NURS 676 ADVANCED PHARMACOLOGY FINAL EXAM
What are complications of dog bites? - CORRECT ANSWER crush
injuries, destructive soft tissue injuries, neurovascular and orthopedic
injuries, and death.
Dog bites commonly affect - CORRECT ANSWER the extremities,
children and young adults, and animals who are provoked.
Cat bites commonly affect - CORRECT ANSWER the hand and
forearm in older women
Why is the infection rate of cat bites higher than dogs? - CORRECT
ANSWER cat bites include a deeper puncture from the cats sharp
teeth
What are the risk factors for bite wound infections? - CORRECT
ANSWER age older than 50 years, advanced liver disease,
alcoholism, DM, location of bite on the hand or foot, failure to irrigate
or debride wound during initial management, treatment delay of more
than 12 hours, edema at the bite site, and peripheral vascular disease
What are the most common pathogens that cause animal bite
infections? - CORRECT ANSWER Aerobic: Pasturella multocida,
streptococci, staphylococci, and Coryneubacterium species.
anaerobic: bacteriodes, actinomyces, porphyromonas, and
fusobacterium.
What rare bacterium in a dogs mouth can cause sepsis? - CORRECT
ANSWER Capnocytophagia Canomoruses
What is often present and transmitted during human bite? - CORRECT
ANSWER Eikinella Corroderes
,why should you be concerned about E corredens? - CORRECT
ANSWER it can be resistant to empirically chosen antibiotics and
produce beta lactamases.
What needs to be included in history about bite injury? - CORRECT
ANSWER the location and time of the bite, species and behavior of
animal, rabies vaccine of animal, and provoktion status.
what needs to be included in documentation for bite? - CORRECT
ANSWER location, extent, depth of wound, type of wound (puncture,
scratch, tear, avulsion), tenderness and other signs of infection (fever,
erythema, edema, warmth, streaking, flcutuation, adenopathy, and
purulent discharge), testing for tendon lacerations, joints and nerves,
and signs of compartment syndrome (pain, paresthesia, pallor,
paralysis)
what diagnostics should you order for infected wounds? - CORRECT
ANSWER CBC, ESR , CRP aerobic and anaerobic wound cultures,
blood cultures if febrile
what diagnostics should you order for deep and complex wounds? -
CORRECT ANSWER xray studies
what diagnostics should you order for human bites - CORRECT
ANSWER HIV, hep B, Hep C and titer
What are CRP and ESR used for? - CORRECT ANSWER to monitor
response to treatment
what is the first step of treatment after assessing for life threatening
injuries in bites? - CORRECT ANSWER irrigate the wound with
150 ml sterile saline solution, remove any foregin bodies or clots,
, when do wounds develop signs of infection? - CORRECT ANSWER
24-72 hours after the bite
what is significant about management of bites to the face? -
CORRECT ANSWER extensive irrigation, cautious debridement,
preemptive antibiotics, primary closure, referral to ED or plastics
What wounds should be left open? - CORRECT ANSWER cat and
human bites, deep puncture wounds, infectied wounds, wounds more
than 6-12 hours old, and bites to the hand.
What is significant about wounds to the hand or foot? - CORRECT
ANSWER They should be immobilized and elevated for 1-3 days
Which bites require 5-7 days of prophylaxis? - CORRECT ANSWER
cat bites or bites to the hand
What is the most effective prophylactic therapy for fresh bites? -
CORRECT ANSWER Augmentin 500/125 every 8 hours for 5-7 days
What is the treatment for bites with penicillin allergy? - CORRECT
ANSWER Clindamycin in combination with doxy or batrim
(additional would be levo or cipro)
What should pregnant patients receive for bites? - CORRECT
ANSWER Macrolides (azith, claryth, eryth)
What is the treatment protocol for older infected bites? - CORRECT
ANSWER 7-14 days of hospitalization and IV antibiotics (possible
referral to infectious diseases for bone and joint damage)
How to treat outpatient MRSA? - CORRECT ANSWER oral linezolid
how to treat inpatient MRSA? - CORRECT ANSWER Bactrim,
Doxy, Clindamycin
What are complications of dog bites? - CORRECT ANSWER crush
injuries, destructive soft tissue injuries, neurovascular and orthopedic
injuries, and death.
