Deck 36: Bacteremia and Sepsis

Question 1

Where does primary bacteremia arise from?

A) An endovascular source
B) The lung
C) The liver
D) The gastrointestinal tract

Answer 1

A
Bacteremia may be classified by its site of origin.Primary bacteremia arises from an endovascular source such as an infected cardiac valve or an infected intravenous catheter,whereas secondary bacteremia arises from an infected extravascular source,such as the lung in patients with pneumonia; a case in which the source of bacteremia remains undefined is termed bacteremia of unknown origin.

Question 2

Bacteremias can be classified by all of the following schemes EXCEPT:

A) Microbiology
B) Acquisition
C) Pathogenesis
D) Duration

Answer 2

C
Bacteremias can be classified by microbiology,acquisition,and duration.

Question 3

Bacteremia with this organism may lead to endocarditis,osteomyelitis,septic arthritis,hepatic abscess,or pyomyositis.

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

Answer 3

C
S.aureus is particularly prone to cause metastatic infection or abscess formation as a consequence of bacteremia; S.aureus bacteremia may lead to endocarditis,osteomyelitis,septic arthritis,hepatic abscess,or pyomyositis.

Question 4

What organism is most commonly associated with bacteremia caused by acute pyelonephritis?

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

Question 5

Where does secondary bacteremia arise from?

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

Question 6

All of the following organisms are colonizers of indwelling catheters EXCEPT:

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

Question 7

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

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

Question 8

The most 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 9

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
B) Interleukin (IL)-1
C) IL-6
D) All of the above

Question 10

How does the biofilm protect the organism?

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

Question 11

All of the following factors are associated with an unfavorable outcome in bacteremia EXCEPT:

A) Pneumonia
B) Polymicrobial bacteremia
C) Presence of malignancy
D) AIDS

Question 12

What immunosuppressive agents increase a patient's risk of bacteremia?

A) Steroids and chemotherapy drugs
B) Steroids and cytotoxic drugs
C) Chemotherapy drugs and cytotoxic drugs
D) All of the above

Question 13

What predisposes a person to a polymicrobial bacteremia?

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

Question 14

Bacteremias are more frequent among persons with the following conditions EXCEPT:

A) Hematologic malignancies
B) AIDS
C) Those receiving immunosuppressive chemotherapy
D) Those undergoing bone marrow transplantation

Question 15

All of the following organisms are common in pneumonia and typically produce a concurrent bacteremia EXCEPT:

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

Question 16

Immunization has decreased which major cause of bacteremia in children?

A) Haemophilus influenzae
B) Streptococcus pneumoniae
C) Escherichia coli
D) Hepatitis A

Question 17

The patient's immune system attempts to control infection via which of the following mechanisms?

A) Antibodies
B) Complement activation
C) Phagocytosis
D) Filtering mechanisms in the lymphatics
E) All of the above

Question 18

What condition results when a procedural manipulation of a particular body site that is colonized by normal florae occurs?

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

Question 19

What condition leads to most (75%)of the cases of bacteremia from intra-abdominal infections?

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

Question 20

What are two potential consequences of bacteremia?

A) Endocarditis and meningitis
B) Meningitis and encephalitis
C) Encephalitis and hepatitis
D) Sepsis and septic shock

Question 21

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 antibiotics

Question 22

If a patient with a bacteremia is receiving antibiotics but not responding to treatment,how does the physician find out if another organism is present in the blood,causing the problem?

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

Question 23

Altered clinical laboratory values that may be indicative of bacteremia include all the following EXCEPT:

A) Disseminated intravascular coagulation (DIC)
B) Thrombocytopenia
C) Coagulopathy
D) Anemia

Question 24

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

A) The amount of ¹⁴CO₂ 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 25

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

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

Question 26

How long are conventional blood cultures held?

A) 4 days
B) 7 days
C) 14 days
D) 21 days

Question 27

The blood culture draw of three sets of blood culture specimens taken at 1-hour intervals within the first 24 hours is recommended to diagnose which of the following conditions?

A) Meningitis
B) Subacute bacterial endocarditis
C) Pneumonia
D) Peritonitis

Question 28

When drawing blood for blood cultures in a child younger than age 10,how much blood do you draw?

A) 1 mL for each year of life
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 29

Septi-Chek is which type of blood culture system?

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

Question 30

What type of a device can cause osteomyelitis,which will then lead to bacteremia?

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