FINAL MN 650 SPECIALIZED
PHARMACOLOGY FOR THE AGACNP
REVESION QUESTIONS
Common infections in the Geriatrics CORRECT ANSWER MRSA- (uncommon from
animals)
Assess body systems function level prior to prescribing ABX therapy CORRECT
ANSWER (i.e. renal function).
Antifungals metabolize through the CORRECT ANSWER Liver
▪An antibiogram is: CORRECT ANSWER overall profile of antimicrobial susceptibility
testing results of a specific microorganism to a battery of antimicrobial drugs
Cultures and sensitivity tell you CORRECT ANSWER Tells you:
-Identifies bacteria/fungus present
-Sensitivity results based on data
Cultures and sensitivity DONT tell you: CORRECT ANSWER -Infection vs.
colonization vs. contamination
-You would not treat colonization or contamination
-Which ABX to use.
MIC (Minimum inhibitory concentration) CORRECT ANSWER min. concentration of an
ABX needed to inhibit proliferation & is important for definitive TX.
Cultures and sensitivity reports start with: CORRECT ANSWER Start w/ beta-lactam if
possible, especially in severe infections (best data supporting their use)
-Exception: atypical infections
▪You are reviewing a report on a urine culture of a 55 year old female with
pyelonephritis. A culture was done which has revealed growth of Ecoli Susceptibility
testing show minimum inhibitory concentration (MIC) score of 1 for Ciprofloxacin 2 for
Levafloxacin 4 for Ceftriaxone and 16 for Nitrofurantoin. Considering the MIC score the
most appropriate antibiotic to prescribe would be ciprofloxacin. CORRECT ANSWER
Chose lower MIC score
,Fluroquinolones (ex: ciprofloxacin) are most associated with causing: CORRECT
ANSWER pseudomembranous colitis.
S/S of pseudomembranous colitis CORRECT ANSWER recent ABX use followed by
diarrhea with possible blood
To prevent further development of ABX resistance, it is recommended that
fluoroquinolones be reserved for treatment of: CORRECT ANSWER CAP with
comorbidities.
If your patient is allergic to sulfonamides, they most likely will have a cross-sensitivity to:
CORRECT ANSWER loop diuretics, sulfonylureas, & thiazide diuretics.
If you patient cannot reliably take PO ABX, ___ or ___ would be an appropriate
treatment option. CORRECT ANSWER IM or IV
Prebiotics are recommended to be co-administered with: CORRECT ANSWER ABX
Rx half-life is longer in: CORRECT ANSWER older adults (watch for atypical
reactions)
Monitor liver enzymes when on __ tx. CORRECT ANSWER long term antifungal tx
Patients taking isoniazid for TB may experience peripheral neuropathy. To prevent,
prescribe: CORRECT ANSWER pyridoxine (vit B6).
Because microbiological results do not become available for 24 to 72 hours, initial
therapy for infection is often _____ and guided by the clinical presentation. CORRECT
ANSWER empiric
empiric is broad-spectrum & treats: ____
Once C&S is received, a more narrowed focused ABX can be prescribed. CORRECT
ANSWER gram-positive and gram-negative, diverse fungi, or parasites
How soon should newly diagnosed HIV patients should start antiviral treatment?
CORRECT ANSWER as soon as the positive diagnosis is given
Initiation of ARV can prevent complications of AIDS-related diseases, such as:
CORRECT ANSWER PCP pneumonia. (pneumocystis jiroveci pneumonia)
When a Herpes Simplex 2 Dx is suspected ___ is the Rx of choice. CORRECT
ANSWER Acyclovir
You are evaluating a patient in the ER who is complaining of pain to his right leg that
developed yesterday. The pain has become increasingly worse in the last few hours to
the point that the patient's wife called EMS to the house to transport him to your ER. His
, wife tells you he has not been acting right over the last few hours and seems "out of it.".