Dog bites commonly affect - CORRECT ANSWER the extremities,
children and young adults, and animals who are provoked.
Cat bites commonly affect - CORRECT ANSWER the hand and
forearm in older women
Why is the infection rate of cat bites higher than dogs? - CORRECT
ANSWER cat bites include a deeper puncture from the cats sharp
teeth
What are the risk factors for bite wound infections? - CORRECT
ANSWER age older than 50 years, advanced liver disease,
alcoholism, DM, location of bite on the hand or foot, failure to irrigate
or debride wound during initial management, treatment delay of more
than 12 hours, edema at the bite site, and peripheral vascular disease
What are the most common pathogens that cause animal bite
infections? - CORRECT ANSWER Aerobic: Pasturella multocida,
streptococci, staphylococci, and Coryneubacterium species.
anaerobic: bacteriodes, actinomyces, porphyromonas, and
fusobacterium.
What rare bacterium in a dogs mouth can cause sepsis? - CORRECT
ANSWER Capnocytophagia Canomoruses
What is often present and transmitted during human bite? - CORRECT
ANSWER Eikinella Corroderes
,why should you be concerned about E corredens? - CORRECT
ANSWER it can be resistant to empirically chosen antibiotics and
produce beta lactamases.
What needs to be included in history about bite injury? - CORRECT
ANSWER the location and time of the bite, species and behavior of
animal, rabies vaccine of animal, and provoktion status.
what needs to be included in documentation for bite? - CORRECT
ANSWER location, extent, depth of wound, type of wound (puncture,
scratch, tear, avulsion), tenderness and other signs of infection (fever,
erythema, edema, warmth, streaking, flcutuation, adenopathy, and
purulent discharge), testing for tendon lacerations, joints and nerves,
and signs of compartment syndrome (pain, paresthesia, pallor,
paralysis)
what diagnostics should you order for infected wounds? - CORRECT
ANSWER CBC, ESR , CRP aerobic and anaerobic wound cultures,
blood cultures if febrile
what diagnostics should you order for deep and complex wounds? -
CORRECT ANSWER xray studies
what diagnostics should you order for human bites - CORRECT
ANSWER HIV, hep B, Hep C and titer
What are CRP and ESR used for? - CORRECT ANSWER to monitor
response to treatment
what is the first step of treatment after assessing for life threatening
injuries in bites? - CORRECT ANSWER irrigate the wound with
150 ml sterile saline solution, remove any foregin bodies or clots,
, when do wounds develop signs of infection? - CORRECT ANSWER
24-72 hours after the bite
what is significant about management of bites to the face? -
CORRECT ANSWER extensive irrigation, cautious debridement,
preemptive antibiotics, primary closure, referral to ED or plastics
What wounds should be left open? - CORRECT ANSWER cat and
human bites, deep puncture wounds, infectied wounds, wounds more
than 6-12 hours old, and bites to the hand.
What is significant about wounds to the hand or foot? - CORRECT
ANSWER They should be immobilized and elevated for 1-3 days
Which bites require 5-7 days of prophylaxis? - CORRECT ANSWER
cat bites or bites to the hand
What is the most effective prophylactic therapy for fresh bites? -
CORRECT ANSWER Augmentin 500/125 every 8 hours for 5-7 days
What is the treatment for bites with penicillin allergy? - CORRECT
ANSWER Clindamycin in combination with doxy or batrim
(additional would be levo or cipro)
What should pregnant patients receive for bites? - CORRECT
ANSWER Macrolides (azith, claryth, eryth)
What is the treatment protocol for older infected bites? - CORRECT
ANSWER 7-14 days of hospitalization and IV antibiotics (possible
referral to infectious diseases for bone and joint damage)
How to treat outpatient MRSA? - CORRECT ANSWER oral linezolid
how to treat inpatient MRSA? - CORRECT ANSWER Bactrim,
Doxy, Clindamycin
