Deck 36: Bacteremia and Sepsis

Question 1

What condition results when there is a procedural manipulation of a body site containing normal microbiota, causing those bacteria to enter the bloodstream?

A) Continuous bacteremia
B) Intermittent bacteremia
C) Septic shock
D) Transient bacteremia

Answer 1

D

Question 2

Which immunosuppressive agent can increase a patient's risk of bacteremia?

A) Cancer chemotherapy
B) Corticosteroid therapy
C) Transplant maintenance therapy
D) All of the above

Answer 2

D

Question 3

Lipopolysaccharide in gram-negative bacteria and the lipoteichoic acid and peptidoglycan in gram-positive bacteria cause which of the following to be released in the human body?

A) Tumor necrosis factor (TNF)
B) Interleukin (IL)-1
C) IL-6
D) All of the above

Answer 3

D

Question 4

Bacteremia with this organism often leads to endocarditis, osteomyelitis, septic arthritis, hepatic abscess, or pyomyositis.

A) Streptococcus pneumoniae
B) Escherichia coli
C) Staphylococcus aureus
D) Pseudomonas aeruginosa

Question 5

All of the following factors are associated with an unfavorable outcome in bacteremia, except

A) surface wound or abscess.
B) polymicrobial bacteremia.
C) presence of malignancy.
D) acquired immunodeficiency syndrome.

Question 6

What organism is most commonly associated with bacteremia due to acute pyelonephritis?

A) Escherichia coli
B) Enterobacter aerogenes
C) Pseudomonas aeruginosa
D) Staphylococcus aureus

Question 7

A vaccine is available to prevent septicemia and invasive infections, particularly in children, caused by this organism.

A) Haemophilus influenzae
B) Klebsiella pneumoniae
C) Escherichia coli
D) Streptococcus agalactiae

Question 8

What organism is primary found in septicemia originated from an upper urinary tract infection?

A) Staphylococcus aureus
B) Staphylococcus saprophyticus
C) Pseudomonas aeruginosa
D) E. coli

Question 9

How does a biofilm protect the organisms from host defenses?

A) By inhibiting phagocytosis
B) By inhibiting chemotaxis
C) By suppressing the lymphoproliferative response
D) All of the above

Question 10

What condition leads to most cases of bacteremia arising from intraabdominal infections?

A) Pleurisy
B) Cholecystitis
C) Peritonitis
D) Irritable bowel syndrome

Question 11

Meningitis following bacteremia and septicemia are often associated with Neisseria meningitidis and

A) Streptococcus pneumoniae.
B) Escherichia coli.
C) Pseudomonas aeruginosa.
D) Staphylococcus aureus.

Question 12

Which of the following has been suggested as a biomarker of fungal sepsis?

A) C-reactive protein
B) Procalcitonin
C) (1-3)- $\beta$ -D-Glucan
D) All of the above

Question 13

Bacteremias are least often associated with which of the following patient conditions?

A) Patients with hematologic malignancies
B) Those undergoing elective outpatient surgical procedures
C) Those receiving immunosuppressive chemotherapy
D) Patients undergoing bone marrow transplantation

Question 14

What organism is the most common cause of community-acquired bacteremia?

A) Pseudomonas aeruginosa
B) Staphylococcus aureus
C) Streptococcus pneumoniae
D) E. coli

Question 15

Which of the following is an example of a secondary bacteremia source?

A) An infected cardiac valve
B) The lung
C) An infected intravenous catheter
D) The bone marrow

Question 16

Common sites associated with bacteremia and sepsis include all the following, except

A) reproductive organs.
B) infected intravascular catheters.
C) the lung.
D) the abdomen.

Question 17

What is the most common clinical manifestation associated with continuous bacteremia?

A) Meningitis
B) Pleurisy
C) Encephalitis
D) Endocarditis

Question 18

Which of the following is an example of a primary bacteremia source?

