Antimicrobial Therapy in Pediatrics: Online Learning Quizzes

Question 1

Which of the following is NOT typically an indication for obtaining a culture and sensitivity test prior to initiating antimicrobial therapy?

Accepted Answer

Assessing patient response to therapy

Answer

Identifying the causative organism

Answer

Determining the most effective antibiotic

Question 2

For a child suspected of having a urinary tract infection (UTI), which antibiotic is the most suitable initial choice?

Accepted Answer

Amoxicillin

Answer

Ceftriaxone

Answer

Ciprofloxacin

Answer

Vancomycin

Question 3

In evaluating the response to antibiotic therapy for pneumonia, the most valuable laboratory test is:

Accepted Answer

C-reactive protein

Answer

Complete blood count

Answer

Sputum culture

Answer

Chest X-ray

Question 4

For a patient with a history of penicillin allergy, which antibiotic should be avoided?

Accepted Answer

Amoxicillin

Answer

Cefazolin

Answer

Clindamycin

Answer

Vancomycin

Question 5

A fundamental principle of appropriate antibiotic use in children is:

Accepted Answer

Using the narrowest spectrum antibiotic possible

Answer

Treating all infections with antibiotics

Answer

Always completing the full course of antibiotics, even if symptoms improve

Answer

Using prophylactic antibiotics whenever possible

Question 6

For empirical treatment of community-acquired pneumonia in a 3-year-old child, the recommended antibiotic is:

Accepted Answer

Amoxicillin

Answer

Azithromycin

Answer

Ceftriaxone

Answer

Levofloxacin

Question 7

Neonates have unique pharmacokinetic properties that impact antibiotic dosing and monitoring. Which of the following is NOT a consideration?

Accepted Answer

Normal blood-brain barrier permeability

Answer

Increased volume of distribution

Answer

Immature hepatic function

Answer

Decreased renal function

Question 8

In the empiric treatment of community-acquired pneumonia (CAP) in a 2-year-old child without underlying medical conditions, which antibiotic regimen is the first-line choice?

Accepted Answer

Amoxicillin-clavulanate

Answer

Ceftriaxone + azithromycin

Answer

Erythromycin + sulfisoxazole

Answer

Levofloxacin

Question 9

Which of the following mechanisms is NOT involved in antimicrobial resistance?

Accepted Answer

Increased passive diffusion across cell membranes

Answer

Efflux pumps

Answer

Inactivation of antibiotics

Answer

Alteration of target sites

Question 10

Which of the following antibiotics is most likely to cause ototoxicity?

Accepted Answer

Ciprofloxacin

Answer

Amoxicillin

Answer

Penicillin

Answer

Vancomycin

Question 11

What is the recommended duration of antimicrobial therapy for children with uncomplicated urinary tract infections (UTIs)?

Accepted Answer

7 days

Answer

3 days

Answer

10 days

Answer

14 days

Question 12

A 6-year-old child with severe combined immunodeficiency (SCID) presents with fever and neutropenia. Which antibiotic regimen is most appropriate for empiric treatment?

Accepted Answer

Ceftriaxone and vancomycin

Answer

Amoxicillin-clavulanate and azithromycin

Answer

Piperacillin-tazobactam and ciprofloxacin

Answer

Cefepime and metronidazole

Question 13

A 2-year-old child with a creatinine clearance of 30 mL/minute is prescribed gentamicin. How should the dosing regimen for this child differ from a child with normal renal function?

Accepted Answer

Decrease the dose to avoid accumulation and toxicity.

Answer

Increase the dose to compensate for the reduced clearance.

Answer

Increase the frequency of administration to maintain therapeutic levels.

Answer

Shorten the duration of therapy to minimize the risk of adverse effects.

Question 14

For a 3-month-old infant with community-acquired pneumonia, which antibiotic is the best initial choice?

