Question 1

A 12-month-old child is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to:

Accepted Answer

Antibiotics like amoxicillin can disrupt the normal gut flora, leading to diarrhea. Recommending probiotics can help restore the balance of gut bacteria and is a common approach to managing antibiotic-associated diarrhea in children.

Question 2

A 25-year-old female is eight weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her?

Accepted Answer

Amoxicillin is considered safe for use during pregnancy for the treatment of urinary tract infections. Ciprofloxacin, Doxycycline, and Trimethoprim-sulfamethoxazole are generally avoided during pregnancy due to potential risks to the fetus.

Question 3

A16-year-old female who is taking minocycline for acne comes to the clinic complaining of a headache. What would be the appropriate care?

Accepted Answer

Minocycline, an antibiotic often used for acne, can cause pseudotumor cerebri (also known as idiopathic intracranial hypertension), which presents with symptoms like headache. It's important to evaluate patients on minocycline who complain of headaches for this condition.

Question 4

Fluoroquinolones have a black box warning regarding ________ even months after treatment.

Accepted Answer

Fluoroquinolones have a black box warning for an increased risk of tendon rupture, which can occur during or even months after treatment has ended. This risk is particularly noted with the Achilles tendon but can involve other tendons as well.

Question 5

A 13-year-old child comes to the clinic with a four-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate treatment would be:

Accepted Answer

The symptoms described (cough, low-grade fever, rhinorrhea, and greenish-yellow mucous) are indicative of a viral upper respiratory infection (URI), which is common in children. Antibiotics are not recommended for viral infections because they are ineffective against viruses and their unnecessary use can contribute to antibiotic resistance. The appropriate treatment is symptomatic care, which includes rest, hydration, and over-the-counter remedies to relieve symptoms.

Question 6

Tetracyclines should not be prescribed to children younger than 8 years due to:

Accepted Answer

Tetracyclines can bind to calcium in developing bones and teeth, leading to discoloration and potential inhibition of bone growth in children under 8 years old.

Question 7

To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed:

Accepted Answer

Pyridoxine (vitamin B6) is prescribed to prevent peripheral neuropathy in patients taking isoniazid for tuberculosis, as isoniazid can cause a deficiency in vitamin B6.

Question 8

An adult female has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Education would include:

Accepted Answer

Doxycycline can potentially reduce the effectiveness of oral contraceptives, so using a backup method like condoms is recommended until her next menstrual cycle.

Question 9

A patient with chronic hepatitis that has led to mildly impaired liver function has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction?

Accepted Answer

The answer of A patient with chronic hepatitis that has...

Question 10

Providers should use an antibiogram when prescribing. An antibiogram is:

Accepted Answer

An antibiogram is a summary of the antibiotic susceptibilities of local bacterial isolates submitted to the laboratory for testing. It helps healthcare providers select the most effective antibiotics for treating infections based on local resistance patterns, ensuring more targeted and effective treatment.

Question 11

To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of:

Accepted Answer

Fluoroquinolones are broad-spectrum antibiotics that should be reserved for more serious bacterial infections to minimize the development of resistance. Community-acquired pneumonia in patients with comorbidities is a condition where the use of fluoroquinolones is often justified due to the severity of the illness and the potential for complications, making it a more appropriate choice compared to the other options listed.

Question 12

Infants and young children are at higher risk of developing antibiotic-resistant infections due to:

Accepted Answer

Young children are often in group settings like daycare, where they are exposed to various pathogens, increasing the risk of infections and subsequent antibiotic use, which can contribute to resistance.

Question 13

If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to:

Accepted Answer

Loop diuretics, sulfonylureas, and thiazide diuretics all contain a sulfonamide moiety, which can potentially cause cross-sensitivity reactions in patients allergic to sulfonamide antibiotics.

Question 14

A patient had a small ventricle septal defect (VSD) repaired when they were three years old and has no residual cardiac problems. They are now 28 and are requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and American Heart Association guidelines is:

Accepted Answer

Patients with a repaired ventricular septal defect (VSD) that have no residual cardiac problems beyond six months after the procedure do not require prophylactic antibiotics for dental procedures according to current guidelines from the American College of Cardiology and the American Heart Association.

Question 15

Factors that place a patient at risk of developing an antimicrobial-resistant organism include:

Accepted Answer

Inappropriate use of antimicrobials, such as unnecessary prescriptions or not completing the prescribed course, can lead to the development of antimicrobial-resistant organisms by giving bacteria the opportunity to adapt and survive exposure to these drugs.

Question 16

A child has been diagnosed with strep throat and needs a prescription for an antibiotic. The parent says the last time they had penicillin they developed a pink, blotchy rash five or six days after starting the antibiotic. An appropriate antibiotic to prescribe would be:

Accepted Answer

The answer of A child has been diagnosed with strep...

Question 17

A patient who was recently treated with clindamycin for an infection calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her?

Accepted Answer

Clindamycin can disrupt the normal gut flora, leading to an overgrowth of Clostridium difficile, which causes pseudomembranous colitis, a serious condition that can present with frequent, bloody diarrhea. This patient's symptoms warrant assessment for this condition.

Question 18

A patient with glucose-6-phosphate dehydrogenase deficiency (G6PD) requires an antibiotic. Which class of antibiotics should be avoided in this patient?

Accepted Answer

Sulfonamides should be avoided in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency because they can cause oxidative stress, leading to hemolysis in these patients.

Question 19

Tetracyclines such as minocycline are safe to use in:

Accepted Answer

Tetracyclines, including minocycline, are generally considered safe for use in adolescents. However, they are not recommended for pregnant women due to the risk of affecting fetal bone growth and tooth coloration, nor are they recommended for patients with severe renal or hepatic dysfunction due to the risk of accumulation and potential toxicity.

Quiz 23: Drugs Used to Treat Bacterial Infections