia. A. Hospitalization for 2 days or more in the preceding 90 days B. Residence in nursing home or extended-care facility C. Home infusion therapy D. All of the above
(The correct answer is D)
Select the risk factor(s) for the acquisition of exogenous pathogens. A. Home health care utilization B. Pregnancy C. Recent antimicrobial use D. a and c E. All of the above
(The correct answer is D)
Select the statement that most accurately describes influenza. A. A bacterial illness caused by Haemophilus influenzae B. A viral illness caused by respiratory syncytial virus (RSV). C. A viral illness caused by rhinovirus. D. A viral illness caused by influenza A and B. E. A bacterial illness caused by Streptococcus pneumoniae.
(The correct answer is D)
Select the viral pathogen(s) that may cause upper respiratory tract infections. A. Haemophilus influenzae B. Influenza C. Adenovirus D. b and c E. All of the above
(The correct answer is D)
Short-course therapy (3 days) is appropriate for which patient group. A. Women with a history of UTIs caused by antibiotic-resistant bacteria B. Men C. Women with >7 days of symptoms D. Women with uncomplicated cystitis
(The correct answer is D)
TM is a 7-year-old patient with a diagnosis of strep throat. Select the bacterial pathogen that causes strep throat. A. Streptococcus pyogenes B. Group A Streptococcus C. Flesh-eating bacteria D. All of the above
(The correct answer is D)
TP is a 26-year-old woman who is 31 weeks pregnant. She visits her obstetrician-gynecologist because of a sore throat, generalized weakness, and a rash on her palms and soles for the past week. Testing is performed and a diagnosis of secondary syphilis is made. The treating physician requests pharmacist consultation because the patient is allergic to penicillin. Select the most appropriate therapy for TP. A. Doxycycline B. Cefoxitin + probenecid C. Levofloxacin D. Desensitization + benzathine penicillin G
(The correct answer is D)
TR is a 29-year-old pregnant patient with a diagnosis of cellulitis. Select the antibiotic that may be used to treat systemic infections in a pregnant patient. A. Imipenem-cilastatin B. Doxycycline C. Levofloxacin D. Cefazolin
(The correct answer is D)
The Jarisch-Herxheimer reaction is an acute febrile reaction associated with therapy for which STD? A. Genital herpes B. Gonorrhea C. Chlamydia D. Syphilis
(The correct answer is D)
The addition of which of the following drugs necessitates follow-up liver function tests in a patient being treated for latent TB infection treated with isoniazid? A. Naproxen B. Multivitamin C. Sertraline D. Acetaminophen E. Lisinopril
(The correct answer is D)
The best agent for prevention of influenza is: A. TIV B. LAIV C. Adamantanes D. a and b E. b and c
(The correct answer is D)
The presence of gram-negative diplococci on Gram stain is suggestive of which organism? A. Treponema pallidum B. Chlamydia trachomatis C. Herpes simplex virus-2 D. Neisseria gonorrhoeae
(The correct answer is D)
What is the brand name for TMP-SMX? A. Bactrim B. Macrobid C. Septra D. a and c
(The correct answer is D)
What is the brand name for hydrocortisone? A. Deltasone B. Sterapred C. Solu-Medrol D. Solu-Cortef
(The correct answer is D)
What is the primary mode of HIV acquisition globally? A. Contaminated blood and tissue products B. Casual contact with an HIV-infected person C. Homosexual contact D. Heterosexual contact
(The correct answer is D)
Which antibiotic is recommended for prophylaxis of recurrent UTIs? A. Amoxicillin/clavulanic acid B. Levofloxacin C. Moxifloxacin D. Nitrofurantoin
(The correct answer is D)
Which medication is typically not included in the first-line regimen for children with active TB disease? A. Isoniazid B. Rifampin C. Pyrazinamide D. Ethambutol
(The correct answer is D)
Which of one of the following organisms is most likely to manifest a positive India ink stain on a cerebral spinal fluid sample? A. Candida albicans B. Candida glabrata C. Aspergillus fumigatus D. Cryptococcus neoformans E. All of the above
(The correct answer is D)
Which of the following antifungal agents has been shown to cause visual acuity side effects? A. Amphotericin B B. Flucytosine C. Fluconazole D. Voriconazole E. Caspofungin
(The correct answer is D)
Which of the following can help reduce or prevent the morbidity and mortality associated with sepsis? A. Preventing organ failures B. Early goal-directed resuscitation C. Eliminating the infection source D. All of the above
(The correct answer is D)
Which of the following first-line TB drugs is recommended not to be given in pregnant patients? A. Isoniazid B. Rifampin C. Ethambutol D. Pyrazinamide
(The correct answer is D)
Which of the following is a reasonable duration of antimicrobial therapy for treating osteomyelitis? A. 1 week B. 2 weeks C. 3 weeks D. 6 weeks
(The correct answer is D)
Which of the following is a risk factor for stress-induced gastrointestinal bleeding? A. Mechanical ventilation B. Corticosteroid therapy C. Warfarin therapy D. All of the above
(The correct answer is D)
Which of the following is an absolute contraindication to therapy with drotrecogin alfa? A. Elevated endogenous levels of protein C B. Previous therapy with drotrecogin alfa C. High risk of death from sepsis D. Increased risk of bleeding
(The correct answer is D)
Which of the following is true regarding acid-fast bacteria? A. They cause the majority of bacterial infectious diseases in the United States. B. Mycobacterium tuberculosis is the only type of acid-fast bacteria. C. Cultures of acid-fast bacteria grow faster than other bacteria. D. They retain their stained color even with acid-alcohol washes.