Accepted Answer

Ampicillin

Answer

Ceftriaxone

Answer

Clindamycin

Answer

Vancomycin

Question 15

Penicillin's mechanism of action is to:

Accepted Answer

Inhibit bacterial cell wall synthesis

Answer

Disrupt bacterial protein synthesis

Answer

Alter bacterial membrane permeability

Answer

Interfere with bacterial nucleic acid synthesis

Question 16

The preferred route of administration for vancomycin is:

Accepted Answer

Intravenous

Answer

Intramuscular

Answer

Oral

Question 17

When is it generally appropriate to discontinue antimicrobial therapy in a child with uncomplicated pneumonia?

Accepted Answer

After 5-7 days of symptom resolution

Answer

After the fever resolves

Answer

After 10 days of therapy

Answer

After the cough subsides

Question 18

Which of the following laboratory tests is primarily used to monitor therapeutic efficacy and potential toxicity of vancomycin therapy?

Accepted Answer

Trough level

Answer

Complete blood count

Answer

Serum creatinine

Answer

Peak level

Question 19

Which of the following antibiotics is contraindicated in children with glucose-6-phosphate dehydrogenase deficiency?

Accepted Answer

Primaquine

Answer

Cefazolin

Answer

Amoxicillin

Answer

Azithromycin

Question 20

What is the preferred route of administration for antibiotics in children with septic shock?

Accepted Answer

Intravenous

Answer

Oral

Answer

Subcutaneous

Answer

Intramuscular

Question 21

What is a primary rationale for using combination antimicrobial therapy in children?

Accepted Answer

To broaden the spectrum of activity and reduce the risk of resistance

Answer

To improve patient compliance

Answer

To decrease the likelihood of adverse effects

Answer

To achieve higher serum concentrations

Question 22

Which of the following is the first-line antibiotic for the empiric treatment of community-acquired pneumonia in children?

Accepted Answer

Amoxicillin

Answer

Erythromycin

Answer

Ciprofloxacin

Answer

Vancomycin

Question 23

Which of the following laboratory tests is most useful for evaluating treatment response in a child with bacterial meningitis?

Accepted Answer

Repeat lumbar puncture

Answer

Serum electrolytes

Answer

Liver function tests

Answer

Complete blood count

Question 24

Which of the following is NOT a potential adverse effect of erythromycin therapy?

Accepted Answer

Neurotoxicity

Answer

Gastrointestinal upset

Answer

Ototoxicity

Answer

Hepatotoxicity

Question 25

What is the most common cause of antibiotic-associated diarrhea in children?

Accepted Answer

Clostridioides difficile infection

Answer

Salmonella infection

Answer

Viral infection

Answer

Inflammatory bowel disease

Question 26

Which of the following conditions in children requires antibiotic prophylaxis prior to dental procedures?

Accepted Answer

Congenital heart disease with unrepaired cyanotic malformation

Answer

Diabetes mellitus

Answer

Asthma

Question 27

Regarding first-line antibiotic selection for community-acquired pneumonia in children, which of the following is appropriate?

Accepted Answer

Amoxicillin

Answer

Clarithromycin, which is more effective against atypical pathogens

Answer

Cefuroxime, which is commonly used for hospital-acquired infections but not first-line for community-acquired pneumonia

Answer

Erythromycin, which has similar efficacy to amoxicillin but more adverse effects

Question 28

For children with normal renal function, what is the recommended dosing regimen for vancomycin?

Accepted Answer

40 mg/kg every 6-8 hours

Answer

60 mg/kg every 8-12 hours, which may increase the risk of nephrotoxicity

Answer

80 mg/kg every 12-24 hours, which is excessive and not supported by evidence

Answer

20 mg/kg every 12 hours, which is too infrequent for optimal efficacy

Question 29

Aminoglycoside antibiotics are commonly used to treat serious infections. Which of the following is a potential adverse effect of this class of antibiotics?

Accepted Answer

Nephrotoxicity

Answer

Rashes, which are more commonly associated with penicillin

Answer

Anaphylaxis, which is more commonly associated with beta-lactam antibiotics

Answer

Diarrhea, which is not a typical adverse effect of aminoglycosides

Question 30

Beta-lactam antibiotics, such as penicillin and cephalosporins, exert their bactericidal effect by:

Accepted Answer

Inhibition of cell wall synthesis

Answer

Inhibition of DNA synthesis, which is the mechanism of action of fluoroquinolones

Answer

Inhibition of folic acid synthesis, which is the mechanism of action of sulfonamides

Answer

Inhibition of protein synthesis, which is the mechanism of action of macrolides

Question 31

For uncomplicated urinary tract infections in children, what is the recommended duration of antibiotic therapy?

