A 53-year-old man is admitted to the hospital with fever, chills, and productive cough. Exam reveals a temperature of 102F and chest X-ray shows a right lower lobe infiltrate. His wife thinks he may have aspirated. The most appropriate antibiotic regimen is piperacillin-tazobactam.

1. Parker Power Half-Hour
Short Term Recall
8/15/2018
Joey Parker

2. A 53M with diabetes and hypertension is admitted to the hospital with fever,
chills, and productive cough. He’s had no sick contacts. Vital signs reveal a
temperature of 102F, HR 105, RR 21, Sp02 95% 3L. His WBC is 17,000. A 2
view CXR shows a right lower lobe infiltrate. His wife thinks he may have
aspirated a day or two ago. He has no antibiotic allergies. Which of the
following is the most appropriate antibiotic regimen?
A. Azithromycin + Ceftriaxone
B. Azithromycin
C. Piperacillin-tazobactam
D. Levofloxacin
E. Moxifloxacin
F. Ciprofloxacin

3. A 53M with diabetes and hypertension is admitted to the hospital with fever,
chills, and productive cough. He’s had no sick contacts. Vital signs reveal a
temperature of 102F, HR 105, RR 21, Sp02 95% 3L. His WBC is 17,000. A 2
view CXR shows a right lower lobe infiltrate. His wife thinks he may have
aspirated a day or two ago. He has no antibiotic allergies. Which of the
following is the most appropriate antibiotic regimen?
A. Azithromycin + Ceftriaxone
B. Azithromycin
C. Piperacillin-tazobactam
D. Levofloxacin
E. Moxifloxacin
F. Ciprofloxacin

4. A 71F with systolic heart failure, diabetes, and hypertension is admitted to
the hospital with chest pain and found to have rapid atrial fibrillation. She is
placed on metoprolol succinate and her heart rate has ranged from 80-100
and is now chest pain free. She has no known valvular disease and her renal
function is normal. She has no prior history of gastrointestinal or
intracerebral bleeding. You approach anticoagulation with her, and she is
opposed to warfarin or any newer medications, as she does not like the
commercials she sees. She takes aspirin 81 mg daily and questions if this is
adequate for stroke prophylaxis. Which of the following is the most
appropriate next step?
A. Continue aspirin 81 mg daily as this is sufficient thromboembolic risk
protection
B. Add Clopidogrel to aspirin
C. Cardiovert her to normal sinus rhythm so she does not need
anticoagulant therapy
D. Demand she takes warfarin or a DOAC

5. A 71F with systolic heart failure, diabetes, and hypertension is admitted to
the hospital with chest pain and found to have rapid atrial fibrillation. She is
placed on metoprolol succinate and her heart rate has ranged from 80-100
and is now chest pain free. She has no known valvular disease and her renal
function is normal. She has no prior history of gastrointestinal or
intracerebral bleeding. You approach anticoagulation with her, and she is
opposed to warfarin or any newer medications, as she does not like the
commercials she sees. She takes aspirin 81 mg daily and questions if this is
adequate for stroke prophylaxis. Which of the following is the most
appropriate next step?
A. Continue aspirin 81 mg daily as this is sufficient thromboembolic risk
protection
B. Add Clopidogrel to aspirin
C. Cardiovert her to normal sinus rhythm so she does not need
anticoagulant therapy
D. Demand she takes warfarin or a DOAC

6. A 65M is seen in the hospital for a STEMI. He was admitted 4 days ago and
underwent stent placement to the LAD. His course has been complicated by
rapid atrial fibrillation and mild contrast induced nephropathy, both of which
have nearly resolved. On day 4 he is noted to be hypoxic and with new
leukocytosis. He has a productive cough. A 2 view CXR shows a new
infiltrate. He has no aspiration risk factors. On further questioning, his
recent history includes cellulitis which was treated 3 weeks with cefazolin for
2 days at an outside facility, prior to being discharged on cephalexin. He has
no antibiotic allergies. Which of the following is NOT an appropriate empiric
antibiotic regimen?
A. Levofloxacin + Vancomycin
B. Piperacillin-tazobactam + vancomycin
C. Cefepime + linezolid
D. Ampicillin-sulbactam + Vancomycin

7. A 65M is seen in the hospital for a STEMI. He was admitted 4 days ago and
underwent stent placement to the LAD. His course has been complicated by
rapid atrial fibrillation and mild contrast induced nephropathy, both of which
have nearly resolved. On day 4 he is noted to be hypoxic and with new
leukocytosis. He has a productive cough. A 2 view CXR shows a new
infiltrate. He has no aspiration risk factors. On further questioning, his
recent history includes cellulitis which was treated 3 weeks with cefazolin for
2 days at an outside facility, prior to being discharged on cephalexin. He has
no antibiotic allergies. Which of the following is NOT an appropriate empiric
antibiotic regimen?
A. Levofloxacin + Vancomycin
B. Piperacillin-tazobactam + vancomycin
C. Cefepime + linezolid
D. Ampicillin-sulbactam + Vancomycin