(The correct answer is D)
Which of the following is true regarding the stages of syphilis infection? A. The characteristic lesion of primary syphilis is a diffuse rash, usually affecting the palms and soles. B. Manifestations of latent syphilis include regional lymphadenopathy and meningitis. C. Tertiary syphilis is highly transmissible. D. Neurosyphilis can present at any stage of syphilis.
(The correct answer is D)
Which of the following patient groups are considered to have complicated UTIs? A. Children B. Men C. Pregnant women D. All of the above
(The correct answer is D)
Which of the following patients should not receive the varicella vaccine? A. A 32-year-old with AIDS B. A 1-year-old with primary immunodeficiency C. A 25-year-old pregnant woman D. The vaccine is contraindicated in all of these patients
(The correct answer is D)
Which of the following patients would be at highest risk for developing hepatotoxicity secondary to nevirapine therapy? A. 31-year-old woman with a CD4+ count equal to 91 cells/mm3. B. 21-year-old man with CD4+ count equal to 270 cells/mm3. C. 50-year-old man with CD4+ count equal to 260 cells/mm3. D. 25-year-old woman with CD4+ count equal to 265 cells/mm3.
(The correct answer is D)
Which of the following treatment regimens would be considered appropriate in a treatment-naïve patient? A. Maraviroc + efavirenz + nevirapine B. Raltegravir + abacavir + indinavir + ritonavir C. Tenofovir + zidovudine + abacavir D. Lamviudine + zidovudine + lopinavir + ritonavir
(The correct answer is D)
Which one of the following antifungal agents is most associated with causing neutropenia and bone marrow suppression? A. Fluconazole B. Amphotericin B C. Voriconazole D. Flucytosine
(The correct answer is D)
Who should be screened for asymptomatic bacteriuria? A. College students B. Men C. Patients with indwelling catheters D. Pregnant women
(The correct answer is D)
YQ is a 6-year-old patient with a severe case of acute bacterial sinusitis. She has a type I (immediate) allergic reaction to penicillin. Select the antibiotic that may be utilized to treat the sinus infection. A. Doxycycline B. Moxifloxacin C. Clindamycin D. Clarithromycin
(The correct answer is D)
ZC is a 35-year-old woman. She does not have a significant past medical history and is currently taking a multivitamin and calcium supplementation. She has a 3-year-old child. Based upon the information provided, provide influenza vaccination recommendations. A. ZC is too young and influenza only affects the elderly and young children. Vaccination not recommended. B. ZC does not have comorbidities that place her at risk for influenza complications. Vaccination not recommended. C. ZC has a child that is at risk for influenza complications. Vaccination recommended for ZC. D. ZC has a child that is at risk for influenza complications. Vaccination recommended for ZC and her 3-year-old child.
