PNN - ID REVIEW QUESTIONS WITH 100%
CORRECT ANSWERS
Define: Minimum inhibitory concentration - correct answer -The minimum concentration of an antibiotic
that inhibits growth of an organism for 24 hours.
What is a broad spectrum antibiotic? Narrow spectrum? - correct answer -Broad = affects both GP and
GN organisms. Narrow spectrum = only GP or GN, not both.
What is the DOC for streptococcus? - correct answer -Penicillin family
What kind of bacteria is strep. Pygogenes? - correct answer -GP, coccus, common pathogen for "strep
throat" and cellulitis.
What is group B strep? - correct answer -Strep. Agalactiae. GP. Normal flora of the vagina - not an issue
for the patient, but can be for the baby. Common pathogen of neonatal infections.
How do we manage a Group B Strep (GBS) positive female patient who is giving birth? - correct answer -
a few weeks prior to delivery, swab to determine if patient is GBS positive or negative (whether she is
colonized by this bacteria: streptococcus agalactiae). If GBS(+), then 24 hours prior to delivery, we give
the mom IV ampicillin to prevent neonatal infections (neonatal meningitis/sepsis).
What is Pneumococcus? - correct answer -Streptococcus pneumoniae. GP organism. Again, DOC for
streptotoccus group is something from the penicillin family. This pathogen is the number 1 cause of
many infections above the diaphragm: otitis media, sinusitis, pneumonia, meningitis.
What is strep. Viridans? - correct answer -A bacterial part of the normal flora of the mouth/GI. We worry
about dental infections, and possible endocarditis in patients that are high risk.
What kind of infections are caused by enterococcus? - correct answer -Enterococcus is another GP
bacteria, found in the GI tract. Causes many infections, especially those that are nosocomial.
What kind of resistance do we see with enterococcus? - correct answer -VRE (vanco resistance)
What drugs can we use to treat VRE? - correct answer -daptomycin, synercid, linezolid, tigecycline.
What drugs do we use to treat MSSA? - correct answer -staphylococcus abx - dicloxacillin, nafcillin,
oxacillin.
What lab exam/test can we use to differentiate between GP organisms? - correct answer -if COAG-
positive, then its staphylococcus.
,What is the causative pathogen for impetigo? - correct answer -superficial skin infection, typically found
on children. Caused by staph. Aureus. Treatment: mupirocin ointment TID x 3-5 days, or retapamulin
(Altebax). If Severe, may need systemic antibiotics.
How do we eradicate MRSA colonized on a patient? - correct answer -use Bactroban nasal or hibiclens
soap; because MRSA lives in the nares. Typically only indicated for patients who have recurrent staph
infections.
What are the PO options for treating MRSA? - correct answer -Bactrim, Doxycycline, Clindamycin,
Linezolid, Rifampin (only as adjunct, never monotherapy).
What are the IV options for treating MRSA? - correct answer -Vanco, Daptomycin, Linezolid, Tigecycline,
Synercid, Clindamycin, Ceftaroline, Telavancin, Dalbavancin, Oritavancin.
What is cornebacterima diptheriae? - correct answer -GP rod. Forms a "pseudomembrane" over the
tonsils that is gray in color (unlike your typical white/yellow for strep). We do have a vaccine for this,
which is why it's not seen very often anymore (diphtheria).
How do we treat cornyebacterium diptheriae infection in patients? - correct answer -this bacteria
produces a toxin which damages tissue. Treatment requires anti-toxin + antibiotic = PCN or
erythromycin x 14 days.
How do we treat patients who have had contact with those infected with cornyebacterium diphtheriae?
- correct answer -they should get the vaccine if they haven't gotten it before; get the booster if they
have received the diphtheria vaccine. And then ABX (PCN IM x 1 dose or erythromycin for 7 days)
(instead of the 14 days required for treatment). This is prevention!
What is listeriosis? - correct answer -a foodborne illness - a GP rod. Causes GI issues, but can also
translocate to the blood causing sepsis and meningitis. Also a concern for newborns.
What are the common causes of neonatal meningitis? - correct answer -GBS (strep. Agalactiae), Listeria
monocytogenes, and e. coli.
How do we treat listeria? - correct answer -Ampicillin & Gentamicin.
What is bacillus anthracis? - correct answer -GP rod.
What are the 2 main bacteria in the GN cocci group? - correct answer -Neisseria and Moraxella
catarrhalis.
What is "meningococcus?" - correct answer -Neisseria - a gram negative cocci.
How do we treat meningitis? - correct answer -Start empiric treatment with Ceftriaxone + Vanco. Get
cultures (from a spinal tap/lumbar puncture). Once cultures show menigicoccus, de-escalate to penicillin
G or ampicillin (may continue ceftriaxone).
What is the treatment for Neisseria gonorrhea? - correct answer -Ceftriaxone 250 mg IM x 1 PLUS
azithro 1gm po x 1 (preferred) or doxycycline 100 mg po BID x 7 days.
