AND DETAILED QUESTIONS (ALREADY APPROVED) GRADE A+
What is the recommended antibiotic therapy for previously healthy patients with no risk
factors for drug-resistant S. pneumonia infection that have community acquired
pneumonia (CAP)?
Macrolide (Azithromycin, clarithomycin, or erythromycin) OR Doxycycline
What is the recommended antibiotic therapy for patients with chronic comorbidites, such
as chronic disease of heart, liver, lungs, or kidneys; diabetes, alcoholism, malignancies,
immunospression, antimicrobial use within the last 3 months that have community
acquired pneumonia?
Respiratory fluoroquinolone (moxifloxacin, gemifloxacin or levofloxacin {750 mg}) OR beta
lactam plus macrolide (preferably high-dose amoxicillin (1 to 3 times daily) or amoxicillin-
clavulanate (2 tabs twice daily). Alternatives include ceftriaxone, cefpodoxime, and cefuroxime
(500 mg, twice daily); with doxycycline as an alternative to the macrolide)
What is the recommended antibiotic therapy for suspected pseudomonas aeruginosa
infection?
Antipneumococcal antipseudomonoal beta lactam (pipercillin-tazobactam, cefepime,
meropenem, or imipenem-cilastatin) plus either ciprofloxacin or levofloxacin (750 mg dose) OR
Antipneumococal antipseudomonoal beta-lactam plus an amino glycoside and azithromycin OR
Antipneumonoccal antipseudomonal beta-lactam plus an amino glycoside and an
antipneumococcal fluoroquinolone.
Aztreonam plus an amino glycoside and an antipneumococcal fluoroquinolone for patients
allergic to penicillin
What is the recommended antibiotic therapy for suspected community acquired MRSA
infection with community acquired pneumonia?
Addition of vancomycin or linezolid
When should you obtain a chest X ray on COPD patient?
During a COPD exacerbation when attempting to rule out a concomitant pneumonia.
What Pathogen is most commonly seen in COPD caused by bacteria?
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
What is the preferred meds for Persistent asthma treatment?
Low dose ICS; Low dose ICS plus LABA, or Medium dose ICS; Medium dose ICS plus LABA.
What are examples of inhaled corticosteroids?
Fluticasone (Flovent HFA)
Budesonide (Pulmicort)
Mometasone (Asmanex Twisthaler)
Beclomethasone (Qvar)
Ciclesonide (Alvesco)
Flunisolide (Aerospan HFA)
What are examples of long acting beta agonists?
Advair, Dulera, and Symbicort (a combination of a long-acting beta-agonist bronchodilator and
an inhaled steroid) Serevent (salmeterol) Foradil (formoterol) Perforomist (formoterol solution
for nebulizers)
What are x-ray findings of acute asthma attack?
, Hyperinflation, focal atelectasis, and bronchial thickening are clinical findings on chest X-ray of
exacerbated asthma.
How is asthma managed without medication?
Peak flow monitoring
Avoidance of asthma triggers
Extensive, ongoing asthma education for the patient and family regarding disease, treatment,
avoidance of triggers, asthma managed plan, and emergency actions. Use of an asthma action
plan can reduce the number of ED visits as well as hospitalizations.
What screening is appropriate for diabetic neuropathy?
Urinalysis for urine protein and a Blod test to check for GFR (kidney function).
The most appropriate screen for diabetic nephropathy is?
Microalbuminuria
a 26 y/o pt with long hx of chronic sinusitis presents today with temperature of 103.2F,
headache, and stiff neck. Which finding below should make the NP suspect meningitis?
A positive Kernig's and Brudzinski's sign
What two tests demonstrate nuchal ridgidity?
Kernig's and Brudzinski's sign
Kernig's sign refers to the what?
inability to allow full extension of the knee when the hip is flexed 90 degrees
Brudzinski's sign refers to the
spontaneous flexion of the hips during attempted passive flexion of the neck
A pt is examined and found to have a positive Kernig's and Brudzinski's signs. What is the
most likely dx?
meningitis
What symptoms point to acute meningitis rather than encephalitis?
Photophobia and severe headache may point to
Chronic subacute meningitis are usually caused by what?
m. tuberculosis
atypical mycobacteria
fungi
spirochetes
SYMPTOMS develop over months; less acutely ill
Which type of meningitis has a slower development of symptoms after exposure, usually
caused bym. tuberculosis, atypical mycobacteria, fungi, or spirochetes?
Chronic meningitis
What is the leading cause of death after stroke?
Pneumonia
What class of medications can be used to tx benign prostatic hyperplasia and provide
immediate relief?
Alpha-1-blockers
An elderly male has benign prostatic hyperplasia (BPH). what drug should be avoided in
him?
Hydrochlorothiazide (HCTZ)
A 73 y/o pt is thought to have benign prostatic hyperplasia. what would be part of the
initial workup?
DRE (digital rectal exam), urinalysis, PSA