You, the AGACNP suspect an infection and order labs/cx/start abx. While initiating
therapy the patient becomes hypotensive and is given a fluid bolus. You preform an in-
depth exam on this patient and notice crepitus on the patient's right thigh. You admitted
him to your ICU and write orders to initiate broad spectrum antibiotics for this patient.
The best antimicrobial combination to begin on this patient is _______ CORRECT
ANSWER Doribax (for nec fasc)
Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye
discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While
awaiting the culture results, the plan of care should be: CORRECT ANSWER IM
ceftriaxone
Although MRSA is uncommon in animal bites, ABX Tx is needing in cat bites due to
their oral flora. Initial cat bite treatment would be: CORRECT ANSWER A thorough
cleansing and debridement, Xray, and amoxicillin-clavulanic acid/7-day regimine.
Pharmacokinetics is: CORRECT ANSWER The branch of pharmacology concerned
with the movement of drugs within the body.
UTI in the geriatric population most commonly caused by: CORRECT ANSWER E. coli
most common cause (80-86%)
UTI in the geriatric population complicated by: CORRECT ANSWER male gender,
immunodeficiency, and comorbidities
Tx UTI in the geriatric population with: CORRECT ANSWER -Bactrim DS
-Macrobid
-Cipro if allergic to PCN and sulfonamides
For UTI in the geriatric population, rule out: CORRECT ANSWER R/O Sepsis,
meningitis, stroke, hypoglycemia...
UTI may lead to urosepsis. Caution with aminoglycosides (ex: gentamicinin) in ______
patients. CORRECT ANSWER acute renal failure (aminoglycosides can cause AKI)
BPH incident increases with age: CORRECT ANSWER - 60yo 50%
- 80yo 88%
Some medications mimic symptoms of BPH: CORRECT ANSWER UTI, over-
hydration, caffeine, diuretics
For UTI in older males order: CORRECT ANSWER Order urinalysis, PSA, renal
studies (could be prostate or renal obstruction)
Dehydration can cause: CORRECT ANSWER Tachycardia, thirst, hyper-lab values
PHARMACOLOGY FOR THE AGACNP
REVESION QUESTIONS
Common infections in the Geriatrics CORRECT ANSWER MRSA- (uncommon from
animals)
Assess body systems function level prior to prescribing ABX therapy CORRECT
ANSWER (i.e. renal function).
Antifungals metabolize through the CORRECT ANSWER Liver
▪An antibiogram is: CORRECT ANSWER overall profile of antimicrobial susceptibility
testing results of a specific microorganism to a battery of antimicrobial drugs
Cultures and sensitivity tell you CORRECT ANSWER Tells you:
-Identifies bacteria/fungus present
-Sensitivity results based on data
Cultures and sensitivity DONT tell you: CORRECT ANSWER -Infection vs.
colonization vs. contamination
-You would not treat colonization or contamination
-Which ABX to use.
MIC (Minimum inhibitory concentration) CORRECT ANSWER min. concentration of an
ABX needed to inhibit proliferation & is important for definitive TX.
Cultures and sensitivity reports start with: CORRECT ANSWER Start w/ beta-lactam if
possible, especially in severe infections (best data supporting their use)
-Exception: atypical infections
▪You are reviewing a report on a urine culture of a 55 year old female with
pyelonephritis. A culture was done which has revealed growth of Ecoli Susceptibility
testing show minimum inhibitory concentration (MIC) score of 1 for Ciprofloxacin 2 for
Levafloxacin 4 for Ceftriaxone and 16 for Nitrofurantoin. Considering the MIC score the
most appropriate antibiotic to prescribe would be ciprofloxacin. CORRECT ANSWER
Chose lower MIC score
,Fluroquinolones (ex: ciprofloxacin) are most associated with causing: CORRECT
ANSWER pseudomembranous colitis.
S/S of pseudomembranous colitis CORRECT ANSWER recent ABX use followed by
diarrhea with possible blood
To prevent further development of ABX resistance, it is recommended that
fluoroquinolones be reserved for treatment of: CORRECT ANSWER CAP with
comorbidities.
