C. diff

Question 1

3rd-4th generation cephalosporins

Answer 1

High risk

Question 2

Clindamycin

Answer 2

High risk

Question 3

Fluoroquinolones

Answer 3

High risk

Question 4

Carbapenems

Answer 4

High risk

Question 5

Broad spectrum penicillins

Answer 5

Moderate risk

Question 6

1st-2nd generation cephalosporins

Answer 6

Moderate risk

Question 7

Trimethoprim & Sulfamethoxazole

Answer 7

Moderate risk

Question 8

Macrolides

Answer 8

Moderate risk

Question 9

Aminoglycosides

Answer 9

Low risk

Question 10

Tetracyclines

Answer 10

Low risk

Question 11

Penicillins

Answer 11

Low risk

Question 12

Chloramphenicol

Answer 12

Low risk

Question 13

Daptomycin

Answer 13

Low risk

Question 14

Tigecycline

Answer 14

Low risk

Question 15

If a patient has 3+ unformed stools in 24 hours and a positive toxin test, what do they most likely have?

Answer 15

C. diff!!!

Question 16

What are the multi-step testings that are preferred for an accurate diagnosis of C.diff?

Answer 16

GDH + toxin A/B assay AND
NAAT (PCR) + toxin A/B assay (this is the most used)

Question 17

For testing for CDI, can a patient be given laxatives, oral contrast, or new tube feeds within the previous 48 hours?

Answer 17

NO - that is not allowed

Question 18

What are the restrictions of C. diff testing?

Answer 18

No repeat testing within 7 days
No testing on formed stool samples (should be liquid)

Question 19

Why can’t alcohol based sanitizers be used when caring for a patient with C.diff?

Answer 19

Alcohol based sanitizers do not kill the spores

Question 20

What type of C. diff is occuring in a patient that is experiencing hypotension, shock, ileus, or megacolon during a C. diff infection?

Answer 20

Fulminant

Question 21

What type of therapy should be used in patients that are experiencing shock, ileus, or megacolon along with their C. diff infection?

Answer 21

PO/NG Vancomycin 500 mg q6h PLUS
IV metronidazole 500 mg q8hr
x 10-14 days

Question 22

What are the risk factors for recurrence of C. diff?

Answer 22

Antibiotic use
Older than 65
PPI therapy
NAP1/BI/027 Strain

Question 23

How often are we going to use Vancomycin + Metronidazole for treatment of C. diff

Answer 23

ONLY in cases of fulminant C. diff

Question 24

If a patient is presenting with leukocytosis <15,000 and SCr < 1.5, how are they classified?

Answer 24

Mild/Moderate

Question 25

If a patient is presenting with leukocytosis >15,000 and SCr > 1.5, how are they classified?

Answer 25

Severe