UWorld Quiz Module #1 Infectious Disease I

KM is a 38-year-old female who comes to the pharmacy with the following new prescription.

Why is it important for KM to complete the full prescribed course of therapy?

To ensure complete bacterial eradication

To limit development of resistant bacterial subpopulations

A 36-year-old female is being treated with Zosyn for a diabetic foot infection. Her home medications, which consist of dapagliflozin, valproic acid, levetiracetam, ergocalciferol, calcium citrate, and folate, have been resumed. Over the past 48 hours, the patient has remained aferbrile and leukocytosis has resolved. Her comprehensive metabolic panel remains normal, and a urine hCG test is negative. An MRI reveals no evidence of osteomyelitis, and a deep tissue culture shows methicillin-susceptible Staphylococcus aureus and pan-susceptible Enterococcus faecalis. The provider discontinues Zosyn and arranges for discharge with a prescription for cephalexin. For which of the following reasons should the pharmacist contact the prescriber to clarify the new discharge medication?

Inappropriate spectrum of activity

A 25-year-old male was admitted to the ICU following a motor vehicle collision. He was intubated and received mechanical ventilation shortly after admission, and he continues to require pulmonary support. On hospital day 7, he develops a fever, increased purulent tracheal secretions, and worsening oxygenation. The patient is diagnosed with VAP, and the care team plans to initiate empiric antibiotic therapy with a beta-lactam. Which of the following antibiotics fit this description?

Cefepime

Meropenem

Zosyn

JP is a 46-year-old male hospitalized for endocarditis caused by viridans group streptococci. The patient will be receiving two weeks of high dose penicillin G potassium and gentamicin. Which of the following are appropriate to monitor for potential toxicity due to gentamicin?

Audiometric testing

Creatinine

Urine output

A 5-day-old neonate is being evaluated for a suspected bacterial infection following signs of fever and poor feeding. The patient has no known drug allergies. Which of the following should be avoided?

Cefrtriaxone

Which of the following antimicrobials has activity against methicillin-resistant Staphylococcus aureus?

Teflaro

FM is a 63-year-old male with a history of severe arthritis who is visting the orthopedic clinic with a swollen, painful knee joint. The physician performs needle aspiration, and a Gram stain of the synovial fluid reveals gram-positive cocci in chains, with final culture results pending. The patient has no known drug allergies. Which antibiotic is appropriate to initate based on the Gram stain findings?

Penicillin G aqueous

TK is a 68-year-old male who was initiated on empiric therapy with polymyxin B and Zosyn for suspected gram- bacteremia. Which of the following are potential adverse effects associated with polymyxin B?

Nephrotoxicity

Peripheral neuropathy

Each dose of SMX/TMP will be prepared with 500 mL of D5W. How many milliliters of SMX/TMP 80 mg/16 mg per mL are needed to prepare all the doses for the day?

60

LJ is a 43-year-old male with a history of HIV who visits the clinic with chills, a productive cough, chest pain and fatigue. The provider initiates therapy with Bactrim.. Which of the following organisms are susceptibile to this antibiotic?

MRSA

Pneumocystis jirovecii

Stenotrophomonas maltophilia

Based on the Gram stain findings, which treatment modification can be recommended?

Discontinue cefepime

A physician orders linezolid for a patient hospitalized with an empyema. Which bacteria is generally susceptible to this antibiotic?

VRE

PL is a 41-year-old male who comes to the pharmacy with the following new prescription.

Which of the following counseling points should be discussed with the patient regarding this medication?

Monitor for skin changes such as redness or hives.

Protect your skin from sunlight.

Take with a full glass of water.

Based on the culutre and susceptibility report, which antibiotic is the most appropriate for consolidating therpay?

Nafcillin

During order entry for azithromycin, a clinical decision support alert related to which adverse effect is most likely to be triggered?

QT prolongation

HW is a 30-year-old female who underwent an emergency cesarean section 14 days ago. Today, she comes to the emergency department with purulent, foul-smelling drainage from her surgical incision site and is having difficulty ambulating due to pain. A 25 mg/kg loading dose of IV vancomycin is ordered for the patient. What is the minimum duration that vancomycin should be infused in minutes?

120

MK is a 58-year-old female who is currently hospitalized for pyelonephritis and is receiving meropenem as treatment. Her culture and susceptibility results have returned and identify E.coli that has the following susceptibility profile:

MK is improving on current therapy, and the provider would like to continue treatment with meropenem. Which of the following are possible outcomes of continuing meropenem in this patient?

Development of resistant bacterial strains

Disruption of the gut microbiome

Increased risk of C.diff

Ertapenem

Change frequency to Q12H

Which of the following are characteristics typically associated with lipohilic antibiotics?

Extensively metabolize