(The correct answer is D)
A 54-year-old man with leukemia developed neutropenia 10 days ago after a chemotherapy course. His absolute neutrophil count (ANC) is 200, and he has been febrile for 7 days despite empiric bacterial therapy with imipenem and vancomycin. He was ordered amphotericin B 5 days ago. His CrCl has diminished to < 30 mL/min. Which one of the following antifungal agents would be the best option for a febrile neutropenic patient with renal insufficiency? The provider would like a broad-spectrum antifungal that covers yeasts and molds and an agent that does not affect the kidneys as much as conventional amphotericin B. A. Liposomal amphotericin B B. Fluconazole C. Caspofungin D. Posaconazole E. a and c
(The correct answer is E)
BCG vaccine should be routinely given to which patient in the United States? A. A 10-year-old child B. A 2-month-old infant C. A 65-year-old man D. A 6-month-old infant E. None of the above
(The correct answer is E)
Fluoroquinolones may prolong the QTc interval. Select the risk factor(s) for prolonged QTc interval. A. Uncorrected hypokalemia B. Concurrent administration of medications known to prolong QTc interval C. Uncorrected hypomagnesemia D. a and c E. All of the above
(The correct answer is E)
LF is 31-year-old man recently diagnosed with HIV. He presents to the HIV clinic for the first time and is eager to start treatment. What is your most appropriate course of action? A. Immediately begin therapy with a triple drug regimen B. Counsel the patient regarding HIV, transmission, prevention of transmission to others, answer his questions, and schedule another follow-up visit C. Obtain baseline labs and schedule another follow-up visit D. a and b only E. b and c only
(The correct answer is E)
NV is diagnosed with cellulitis. Pharmacologic treatment of cellulitis is with an antibiotic that is active against penicillinase-producing strains of S. aureus (MSSA). Select the penicillin that is active against penicillinase-producing strains of S. aureus. A. Cephalexin B. Amoxicillin C. Clindamycin D. Doxycycline E. Nafcillin
(The correct answer is E)
RS is a 25-year-old Hispanic woman who is recently diagnosed with active tuberculosis. Her physician asks what drug regimen you would recommend to treat her disease. She does not have any contraindications to any of the tuberculosis medications. You do not have susceptibility testing back yet. A. INH, RIF, PZA x 8 weeks, then INH, RIF x 18 weeks B. INH x 9 months C. INH, RIF x 9 months D. INH, RIF, EMB, FQ x 8 weeks, then INH, RIF x 18 weeks E. INH, RIF, EMB, PZA x 8 weeks, then INH, RIF x 18 weeks
(The correct answer is E)
Select the anti-infective(s) that is associated with the adverse reaction of antibiotic- associated diarrhea (C. difficile). A. Augmentin B. Levaquin C. Cleocin D. Vancocin E. a, b, and c
(The correct answer is E)
Select the antibiotic used in the treatment of upper respiratory tract infections in children less than 8 years of age that can cause photosensitivity. A. Doxycycline B. Levofloxacin C. Moxifloxacin D. All of the above E. None of the above
(The correct answer is E)
Select the antimicrobial pharmacokinetic (PK) property that impacts the dose and/or interval. A. Bioavailability B. Volume of distribution C. Metabolism D. Elimination E. All of the above
(The correct answer is E)
Select the antimicrobial that may be used to treat lower respiratory tract infections in pregnant patients. A. Clarithromycin B. Azithromycin C. Doxycycline D. Cefuroxime E. b and d
(The correct answer is E)
Select the antimicrobial that may cause collateral damage by selecting for a nontargeted organism (ie, Clostridium difficile) leading to a colitis infection. A. Clindamycin B. Levofloxacin C. Ciprofloxacin D. b and c E. All of the above
(The correct answer is E)
Select the antimicrobial utilized to treat SSTIs that may cause photosensitivity. A. Ciprofloxacin B. Doxycycline C. Levofloxacin D. a and c E. All of the above
(The correct answer is E)
Select the bacterial pathogen(s) that cause upper respiratory tract infections. A. Streptococcus pneumoniae B. Streptococcus pyogenes C. Haemophilus influenzae D. Moraxella catarrhalis E. All of the above
(The correct answer is E)
Select the bacterial resistance mechanism of action that may impact empiric therapy for acute otitis media. A. Altered penicillin-binding proteins B. Beta lactamase C. Penicillinase D. b and c E. All of the above
(The correct answer is E)
Select the beta-lactam antibiotic(s) that is (are) renally eliminated and require dose and/or interval modification in renal dysfunction. A. Keflex B. Ceftin C. Unasyn D. Zosyn E. All of the above
(The correct answer is E)
Select the cause(s) of lower respiratory tract infections. A. Bacteria B. Virus C. Streptococcus pneumoniae D. Respiratory syncytial virus E. All of the above
(The correct answer is E)
Select the classic signs and symptoms of influenza. A. Rapid onset of fever B. Myalgia C. Headache D. Nonproductive cough E. All of the above
