APHA NAPLEX ACTUAL QUESTIONS AND

APHA NAPLEX (ACTUAL / ) QUESTIONS AND

VERIFIED ANSWERS

When 2 anti-infective therapies together produce a greater effect than the effects of each used alone, this phenomenon is termed

• commensalism
• synergy
• antagonism
• additive
• interacting ----Answers----B. Synergy

Analysis of the cerebrospinal fluid may give valuable clues to the identity of the pathogen in meningitis. Given the following results, what would be indicative of a bacterial infx?

• increased WBCs

II. increased glucose III. increased protein

• I only
• II only
• I and III only 1 / 4

• II and III only
• all of the above ----Answers----C. Bacterial meningitis infx

show an increase in WBC and proteins in the CSF. Glucose is decreased

Empiric therapy for meningitis for pts up to 1mo of age includes

• vanco and ampicillin
• aminoglycoside and ampicillin
• ceftriaxone and vancomycin
• vanco and aminoglycosides
• ampicillin and ceftriaxone ----Answers----B. the regimen

covers the most likely organisms for meningitis in this age

group: Stept agalactiae, E.coli, Listeria monocytogenes

(ampicillin), and Klebsiella species. Ampicillin and cefotaxime would be another appropriate choice for empiric therapy in pts up to 1mo of age

CF is a 65yo male diagnosed with endocarditis. Blood cultures reveal a highly sensitive strain of Streptococcus. Which of the following is most appropriate if CF has an anaphylactoid penicillin allergy?

• vancomycin
• gentamicin
• ceftriaxone and gentamicin 2 / 4

• meropenem
• rifampin and gentamicin ----Answers----A. Vancomycin is

appropriate for penicillin allergic pts with endocarditis caused by Strept species. Other regimens for strep include penicillin or ceftriaxone (w/ or w/o gent), which has a potential for cross-linking reactivity in pts w/ penicillin allergies

Pts presenting with acute bronchitis without risk factors should be treated empirically with

• supportive care
• clarithromcyin
• cefuroxime
• ciprofloxacin
• erythromycin ----Answers----A. B/c half of bronchitis infx

are caused by viral etiology, antibacterial therapy for low-risk pts should not be attempted unless severe presentation

The most common organisms associated with CAP in adults treated as outpts are

• pseudomonas aeruginosa, mycoplasma pneumo, and h. flu
• strept pneumo, h. flu. and klebsiella pneumo
• mycoplasma pneumo, strept pneumo, h. flu, and kleb

pneumo

• mycoplasma pneumo, strept pneumo, h. flu, and

chlamydophila pneumo 3 / 4

• mycoplasma pneumo, strept pneumo, h. flu, and

pseudomonas aeruginosa ----Answers----D. Pseudomonas aeruginosa is more likely in pts with risk factors for multidrug resistant bacteria such as late-onset HAP or VAP. Kleb pneumoniae is also not commonly associated with CAP.

Which of the following is an appropriate regimen for a pt w/ early-onset HAP w/o risk factors for MDR pathogens?

• doxycycline
• azithromycin
• unasyn
• cipro and vanco
• cefepime, cipro, and vanco ----Answers----C. Empiric

therapy for early-onset HAP w/o risk factors for MDR

resistant pathogens is as follows: ceftriaxone, a

fluoroquinolone, unasyn, or ertapenem. Doxycycline or azithromycin is appropriate for outpatient treatment of CAP.Cefepime, cipro and vanco in combination are appropriate for late-onset HAP or pts w/ risk factors for MDR.

Initial treatment of active TB infections in which no resistant strains of mycobacterium tuberculosis are suspected should include

• rifabutin and pyrazinamide
• rifampin and pyrazinamide
• ethambutol, rifampin, isoniazid, and pyrazinamide
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