9. GI infections-4 Flashcards
A 72 year old women has been in the hospital been treat for pneumonia for the past 2 weeks. She is currently taking ampicillin, Doxycycline, losartan,clindamycin and streptomycin. She has started feel nauseous and lose weight quickly. She has been producing 5 watery stools a day. Which of her medication has the greatest risk associated with her current symptoms?
A. Streptomycin B. Clindamycin C. Losartan D.Doxycline E. Ampicillin
RFA
Ans. B. Clindamycin- is associated with highest risk of C. Difficile infection
A. Streptomycin- is a aminoglycoside, low risk
C. Losartan- is an ARB used for HTN, no noted risk
D. Doxycycline- is tetracycline no noted risk
E. Ampicillin- is a penicillin which has moderate risk of C diff. infection
A 28 year man went into surgery to remove his appendix. Two days after surgerys he started to have watery diarrhea and low grade fever and abdominal cramps. CBC is done which find a gram negative anaerobic, non spore forming rod. You are tasked with treating this patient, which antibiotic would be ineffective in this patient?
A. Streptomycin B. Clindamycin C. Penicillin V D.Doxycycline E. Daptomycin
RFA
Ans. C Penicillin V- the infectious ogramisism is B fragilis which has B-lactases so can’t use a penicillin
B. fragilis- gram negative anaerobic, non spore forming rod
C. Difficile- gram positive, anaerobic, endospore former
A 40 year old female presents with fever and abdominal pain. Imaging reveals the presence of a large intra-abdominal mass. CBC shows elevated neutrophils. Bacteriology shows the presence of a gram negative, anaerobic, non-spore forming rod. What is the causative organism? (MG)
A. C. difficile B. Bacteroides fragilis C. Campylobacter D. Salmonella E. Shigella F. E. coli
B. Bacteroides fragilis
The intra-abdominal mass is an intra-abdominal abscess
A 67 year old male is hospitalized with an intra-abdominal abscess. He is taking clindamycin, ampicillin, and gentamycin. Subsequently, he develops frequent (3+ times per day) watery diarrhea. What exotoxin is produced by the causative organism? (MG)
A. ETEC B. EPEC C. O antigens D. TcdA E. ST F. LT
D. TcdA
TcdA and TcdB are toxins produced by C. difficile