, In treating Neisseria gonorrhea, how do we treat if a patient is allergic to PCNs? - correct answer -give
azithromycin 2gm.
What is Moraxella Catarrhalis? - correct answer -Normal flora of the respiratory tract. This is a GN cocci.
Common cause of otitis media and sinusitis.
What are the common causative pathogens for otitis media? - correct answer -strep pneumoniae
(Pneumococcus), H. Influenzae, Moraxella Catarrhalis
What is the most common cause of UTIs? - correct answer -E. coli
What are the antibiotics that have activity against pseudomonas? - correct answer -Pip/tazo,
ceftazidime, cefepime, carbapenems except ertapenem, ciprofloxacin and levofloxaxin, aztreonam.
What is the duration of treatment for pyelonephritis? - correct answer -10 days.
What is the duration of treatment for a simple UTI? - correct answer -3 days
What is the duration of treatment for acute cystitis? - correct answer -3-7 days
What is the treatment duration of prostatisis? - correct answer -28 days
Can avelox be used to treat a UTI? - correct answer -no. Avelox goes through the liver, it does not
concentrate in the urine - ineffective for UTIs.
What is the treatment regimen for H. Pylori? - correct answer -usually triple or quadruple therapy.
Traditional: amoxicillin 1000 mg BID, Clarithromycin 500 mg BI, + PPI once daily, for 14 days. If pt is
allergic to PCNs, give metronidazole 500 mg BID.
What is the treatment for meningitis due to haemophilus influenzae? - correct answer -Ceftriaxone. Can
also use cefotaxime and ampicillin as alternatives.
Which pathogens require treatment if patients don't have the infection, but have come into close
contact with other patients who have? - correct answer -(1) Cornyebacterium diphtheriae. (2) Neisseria
meningitidis (meningococcus), (3) haemphilus influenzae
What is the post-exposure prophgylaxis we give to patients with close contacts to h. influenzae? -
correct answer -Rifampin 600 mg daily x 4 days, or cipro 500 mg single dose, or ceftriaxone IM x 1 dose.
What infection does pertussis cause? - correct answer -Whooping cough.
What is the drug of choice for whooping cough? - correct answer -Macrolides. This does not reduce
duration of symptoms (which can last 3 months) but reduces the chance of transmission.
What is the DOC of bacteroides fragilis? - correct answer -metronidazole. This organism is a gram
negative rod, ANAEROBE. Commonly causes intra-abdominal infections.
CORRECT ANSWERS
Define: Minimum inhibitory concentration - correct answer -The minimum concentration of an antibiotic
that inhibits growth of an organism for 24 hours.
What is a broad spectrum antibiotic? Narrow spectrum? - correct answer -Broad = affects both GP and
GN organisms. Narrow spectrum = only GP or GN, not both.
What is the DOC for streptococcus? - correct answer -Penicillin family
What kind of bacteria is strep. Pygogenes? - correct answer -GP, coccus, common pathogen for "strep
throat" and cellulitis.
What is group B strep? - correct answer -Strep. Agalactiae. GP. Normal flora of the vagina - not an issue
for the patient, but can be for the baby. Common pathogen of neonatal infections.
How do we manage a Group B Strep (GBS) positive female patient who is giving birth? - correct answer -
a few weeks prior to delivery, swab to determine if patient is GBS positive or negative (whether she is
colonized by this bacteria: streptococcus agalactiae). If GBS(+), then 24 hours prior to delivery, we give
the mom IV ampicillin to prevent neonatal infections (neonatal meningitis/sepsis).
What is Pneumococcus? - correct answer -Streptococcus pneumoniae. GP organism. Again, DOC for
streptotoccus group is something from the penicillin family. This pathogen is the number 1 cause of
many infections above the diaphragm: otitis media, sinusitis, pneumonia, meningitis.
What is strep. Viridans? - correct answer -A bacterial part of the normal flora of the mouth/GI. We worry
about dental infections, and possible endocarditis in patients that are high risk.
What kind of infections are caused by enterococcus? - correct answer -Enterococcus is another GP
bacteria, found in the GI tract. Causes many infections, especially those that are nosocomial.
What kind of resistance do we see with enterococcus? - correct answer -VRE (vanco resistance)
What drugs can we use to treat VRE? - correct answer -daptomycin, synercid, linezolid, tigecycline.
What drugs do we use to treat MSSA? - correct answer -staphylococcus abx - dicloxacillin, nafcillin,
oxacillin.
What lab exam/test can we use to differentiate between GP organisms? - correct answer -if COAG-
positive, then its staphylococcus.
,What is the causative pathogen for impetigo? - correct answer -superficial skin infection, typically found
on children. Caused by staph. Aureus. Treatment: mupirocin ointment TID x 3-5 days, or retapamulin
(Altebax). If Severe, may need systemic antibiotics.
