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Infection

Total questions: 21

Worksheet time: 8mins

Name
Class
Date
1.

Transferrin plays a role in host defense by

a)

Sequestering iron, which is necessary for microbial growth

b)

Increasing the ability of fibrinogen to trap microbes

c)

Direct injury to bacterial cell membrane

d)

Direct injury to bacterial mitochondria

2.

Which is not a component of SIRS?

a)

Temperature

b)

WBC

c)

BP

d)

HR

3.

The best method for hair removal from an operative field is

a)

Shaving the night before

b)

Depilating the night before surgery

c)

Shaving in the OR

d)

Using hair clippers in the OR

4.

A pt w/necrotizing pancreatitis undergoes CT guided aspiration, which results in growth of E. coli on culture. The most appropriate treatment is

a)

Culture appropriate ABX

b)

ERCP w/sphincterotomy

c)

CT guided drain placement

d)

Exploratory laparotomy

5.

Which does not influence the development of surgical site infections?

a)

Duration of procedure

b)

Degree of microbial contamination of the wound

c)

Malnutrition

d)

General anesthesia

6.

During a lap appendectomy, a large bowel injury was caused during trochar placement w/spillage of bowel contents into the abdomen. What is the surgical wound class?

a)

Clean (I)

b)

Clean Contaminated (II)

c)

Contaminated (III)

d)

Dirty (IV)

7.

The most appropriate therapy for a 4 cm hepatic abscess is

a)

ABX therapy alone

b)

Aspiration for culture & ABX therapy

c)

Percutaneous drainage & ABX therapy

d)

Operative exploration, open drainage of the abscess, & ABX therapy

8.

Post-op UTIs

a)

Are usually treated with a 7-10 day course of ABX

b)

Initial therapy should be directed by results of urine culture

c)

Are established by >104 CFU/ml of bacteria in urine culture in asymptomatic patients

d)

Can be reduced by irrigating indwelling Foley catheter daily

9.

The first step in evaluation & treatment of a pt w/ an infected bug bite on the leg w/ cellulitis, bullae, thin grayish fluid draining form the wound, and pain out of proportion to the physical findings is

a)

Obtain CRP

b)

CT scan

c)

MRI

d)

Operative exploration

10.

What is FALSE regarding IV catheter infections?

a)

Selected low virulence infections can be treated with a prolonged course of ABX

b)

In high risk patients, PPX ABX infused through the catheter can reduce rate of catheter infections

c)

Bacteremia w/ gam-negative bacteria or fungi should prompt catheter removal

d)

Many patients w/ IV catheter infections are asymptomatic

11.

Patients with a PCN allergy are least likely to have a cross reaction w/

a)

Synthetic penicillins

b)

Carbapenems

c)

Cephalosporins

d)

Monobactams

12.

What is the estimated risk of HIV transmission from a needlestick from a source w/HIV infected blood ?

a)

<0.5%

b)

1%

c)

5%

d)

10%

13.

Closure of an appendectomy wound in a patent with perforated appendicitis who is receiving appropriate ABX will result in a wound infection in what percentage of patients?

a)

3-4%

b)

8-12%

c)

15-18%

d)

22-25%

14.

A chronic carrier state occurs w/ HCV infection in what percentage of patients?

a)

90-99%

b)

75-80%

c)

50-60%

d)

10-30%

15.

Possible exposure to anthrax should be initially treated with

a)

Colistin

b)

Ciprofloxacin or doxycylcine

c)

Amoxicillin

d)

Observation

16.

The most effective post exposure apps for a surgeon w/ a needle stick while operating on an HIV positive patient is

a)

None

b)

2 or 3 drug therapy started w/in hours

c)

Single drug therapy started within 24 hours of exposure

d)

3 drug therapy started within 24 hours of exposure

17.

What is not an early goal in treatment of severe sepsis?

a)

MAP > 65 mm Hg

b)

CVP 8-12 mm Hg

c)

Uine output >0.5cc/kg/h

d)

Serume lactate <2 mol

18.

A patient in the ICU has been on ventilator support for 3 weeks. He has new onset elevated WBC count, fever, & consolidation seen on CXR. What is an appropriate next step?

a)

Exchange eT tube & change respiratory circuit

b)

Obtain BAL

c)

Start treatment w/Empiric Penicillin G

d)

Obtain chest CT

19.

Patient w/ severe necrotizing pancreatitis should be treated with

a)

No ABX unless CT guided aspiration of the area yields positive cultures

b)

Empiric cefoxitin or cefotetan

c)

Empiric cefuroxime plus gentamicin

d)

Empiric carbapenems or fluroquinolones

20.

A patient w/ a localized wound infection after surgery should be treated with

a)

ABX & warm soaks to the wound

b)

ABX alone

c)

ABX & opening the wound

d)

I & D alone

21.

Which areas likely do not contain resident microorganisms?

a)

Terminal ileum

b)

Oropharynx

c)

Main pancreatic duct

d)

Nares