A) An infected heart valve
B) A case of pneumonia
C) A patient with hepatitis
D) A wound abscess

Question 19

All of the following organisms are noted colonizers of indwelling catheters, except

A) coagulase-negative staphylococci.
B) Streptococcus pyogenes.
C) Staphylococcus aureus.
D) Enterococcus spp.

Question 20

What underlying condition predisposes a person to a polymicrobial bacteremia?

A) Intravenous drug use
B) Burns
C) Gastrointestinal tract sources
D) All of the above

Question 21

What type of a medical implant device is commonly associated with osteomyelitis, which will then lead to bacteremia?

A) Prosthetic joints
B) Stainless steel rods
C) Orthopedic screws
D) Orthopedic plates

Question 22

What is the principle of a continuous monitoring blood culture system?

A) The amount of CO₂ produced is measured as a growth index and compared with a threshold.
B) The amount of increased lipopolysaccharide is measured and compared against the null value.
C) The pH of the media is continuously measured to check for bacterial metabolic by-products.
D) An optical monitor records the number of bacteria and records the growth.

Question 23

Sodium polyanetholsulfonate (SPS) performs all the following functions in the blood culture bottles, except

A) anticoagulation.
B) prevention of phagocytosis.
C) act as a bacterial nutrient.
D) inactivate certain antimicrobials.

Question 24

The recommendation of three sets of blood culture drawn at 1-hour intervals is recommended to diagnose which of the following conditions?

A) Meningitis
B) Infective endocarditis
C) Pneumonia
D) Peritonitis

Question 25

A patient receiving chemotherapy for leukemia has developed a fever causing the physician to request blood cultures times three. Each set of cultures grows an $\alpha$ -hemolytic streptococcal organism. What is the most likely explanation for these results?

A) The patient probably has an infection with $\alpha$ -hemolytic strep.
B) The blood cultures were contaminated with skin biota
C) The blood cultures were probably contaminated in the laboratory.
D) The patient probably has an infection with Bacillus spp.

Question 26

What can happen when a transient bacteremia is produced from a dental procedure or a superficial skin infection?

A) Hepatitis
B) Pneumonia
C) Deep vein thrombosis
D) Cardiac valves can be seeded with bacteria

Question 27

Septi-Chek is which type of blood culture system?

A) Continuous-monitoring blood culture system
B) Lysis-centrifugation blood culture system
C) Aerobic-anaerobic blood culture system
D) Biphasic broth-slide system

Question 28

Which of the following organisms is inhibited by the anticoagulant SPS?

A) Enterobacter aerogenes
B) Escherichia coli
C) Peptostreptococcus anaerobius
D) Streptococcus pyogenes

Question 29

Abnormal conditions that may indicate the presence of bacteremia include all the following, except

A) disseminated intravascular coagulation (DIC).
B) thrombocytopenia.
C) coagulopathy.
D) anemia.

Question 30

If a patient with a bacteremia is receiving appropriate antimicrobial therapy for a known infection but is not responding to treatment, how does the physician find out if another organism is causing the problem?

A) Redraw the blood cultures.
B) Redraw the blood cultures using an antimicrobial removal device.
C) Switch the patient to another agent that will resolve the clinical symptoms.
D) Perform hemodialysis to remove the organisms from the patient's blood.

Question 31

When drawing blood for blood cultures in a child younger than age 10 years, how much blood should be drawn?

A) 1% of total blood volume
B) 5 mL
C) 2 mL
D) 1 mL for children younger than 2 years old, 3 mL for children younger than 7 years old, and 5 mL for children up to 10 years old

Question 32

Separate venipunctures were performed to collect three sets of blood cultures from a patient with an artificial heart valve. The first and third sets grew a gram-positive pleomorphic rod in 1 of 2 bottles while the second set had no growth in either bottle. What is the most likely explanation for these findings?

A) The patient probably has an infection with Clostridium spp.
B) The blood cultures were contaminated with skin biota.
C) The blood cultures were probably contaminated in the laboratory.
D) The patient probably has an infection with Bacillus spp.