Accepted Answer

3-7 days

Answer

10-14 days, which is unnecessarily prolonged and increases the risk of antibiotic resistance

Answer

1-3 days, which is too short and may result in treatment failure

Answer

7-10 days, which is longer than necessary and increases the risk of adverse effects

Question 32

Sulfonamide antibiotics are generally well-tolerated, but there is a potential contraindication to their use. Which of the following conditions is a contraindication to sulfonamide antibiotics?

Accepted Answer

Glucose-6-phosphate dehydrogenase deficiency

Answer

Pregnancy, which is not a contraindication but should be considered when weighing risks and benefits

Answer

Renal dysfunction, which is not a contraindication but may require dose adjustment

Answer

Hepatic dysfunction, which is not a contraindication but may require dose adjustment

Question 33

What is the primary objective of antibiotic stewardship programs?

Accepted Answer

To improve antibiotic use and reduce antimicrobial resistance

Answer

To prevent infections, which is a broader goal of public health but not the specific aim of antibiotic stewardship programs

Answer

To decrease the cost of antibiotics, which is a secondary benefit

Question 34

To monitor the effectiveness of vancomycin therapy, which laboratory test is used?

Accepted Answer

Trough level

Answer

Minimum inhibitory concentration (MIC), which is used to determine susceptibility but not to monitor therapy

Answer

Area under the curve (AUC), which is not routinely used for monitoring vancomycin therapy

Answer

Peak level, which is less useful for monitoring vancomycin therapy

Question 35

When a child has an infection caused by a multidrug-resistant organism, which of the following approaches is most appropriate?

Accepted Answer

Combination therapy with tailored dosing

Answer

Prolonged duration of therapy, which may increase the risk of adverse effects without improving efficacy

Answer

Monotherapy with increased dosing, which may not be effective against resistant organisms

Answer

Discontinuation of antibiotics, which is not appropriate for treating an active infection

Question 36

Effective Laboratory Test for Monitoring Antimicrobial Therapy

Accepted Answer

Serial serum antibiotic levels are the most useful laboratory test to monitor the effectiveness of antimicrobial therapy.

Answer

Complete blood count is not as specific as serum antibiotic levels for monitoring antimicrobial therapy.

Answer

Erythrocyte sedimentation rate and C-reactive protein are non-specific markers of inflammation and may not accurately reflect antimicrobial effectiveness.

Question 37

Main Cause of Antimicrobial Resistance in Bacteria

Accepted Answer

Overuse and misuse of antibiotics are the primary drivers of antimicrobial resistance in bacteria.

Answer

Environmental factors can contribute to antimicrobial resistance, but they are not the main cause.

Answer

Mutation of bacterial genes is a natural process that can lead to antibiotic resistance, but it's not the primary cause.

Answer

Horizontal gene transfer is one way that bacteria share antibiotic-resistance genes, but it's not the main cause.

Question 38

Example of a Narrow-Spectrum Antibiotic

Accepted Answer

Vancomycin is a narrow-spectrum antibiotic, meaning it has a limited range of activity and affects only certain types of bacteria.

Answer

Ampicillin is a broad-spectrum antibiotic that covers a wide range of bacteria.

Answer

Azithromycin is a broad-spectrum antibiotic that affects many different types of bacteria.

Answer

Cefazolin is a medium-spectrum antibiotic with a wider range of activity than vancomycin.

Question 39

Mechanism of Action of Beta-Lactam Antibiotics

Accepted Answer

Beta-lactam antibiotics, such as penicillin, inhibit bacterial cell wall synthesis by interfering with the formation of the bacterial cell wall.

Answer

Beta-lactam antibiotics do not target bacterial membranes.

Answer

Beta-lactam antibiotics do not interfere with bacterial protein synthesis.