If your patient is allergic to sulfonamides, they most likely will have a cross-sensitivity to:
CORRECT ANSWER loop diuretics, sulfonylureas, & thiazide diuretics.
If you patient cannot reliably take PO ABX, ___ or ___ would be an appropriate
treatment option. CORRECT ANSWER IM or IV
Prebiotics are recommended to be co-administered with: CORRECT ANSWER ABX
Rx half-life is longer in: CORRECT ANSWER older adults (watch for atypical
reactions)
Monitor liver enzymes when on __ tx. CORRECT ANSWER long term antifungal tx
Patients taking isoniazid for TB may experience peripheral neuropathy. To prevent,
prescribe: CORRECT ANSWER pyridoxine (vit B6).
Because microbiological results do not become available for 24 to 72 hours, initial
therapy for infection is often _____ and guided by the clinical presentation. CORRECT
ANSWER empiric
empiric is broad-spectrum & treats: ____
Once C&S is received, a more narrowed focused ABX can be prescribed. CORRECT
ANSWER gram-positive and gram-negative, diverse fungi, or parasites
How soon should newly diagnosed HIV patients should start antiviral treatment?
CORRECT ANSWER as soon as the positive diagnosis is given
Initiation of ARV can prevent complications of AIDS-related diseases, such as:
CORRECT ANSWER PCP pneumonia. (pneumocystis jiroveci pneumonia)
When a Herpes Simplex 2 Dx is suspected ___ is the Rx of choice. CORRECT
ANSWER Acyclovir
You are evaluating a patient in the ER who is complaining of pain to his right leg that
developed yesterday. The pain has become increasingly worse in the last few hours to
the point that the patient's wife called EMS to the house to transport him to your ER. His
, wife tells you he has not been acting right over the last few hours and seems "out of it.".
You, the AGACNP suspect an infection and order labs/cx/start abx. While initiating
therapy the patient becomes hypotensive and is given a fluid bolus. You preform an in-
depth exam on this patient and notice crepitus on the patient's right thigh. You admitted
him to your ICU and write orders to initiate broad spectrum antibiotics for this patient.
The best antimicrobial combination to begin on this patient is _______ CORRECT
ANSWER Doribax (for nec fasc)
Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye
discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While
awaiting the culture results, the plan of care should be: CORRECT ANSWER IM
ceftriaxone
Although MRSA is uncommon in animal bites, ABX Tx is needing in cat bites due to
their oral flora. Initial cat bite treatment would be: CORRECT ANSWER A thorough
cleansing and debridement, Xray, and amoxicillin-clavulanic acid/7-day regimine.
Pharmacokinetics is: CORRECT ANSWER The branch of pharmacology concerned
with the movement of drugs within the body.
UTI in the geriatric population most commonly caused by: CORRECT ANSWER E. coli
most common cause (80-86%)
UTI in the geriatric population complicated by: CORRECT ANSWER male gender,
immunodeficiency, and comorbidities
Tx UTI in the geriatric population with: CORRECT ANSWER -Bactrim DS
-Macrobid
-Cipro if allergic to PCN and sulfonamides
For UTI in the geriatric population, rule out: CORRECT ANSWER R/O Sepsis,
meningitis, stroke, hypoglycemia...
UTI may lead to urosepsis. Caution with aminoglycosides (ex: gentamicinin) in ______
patients. CORRECT ANSWER acute renal failure (aminoglycosides can cause AKI)
BPH incident increases with age: CORRECT ANSWER - 60yo 50%
- 80yo 88%
Some medications mimic symptoms of BPH: CORRECT ANSWER UTI, over-
hydration, caffeine, diuretics
For UTI in older males order: CORRECT ANSWER Order urinalysis, PSA, renal
studies (could be prostate or renal obstruction)
Dehydration can cause: CORRECT ANSWER Tachycardia, thirst, hyper-lab values
