1. More Antibiotics Tutoring
Alaina Darby

2. UTI

3. HF is a 22 YO WF with no symptoms, but whose initial urine cultures come back with 110,000 CFUs. How should she be diagnosed?
Complicated UTI
Uncomplicated UTI
Bacteriuria only
She can’t be diagnosed yet D

4. HF is a 22 YO WF with no symptoms with urine cultures come back with 110,000 CFUs on each. How should she be diagnosed?
Complicated UTI
Uncomplicated UTI
Bacteriuria only
She can’t be diagnosed yet C

5. HF is a 22 YO WF with no symptoms with urine cultures come back with 110,000 CFUs on each. She is diagnosed with asymptomatic bacteriuria. When would a regimen of Augmentin be an appropriate treatment?
Catheterized
Recurrent UTI
Pregnancy
Asymptomatic bacteriuria is never treated C

6. HF is a 22 YO WF with hematuria and whose initial urine cultures come back with 50 CFUs. How should she be diagnosed?
Complicated UTI
Uncomplicated UTI
Bacteriuria only
She can’t be diagnosed yet D

7. HF is a 22 YO WF with painful urination and increased frequency and whose initial urine cultures come back with 1,100 CFUs. How should she be diagnosed?
Complicated UTI
Uncomplicated UTI
Bacteriuria only
She can’t be diagnosed yet B

8. JR is a 55 YO AAF with no structural abnormalities and symptoms of dysuria and urgency. Urinalysis: neg for WBC casts, positive for nitrites, and cloudy. How should she be diagnosed?
Complicated, most likely E. coli
Uncomplicated, most likely E. coli
Complicated, most likely S. saprophyticus
Uncomplicated, most likely S. saprophyticus A

9. JR is a 55 YO AAF with no structural abnormalities and symptoms of dysuria and urgency. Urinalysis: neg for WBC casts, positive for nitrites, and cloudy. How should she be treated?
Bactrim DS BID x 10 days
Nitrofurantoin 100 mg BID x 5 days
Fosfomycin 3 mg x 1
Augmentin 500 mg BID x 10 days A

10. JD is a 25 YO WM symptoms of dysuria and urgency
JD is a 25 YO WM symptoms of dysuria and urgency. How should he be treated?
Bactrim DS BID x 3 days
Nitrofurantoin 100 mg BID x 5 days
Levofloxacin 250 mg BID x 7 days
Nitrofurantoin 100 mg BID x 14 days C

11. On the urinalysis, the pH is increased
On the urinalysis, the pH is increased. Which of the following is most likely?
E. coli
Proteus
Enterococcus
Candida B

12. Your 24 YO WF patient has compliance issues and comes to you with a prescription for Augmentin 500 mg TID x 7 days. You know that she has compliance issues. What might you suggest as the best alternative?
Cipro because it is BID instead of TID
Fosfomycin because it is dosed once
Nitrofurantoin because it is dosed once
Bactrim because it is dosed for 3 days instead of 7 B

13. Your 23 YO WF patient an uncomplicated UTI
Your 23 YO WF patient an uncomplicated UTI. This is her 5th UTI this year. How would you treat her?
Augmentin 500 mg TID x 14 days
Augmenting 500 mg TID x 7 days
Bactrim DS BID chronically
Bactrim ½ SS QD chronically A

14. Which of the following is not a viable option for prophylaxis?
Cephalexin 250 mg
Trimethoprim 100 mg
Bactrim DS
Nitrofurantoin 100 mg C

15. Remember… You don’t ‘One’NT a UTI, so you use prophylaxis!
ONE: 1st generation cephalosporin (cephalexin)
N: nitrofurantoin or norfloxacin
T: TMP or TMP/SMX

16. BR is a WM who has experienced recurrent UTI’s
BR is a WM who has experienced recurrent UTI’s. He presents to you with low back pain and has some trouble voiding. How would he be best treated?
Ciprofloxacin x 8 weeks
Levofloxacin x 4 weeks
Bactrim x 8 weeks
Bactrim x 4 weeks B

17. URTI

18. CK is a 8 week old WM whose mother is worried about his risk of ear infections, since his older brother and sister have had many ear infections in the past. What would not be a step that would be beneficial in reducing his risk?
Proper immunizations
Pacifier use
Breastfeeding
Not smoking B

19. When CK is 4 months old, he develops ear pain
When CK is 4 months old, he develops ear pain. The tympanic membrane is moderately bulging. How should he be diagnosed?
Definitively AOM
Possibly AOM
Not AOM A

20. OME AOM! Fluid ONLY Fluid + Infection ROM 3 in 6 mo 4+ in 12 mo
Definite:
Moderate/severe bulging OR
New onset of fluid drainage
Maybe:
Mild bulging + 48 hours or less
ROM
3 in 6 mo
4+ in 12 mo

21. When CK is 4 months old (10 kg), he develops ear pain
When CK is 4 months old (10 kg), he develops ear pain. The tympanic membrane is moderately bulging. His ear pain is moderate and has lasted for almost 24 hours. It is present in one ears. His temperature is 102F. How would you treat him?
Watchful waiting
Augmentin 900/64 mg PO BID
Amoxcillin 450 mg PO BID
Ceftriaxone 500 mg IM Q day C

22. If CK fails the amoxicillin after 48 hours, how should you treat him?
Augmentin 450/32 mg PO BID
Clindamycin 100 mg PO TID
Ceftriaxone 500 mg IM Q day
Clindamycin + Ceftriaxone A

23. When is prophylaxis recommended?
Pneumovax for 4 mo and high risk
Pneumovax for 3 yo and high risk
Amoxcillin for 4 mo with 3 episodes in 6 months
Amoxcillin for 3 yo with 3 episodes in 6 months B

24. BR (5 month old WM) starts having middle ear effusion 2 months after his last ear infection. What should be done?
Watchful waiting x 1 month
Watchful waiting x 3 months
Watchful waiting x 6 months
Treat ASAP D

25. BR (18 month old WM) starts having middle ear effusion 2 months after his last ear infection. What should be done?
Watchful waiting x 1 month
Watchful waiting x 3 months
Watchful waiting x 6 months
Treat ASAP B