How do we eradicate MRSA colonized on a patient? - correct answer -use Bactroban nasal or hibiclens
soap; because MRSA lives in the nares. Typically only indicated for patients who have recurrent staph
infections.
What are the PO options for treating MRSA? - correct answer -Bactrim, Doxycycline, Clindamycin,
Linezolid, Rifampin (only as adjunct, never monotherapy).
What are the IV options for treating MRSA? - correct answer -Vanco, Daptomycin, Linezolid, Tigecycline,
Synercid, Clindamycin, Ceftaroline, Telavancin, Dalbavancin, Oritavancin.
What is cornebacterima diptheriae? - correct answer -GP rod. Forms a "pseudomembrane" over the
tonsils that is gray in color (unlike your typical white/yellow for strep). We do have a vaccine for this,
which is why it's not seen very often anymore (diphtheria).
How do we treat cornyebacterium diptheriae infection in patients? - correct answer -this bacteria
produces a toxin which damages tissue. Treatment requires anti-toxin + antibiotic = PCN or
erythromycin x 14 days.
How do we treat patients who have had contact with those infected with cornyebacterium diphtheriae?
- correct answer -they should get the vaccine if they haven't gotten it before; get the booster if they
have received the diphtheria vaccine. And then ABX (PCN IM x 1 dose or erythromycin for 7 days)
(instead of the 14 days required for treatment). This is prevention!
What is listeriosis? - correct answer -a foodborne illness - a GP rod. Causes GI issues, but can also
translocate to the blood causing sepsis and meningitis. Also a concern for newborns.
What are the common causes of neonatal meningitis? - correct answer -GBS (strep. Agalactiae), Listeria
monocytogenes, and e. coli.
How do we treat listeria? - correct answer -Ampicillin & Gentamicin.
What is bacillus anthracis? - correct answer -GP rod.
What are the 2 main bacteria in the GN cocci group? - correct answer -Neisseria and Moraxella
catarrhalis.
What is "meningococcus?" - correct answer -Neisseria - a gram negative cocci.
How do we treat meningitis? - correct answer -Start empiric treatment with Ceftriaxone + Vanco. Get
cultures (from a spinal tap/lumbar puncture). Once cultures show menigicoccus, de-escalate to penicillin
G or ampicillin (may continue ceftriaxone).
What is the treatment for Neisseria gonorrhea? - correct answer -Ceftriaxone 250 mg IM x 1 PLUS
azithro 1gm po x 1 (preferred) or doxycycline 100 mg po BID x 7 days.
, In treating Neisseria gonorrhea, how do we treat if a patient is allergic to PCNs? - correct answer -give
azithromycin 2gm.
What is Moraxella Catarrhalis? - correct answer -Normal flora of the respiratory tract. This is a GN cocci.
Common cause of otitis media and sinusitis.
What are the common causative pathogens for otitis media? - correct answer -strep pneumoniae
(Pneumococcus), H. Influenzae, Moraxella Catarrhalis
What is the most common cause of UTIs? - correct answer -E. coli
What are the antibiotics that have activity against pseudomonas? - correct answer -Pip/tazo,
ceftazidime, cefepime, carbapenems except ertapenem, ciprofloxacin and levofloxaxin, aztreonam.
What is the duration of treatment for pyelonephritis? - correct answer -10 days.
What is the duration of treatment for a simple UTI? - correct answer -3 days
What is the duration of treatment for acute cystitis? - correct answer -3-7 days
What is the treatment duration of prostatisis? - correct answer -28 days
Can avelox be used to treat a UTI? - correct answer -no. Avelox goes through the liver, it does not
concentrate in the urine - ineffective for UTIs.
What is the treatment regimen for H. Pylori? - correct answer -usually triple or quadruple therapy.
Traditional: amoxicillin 1000 mg BID, Clarithromycin 500 mg BI, + PPI once daily, for 14 days. If pt is
allergic to PCNs, give metronidazole 500 mg BID.
What is the treatment for meningitis due to haemophilus influenzae? - correct answer -Ceftriaxone. Can
also use cefotaxime and ampicillin as alternatives.
Which pathogens require treatment if patients don't have the infection, but have come into close
contact with other patients who have? - correct answer -(1) Cornyebacterium diphtheriae. (2) Neisseria
meningitidis (meningococcus), (3) haemphilus influenzae
What is the post-exposure prophgylaxis we give to patients with close contacts to h. influenzae? -
correct answer -Rifampin 600 mg daily x 4 days, or cipro 500 mg single dose, or ceftriaxone IM x 1 dose.
What infection does pertussis cause? - correct answer -Whooping cough.
What is the drug of choice for whooping cough? - correct answer -Macrolides. This does not reduce
duration of symptoms (which can last 3 months) but reduces the chance of transmission.
What is the DOC of bacteroides fragilis? - correct answer -metronidazole. This organism is a gram
negative rod, ANAEROBE. Commonly causes intra-abdominal infections.
