Microbiology - GRS

Question 1

Most marked deficits in the elderly

Answer 1

Drying of skin and mucus membranes, low antibody production, low IL-2 and T cell

Question 2

Greatest impact on innate and host resistance is

Answer 2

comorbidity - presence of chronic disease

Question 3

Factors affecting immune function in elders

Answer 3

comorbidity, nutrition, medications, depression,

Question 4

Atypical presentation of a sick elderly

Answer 4

Fever, Chills and sweating can be absent during bacteremia and sepsis

Question 5

Fever definition in an elderly

Answer 5

Temp >2F over baseline
Oral Temp >99F
Rectal temp >99.5F

Question 6

Septic management in elderly

Answer 6

Adjunct therapy with activated Vitamin C for >75yrs

Question 7

Strongest predictor of mortality of pneumonia in elderly

Answer 7

Comorbidity

Question 8

Most predominant organism cause of pneumonia in elderly

Answer 8

Streptococcus pneumoniae

Question 9

H. influenza, Moraxella catarrhalis, Klesiella are more common in younger people or elderly

Answer 9

Elderly, especially those with COPD and in long term facilities

Question 10

Common causes of community acquired pneumoniae in nursing home patients

Answer 10

S. aureus and respiratory viruses

Question 11

First line therapy for elderly

Answer 11

beta-lactam/beta lactamases or cephalosporin

Question 12

Most effective drug therapy for S. pneumoniae or very sick elderly

Answer 12

Fluoroquinolones

Question 13

Elderly in MRSA region, the initial regimen of treatment should include

Answer 13

Vancomycin or linezolid

Question 14

Ways to reduce risk of pneumonia in elderly

Answer 14

Immunization, smoking cessation, treat cormobidities, and good infection control

Question 15

What age to vaccinate elderly with influenza

Answer 15

> 50yrs

Question 16

Most effective treatment of H. influenza in elderly

Answer 16

M2 inhibitors or neuraminidase inhibitor within 24 hours of onset

Question 17

Most common organism in UTI

Answer 17

G- just like younger adults

Question 18

What organism difference in elderly with UTI than younger adult

Answer 18

Pseudomonas, Entoerococcus, S. agalactiae, coagulase negative Staphy

Question 19

Mode of action for asymptomatic bacteruria

Answer 19

Nothing!!!!

Question 20

Older woman with dysuria, urgency and frequency changes. Diagnosis and Treatment

Answer 20

Lower UTI and Fluoroquinolones

Question 21

Older woman with fever, chills, nausea, flank pain. Diagnosis and treatment

Answer 21

Upper UTI and IV antibiotics

Question 22

Primary or Secondary contraction of TB in elderly

Answer 22

Most active cases are reactivation

Question 23

Difference in TB in younger and older person

Answer 23

Older more likely to have extrapulmonary disease

Question 24

Treatment of TB in elderly

Answer 24

Like young adults…..9 months of prophylactic therapy

Question 25

Organism causing septic arthritis and osteomyelitis in elderly

Answer 25

S. aureus

Question 26

HIV mode of infection in elderly

Answer 26

intercourse

Question 27

Difference in approach of HIV in elderly and youths

Answer 27

Just more awareness of CVD

Question 28

Most treatable infectious cause of dementia

Answer 28

HIV

Question 29

Drug of choice for bacterial meningitis

Answer 29

Ceftriaxone plus vancomycin

Question 30

Drug of choice for Listeria

Answer 30

Ampicillin

Question 31

Drug of choice for Pseudomonas

Answer 31

Ceftazidime

Question 32

Treatment of Neurosyphilis

Answer 32

Penicillin G

Question 33

Major risk factor for reactivated varicella zoster virus

Answer 33

Advancing age

Question 34

Most disabling complication of reactivated varicella zoster virus

Answer 34

Herpetic neuralgia - shocking pain

Question 35

Fever of unknown definition

Answer 35

Temp >38.3 for 3 weeks and undiagnosed after 1 week of medical evaluation

Question 36

What causes more fever of unknown origin in elderly than young adults

Answer 36

Collagen vascular disease