1. What is the best therapy for the treatment of bacterial meningitis?
    IV therapy at HIGH DOSE (bactericidal are preferred)
  2. True or false. Beta-lactams are the mainstay agent for the treatment of bacterial meningitis.
  3. Which anitbiotics are the most sufficient at penetrating the blood-brain-barrier and blood-CSF-barrier?
    • penicillin
    • 3rd/4th generation cephalosporins (Ceftriaxone (3rd gen), Cefepime (4th gen))
    • ampicillin
    • vancomycin
    • TMP/SMX (used for patients with beta-lactam allergies)
    • fluroquinolones
    • metronidazole
  4. A 3-day old infant has contracted bacterial meningitis. How should you treat this infant?

    D. ampicillin + gentamycin
  5. What are the 3 most common causative agents for bacterial meningitis in an infant that is less than 1 month old?
    • S. agalactiae (GBS)
    • E. coli
    • L. monocytogenes
  6. A 6-month old infant presents with a fever, irritability, poor feeding and a bulging fontanel. You suspect bacterial meningitis. What is your first-line of treatment?

    D. vancomycin + ceftriaxone
  7. What are the 3 most common causative agents for bacterial meningitis in persons 1 to 23 months of age?
    • S. pneumoniae
    • N. meningitidis
    • S. agalactiae (GBS)
  8. A 21-year old college student presents with a fever, stiff neck, mental status change and a petechial rash. He is later diagnosed with bacterial meningitis. What is the best drug treatment for this patient?

    B. dexamethasone + vancomycin + ceftriaxone
  9. What is the rationale behind giving a patient with bacterial meningitis a corticosteroid prior to the first antibiotic dose?
    decrease inflammation in subarachnoid space caused by immunological response to lysis of bacteria
  10. A 62-year old man has developed bacterial meningtitis. He has a fever, stiff neck, mental status change, but no rash, and he does not have a history of dementia or Alzheimer's disease. His wife tells you that he has a penicillin allergy. What is the best treatment for him?

    B. TMP/SMX
  11. In what age group is a bacterial meningitis infection caused by Listeria monocytogenes the most likely? What is the drug of choice to fight this infection?
    • <1 month old
    • >50 years old
    • ampicillin
  12. The use of _____ to treat bacterial meningitis in neonates should be avoided.
  13. What is the best drug treatment for prophylaxis of bacterial meningitis that is caused by N. meningitidis?

    B. ciprofloxacin in 1 dose
  14. An HIV-patient comes in your office and presents with a headache, fever, neck stiffness and photophobia. You suspect bacterial meningitis caused by Cryptococcus neoformans. How would you go about treating this patient?

    A. amphotericin B + flucytosine for 2 weeks then fluconazole for 8 weeks
  15. True or false. The vast majority of acute bronchitis infections are bacterial.
    False,  the vast majority of acute bronchitis infections are viral.
  16. What are the 3 best treatment options for Pertussis (Whooping cough)?
    • macrolides (azithromycin - "Z-pack")
    • tetracyclines (doxycycline)
    • TMP/SMX
  17. True or false. Influenza is easily treated with antivirals.
    False, antivirals have minimal efficacy. Vaccines are key.
  18. What are the 5 most common pathogens associated with COPD exacerbation?
    • S. pneumoniae
    • H. influenzae
    • M. cattarhalis
    • C. pneumoniae
    • M. pneumoniae
  19. A 52-year old woman comes into your office presenting with a mild case of COPD exacerbation most likely caused by S. pneumoniae. How would you treat her?

    A. amoxicillin
  20. A 16-year old boy comes into your office complaining of a high fever, purulent nasal discharge and facial pain that has persisted for more than 4 days. You suspect bacterial sinusitis. How would you treat him?

    C. amoxicillin/clavulanic acid
  21. "The Big 6" pathogens that are most commonly involved in community-acquired bacterial pneumonia are:
    • S. pneumoniae
    • H. influenzae
    • M. cattarhalis
    • M. pnuemoniae
    • C. pneumoniae
    • L. pneumophila
  22. How would you treat a community-acquired pneumonia out-patient who is previously healthy and has no risk for drug-resistance?
    macrolide (azithromycin)
  23. An immunosuppressed patient presents with community-acquired pneumonia that is caused by S. pneumoniae. They do not have any known drug allergies and are not resistant to any drugs. What is the best outpatient therapy for this patient?

    B. penicillin + azithromycin
  24. How would you treat a community-acquired pneumonia in-patient who is in the ICU with a concern for MRSA?
    ceftriaxone (IV) + macrolide (IV) + vancomycin (IV)
  25. How would you treat an outpatient with aspiration pneumonia?
    • clindamycin
    • amoxicillin/clavulanic acid
    • moxifloxacin
  26. How would you treat an inpateint with aspiration pneumonia?
    • ampicillin/sulbactam
    • clindamycin
    • moxifloaxin
  27. _____ (2 words) and _____ (2 words) are the main pathogens of concern for HAP/HCPP/VAP respiratory tract infections.
    • Pseudomonas aeruginosa
    • Staphylcoccus aureus
  28. Empiric therapy for HAP/HCPP/VAP respiratory tract infections is:
    antipseudomonal (4th gen cephalosporins, group 2 carbapenems) + antipseudomonal (fluroquinolones or aminoglycoside) + vancomycin (or linezolid)
  29. True or false. When treating HAP/HCPP/VAP respiratory tract infections, it is best to find the most narrow spectrum agent as possible.
  30. A patient in the hospital has contracted nosocomial pneumonia. The pathogen that is responsible is Stenotrophomonas maltophilia. What is the drug of choice to use in order to treat this patient?
  31. Cystic fibrosis patients have an extremely _____  (2 words) rate for antimicrobials. Because of this, we generally consider the ______ dose possible for treatment.
    high metabolic; maximal
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