(The correct answer is E)
Select the common cause of influenza. A. Influenza A B. Influenza B C. Haemophilus influenzae D. Streptococcus pneumoniae E. a and b
(The correct answer is E)
Select the drug interaction(s) with aminoglycosides. A. Amphotericin B B. Vancomycin C. Furosemide D. Cisplatin E. All of the above
(The correct answer is E)
Select the fluoroquinolone that inhibits the CYP-450 system. A. Doxycycline B. Levofloxacin C. Trimethoprim-sulfamethoxazole D. Nafcillin E. Ciprofloxacin
(The correct answer is E)
Select the following patient(s) that should receive influenza vaccination. A. Pregnant patients B. Children 18 to 24 months of age C. Diabetes D. A 65-year-old healthy man E. All of the above
(The correct answer is E)
Select the host factor(s) that may impact antimicrobial therapy. A. Age B. Pregnancy C. Metabolic abnormalities D. Organ dysfunction E. All of the above
(The correct answer is E)
Select the most common signs of symptoms of primary HIV infection in an adult patient. A. Mononucleosis-like illness (fever, sore-throat, fatigue, weight loss) B. GI upset (nausea, vomiting, diarrhea) C. Lymphadenopathy D. Night sweats E. All of the above
(The correct answer is E)
Select the multidrug resistant pathogen that may cause late-onset health care-associated pneumonia. A. Pseudomonas aeruginosa B. Extended-spectrum beta-lactamase (ESBL) Klebsiella pneumoniae C. Acinetobacter species D. Methicillin-resistant Staphylococcus aureus (MRSA) E. All of the above
(The correct answer is E)
Select the nonpharmacologic management option(s) for acute otitis media. A. Watchful waiting B. Tympanostomy tubes C. Adenoidectomy D. b and c E. All of the above
(The correct answer is E)
Select the oral anti-infective(s) that displays good bioavailability. A. Fluconazole B. Linezolid C. Levofloxacin D. Vancomycin E. a, b, and c
(The correct answer is E)
Select the parenteral cephalosporin that is often administered intramuscularly as a 3-day regimen for acute otitis media. A. Clarithromycin B. Amoxicillin-clavulanate C. Trimethoprim-sulfamethoxazole D. Clindamycin E. Ceftriaxone
(The correct answer is E)
Select the patient risk factor(s) for health care-associated MRSA (haMRSA). A. Prolonged hospitalization B. Nursing home residence C. Indwelling catheters D. Previous antimicrobial use E. All of the above
(The correct answer is E)
Select the penicillin antimicrobial that is broad-spectrum and has coverage against nonlactose negative (oxidase-positive) gram-negative bacilli. A. Amoxicillin B. Nafcillin C. Cefepime D. Doripenem E. Piperacillin/tazobactam
(The correct answer is E)
Select the pharmacologic management option(s) for acute otitis media in children. A. Antibiotics B. Acetaminophen C. Decongestants D. Aspirin E. a and b
(The correct answer is E)
Select the potential cause of a fever. A. Infection B. Piperacillin C. Trauma D. Cancer E. All of the above
(The correct answer is E)
Select the side effect(s) associated with fluoroquinolone antimicrobials. A. Hypoglycemia B. Clostridium difficile infection C. Confusion in the elderly D. QTc prolongation E. All of the above
(The correct answer is E)
Select the two surface antigens that categorize influenza A. A. Hemagglutinin B. Thimerosal C. Neuraminidase D. Guillain-Barre syndrome E. a and c
(The correct answer is E)
Select the upper respiratory tract infection(s) that may be caused by viruses such as respiratory syncytial virus, influenza virus, rhinovirus, and adenovirus. A. Otitis media B. Sinusitis C. Pharyngitis D. Rhinitis E. All of the above
(The correct answer is E)
What time period is the risk highest for conversion to active disease in those patients with latent tuberculosis infection? A. 10 years after exposure B. 8 years after exposure C. 6 years after exposure D. 4 years after exposure E. 2 years after exposure
(The correct answer is E)
Which of the following antiretrovirals is/are available in an injectable form? A. Zidovudine B. Etravirine C. Enfuvirtide D. Darunavir E. a and c
(The correct answer is E)
Which of the following antiretrovirals should be used with caution in patients with documented sulfa allergy? A. Fosamprenavir B. Tipranavir C. Darunavir D. a and b E. All of the above
(The correct answer is E)
Which of the following condition(s) would be a contraindication for receiving LAIV? A. Diabetes mellitus B. Development of Guillain-Barre syndrome (GBS) within 6 weeks of receiving previous influenza vaccine C. Egg allergy D. Recently received amantadine (within 48 hours) E. All of the above
(The correct answer is E)
Which of the following group or groups are at higher risk for hepatotoxicity related to their TB treatment regimens? A. Pregnant B. Postpartum C. Drinks 2 beers daily D. 65-year-olds E. All of the above
(The correct answer is E)
Which of the following organisms cause sepsis? A. Gram-positive bacteria B. Gram-negative bacteria C. Viruses D. a and b E. All of the above
(The correct answer is E)
