In the Air
Down Below
Under the Skin
Complications
Right Amount
100

What are common symptoms of pneumonia? (4/7)

Fever, dyspnea, cough, sputum production, tachypnea, pleuritic chest pain, malaise

100

What factors make a UTI complicated? (Name 3/6)

  • Fever, systemic symptoms (chills, rigors, fatigue, malaise), flank pain/CVA tenderness, pelvic/perineal pain in men, pregnancy, renal transplant
  • Any one factor makes it complicated. Suggests infection extends beyond the bladder or needs special considerations.
100

What 2 broad classifications do we use to categorize acute cellulitis to help with antibiotic selection?

Purulent and non-purulent

100

What is the name of a hypersensitivity reaction associated with vancomycin infusion rate?

Vancomycin infusion reaction (red man syndrome)

100

Name 3 common inpatient antibiotics that must be renally dosed.

  • Ancef, cefepime, Zosyn, vancomycin, meropenem, Augmentin/Unasyn, Bactrim, fluoroquinolones, aminoglycosides, daptomycin, Dalvance
  • Don’t need: Ceftriaxone, doxycycline, azithromycin, metronidazole, linezolid
200

What are the common causes of bacterial pneumoniae? (3 categories)

  • Gram-positive (S. pneumoniae, streptococci, Staph aureus)
  • Gram negative (H. influenzae, Moraxella catarrhalis, E. coli, Klebsiella)
  • Atypicals (Legionella, Mycoplasma, Chlamydia, Coxiella)
200

What are the 3 indications to treat asymptomatic bacteriuria?

  • Pregnancy, patients undergoing urologic intervention, early renal transplant (first 1-2 months)
  • Symptoms of UTI: Dysuria, urinary frequency/urgency, suprapubic pain, fevers, flank pain, CVA tenderness
200

Name 3 physical exam findings concerning for necrotizing soft tissue infection.

  • Crepitus, rapid progression of erythema, severe pain out of proportion to skin findings
  • Hemodynamic instability
200

What percent cross reactivity is there between penicillins and cephalosporins?

2-3%

200

What piperacillin-tazobactam (Zosyn) dosing is needed for pseudomonas coverage? (2.25, 3.375, 4.5, 5.625)

4.5 g

300

What is standard empiric antibiotic therapy for community acquired pneumonia? (Bonus points for dosage)

Ceftriaxone 1g q24h + azithromycin 500 mg 3-5 days

300

What antibiotic should be used for inpatient empiric UTI treatment in stable patients?

  • Ceftriaxone 1g daily
  • fluoroquinolone
300

What antimicrobial therapy coverage is needed for necrotizing fasciitis? (4)

Gram-positive, gram-negative, anaerobic, anti-toxin

300

What 2 antibiotic classes have an absolute contraindication to long QT syndrome?

  • Macrolide and fluoroquinolones
  • Oxazolidinones (Linezolid)
300

What are 3 indications for ceftriaxone 2g daily?

  • Bacteremia, Bite wound, bone infections (osteomyelitis, joint infections, odontogenic), SBP
  • 2g q12h for meningitis
400

What are major risk factors for MRSA and Pseudomonas? (list at least 2 for each)

  • MRSA – Known colonization, Prior MRSA infection, gram positive cocci on sputum gram stain, severe CAP (vasopressor, ventilator)
  • Pseudomonas – known colonization, prior infection, gram negative rods on sputum gram stain, hospitalization with IV antibiotics in past 3 months, severe CAP (vasopressor, ventilator)
400

Name 5 factors that make diverticulitis complicated.

  • Perforation, abscess, fistula, obstruction, hemodynamic instability
  • Complicated diverticulitis indicates the need for surgical intervention.
400

Why should antibiotic therapy be delayed if possible in osteomyelitis?

To obtain a bone biopsy with better yield.

400

What side effects should patients specifically be counseled on for doxycycline? (name 2)

Photosensitivity and pill esophagitis

400

What is special about ertapenem dosing compared to meropenem?

Once daily (remember that ertapenem does not have pseudomonas coverage)

500

What bacteria coverage is needed for empiric antibiotic treatment of empyema?

Anaerobic coverage

500

What is the correct empiric antibiotic regimen for uncomplicated diverticulitis? (3 possible answers)

  • Ceftriaxone + metronidazole
  • Fluoroquinolone + metronidazole
  • Piperacillin-tazobactam
500

ROLLING JEOPARDY

Name as many antibiotics that cover MRSA as you can. (18)

500

What major precautions should be taken before administering Bactrim? (Name 3/5)

  • Folate deficiency (inhibits dihydrofolate reductase), G6PD deficiency, sulfa allergy, hyperkalemia, pregnancy.
  • Nephrotoxicity and hepatotoxicity
500

Oral vancomycin comes in 125 mg tablets, what is the daily dosing for prophylactic and c. diff treatment dose?

  • Prophylactic dose, 125 mg once daily; continue for 5-7 days after completion of systemic antibiotics.
  • Treatment dose, 125 mg 4 times daily for 10 days.
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