Answer

Beta-lactam antibiotics do not disrupt bacterial DNA replication.

Question 40

Primary Excretion Pathway for Penicillin G

Accepted Answer

Penicillin G is primarily excreted by the kidneys; it undergoes renal filtration and is eliminated through the urine.

Answer

Clindamycin is primarily excreted through the liver.

Answer

Erythromycin is primarily excreted through the liver.

Answer

Metronidazole is excreted through both the kidneys and the liver.

Question 41

Term for Development of Resistance During Antibiotic Therapy

Accepted Answer

Emergence of resistance refers to the development of resistance to a specific antibiotic during the course of antimicrobial therapy.

Answer

Cross-resistance refers to the development of resistance to multiple antibiotics simultaneously, not during the course of therapy.

Answer

Collateral damage is not a term used in the context of antimicrobial resistance.

Question 42

Antibiotic Class Associated with Clostridioides difficile Infection

Accepted Answer

Fluoroquinolones are a class of antibiotics that are commonly associated with an increased risk of Clostridioides difficile infection.

Answer

Tetracyclines are not typically associated with Clostridioides difficile infection.

Answer

Beta-lactams are not typically associated with Clostridioides difficile infection.

Answer

Macrolides are not typically associated with Clostridioides difficile infection.

Question 43

Recommended Duration of Antibiotic Therapy for Streptococcal Pharyngitis

Accepted Answer

The recommended duration of antibiotic therapy for uncomplicated pharyngitis caused by Group A Streptococcus is 10 days.

Answer

A longer duration of 21 days is not necessary and may increase the risk of adverse effects.

Answer

A duration of 14 days is not typically recommended for uncomplicated pharyngitis.

Answer

A shorter duration of 5 days may not be sufficient to eradicate the bacteria.

Question 44

A 6-year-old child presents with a high fever and sore throat. You suspect streptococcal pharyngitis. Which antibiotic is the most appropriate initial treatment?

Accepted Answer

Penicillin V

Answer

Vancomycin

Answer

Azithromycin

Answer

Cefuroxime

Question 45

A 3-month-old infant, born prematurely, is admitted for suspected sepsis. Which factor would most influence your decision to administer intravenous antibiotics?

Accepted Answer

The infant's gestational age and weight

Answer

The infant's feeding history

Answer

The infant's blood type

Answer

The infant's sex

Question 46

A 5-year-old child presents with fever and cough. The child's mother reports exposure to pertussis. Which antibiotic is most appropriate for treatment?

Accepted Answer

Azithromycin

Answer

Vancomycin

Answer

Penicillin V

Answer

Cefuroxime

Question 47

A 1-year-old child with bronchiolitis is hospitalized. What is the most appropriate management strategy?

Accepted Answer

Supportive care, including oxygen therapy and hydration.

Answer

Antibiotics are usually indicated.

Answer

Bronchodilators are the mainstay of treatment.

Question 48

A 12-year-old child with cystic fibrosis is experiencing a pulmonary exacerbation. What is the most important factor to consider when choosing antibiotics?

Accepted Answer

The child's current lung function and previous antibiotic history

Answer

The child's weight

Answer

The child's sex

Question 49

A 7-year-old child is prescribed amoxicillin for a skin infection. The child's mother reports a history of penicillin allergy. What is the most appropriate next step?

Accepted Answer

Obtain a detailed history of the previous allergic reaction.

Answer

Prescribe a different antibiotic without further investigation.

Answer

Advise the mother to give the child amoxicillin anyway.

Question 50

A 4-year-old child with recurrent urinary tract infections is being considered for prophylactic antibiotic therapy. What is a significant risk factor associated with long-term antibiotic use?

Accepted Answer

Increased risk of antibiotic resistance

Answer

Increased risk of allergies

Answer

Increased risk of vitamin deficiencies

Question 51

A 9-year-old child with acute otitis media is treated with amoxicillin. After 5 days, the child's symptoms haven't improved. What is the most appropriate next step?

Accepted Answer

Consider changing the antibiotic to a broader-spectrum agent.

Answer

Prescribe a corticosteroid.

Answer

Continue amoxicillin for another 5 days.