1. Single-choice questions (2 points each, ***20 questions 40 points)
1. The proportion of antimicrobial drug prescriptions for outpatients does not exceed A
A.20% B.30% C.40% D.50%
2. The main pathogenic bacteria causing hospital infections are B
A. Gram-positive bacteria B. Gram-negative bacteria C. Fungi D. Mycoplasma
3. When using antibacterial drugs for the elderly and children, the safest variety is C
A. Fluoroquinolones B .Aminoglycosides C. Lactams D. Chloramphenicol
4. There is a lack of indication for preventive antibacterial drugs (ineffective and prone to drug-resistant bacterial infections). D
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A. Patients with fever due to common cold, measles, viral hepatitis, poliomyelitis, chickenpox and other viral diseases B. Patients with coma, shock, heart failure C. Immunosuppressant users D. All of the above
5. According to the requirements of Document No. 38 [2009] of the Ministry of Health, when the target bacterial resistance rate exceeds 50% of antibacterial drugs, B
A. Promptly send early warning Notify the medical staff of this institution B. Select according to the results of drug susceptibility test
C. Use empirical drugs with caution D. Suspend the clinical application of this type of antibacterial drugs
6. Purchase by secondary hospitals The number of antimicrobial drugs shall not exceed Type B.
A. 40 B. 35 C. 50 D. 60
7. Physicians with B-level or above professional and technical qualifications can only be awarded the title after training and passing the examination. Restriction of prescribing authority for use-grade antibacterial drugs.
A. Elementary B. Intermediate C. Advanced D. Both junior, middle and high schools are acceptable
8. In emergency situations, doctors can use antibacterial drugs at a higher level, and the prescription amount should be limited to A day's dosage.
A. 1 day B. 2 days C. 4 days D. 7 days
9. Medical institutions should file a complaint against doctors who prescribe antibiotics for D or more without justifiable reasons. Warning, limiting its authority to prescribe special-use and restricted-use antibacterial drugs.
A. 2 times B. 4 times C. 5 times D. 3 times
10. The drug with good antibacterial effect on most anaerobic bacteria is D
A. Cefazolin B. Gentamicin C. Penicillin G D. Metronidazole
11. Indications for combined use of antibacterial drugs do not include C
A .Mixed infections that cannot be effectively controlled by a single antibacterial drug
B. Those who require long-term medication and the bacteria may develop resistance
C. Those with combined viral infections
D. Combined use of drugs to reduce the dose of more toxic antibacterial drugs
12. The course of antibacterial drug treatment varies depending on the infection. Generally, it should be used until the body temperature is normal and a few hours after the symptoms subside. In special circumstances , handle it properly C
A.24h B.48h C.72～96h D.96h
13. Preventive medication is not considered in the following situations of clean surgery D
A. The scope of the operation is large, the time is long, and the chance of contamination increases
B. The operation involves important organs, and infection may easily lead to serious consequences
C. Artificial joint replacement surgery< /p>
D. The surgical field is a sterile site, with no local inflammation, damage, or pollution, and does not involve organs that communicate with the outside world
14. Antibacterial drugs that do not belong to second-line management C
A. Cefminox B. Cefoperazone C. Aztreonam D. Ceftazidime
15. D should be used for the treatment of methicillin-resistant Staphylococcus aureus (MRSA)
A. Penicillin B. Cefradine C. Cefoperazone D. Vancomycin
16. Penem antibiotics such as imipenem and meropenem are mainly used In A
A. Gram-negative enzyme-producing bacteria B. Gram-positive enzyme-producing bacteria C. Fungi D. Mycoplasma
17. Patient, male, 58 years old, due to ? Cough and expectoration for 8 days? See a doctor. Preliminary diagnosis: acute bronchitis. Give roxithromycin orally, please tell the patient the optimal number of times to take the medicine every day B
A. Once a day B. 2 times a day C. 3 times a day D. 4 times a day
18. Preventive medication for surgery generally does not exceed B
A. 3 days after surgery B. 24 hours after surgery C. 1 week after surgery D. Use until the patient is discharged
< p> 19. Among the following alternatives, except C, all are prone to renal toxicityA. Aminoglycosides B. Cefazolin C. Rifampicin D. Amphotericin B
< p> 20. When an allergic reaction occurs during treatment with penicillins, BA. Reduce the dose and treat symptoms B. Stop the drug and treat symptoms C. Continue taking the drug and treat symptoms
D. Stop taking the drug and wait until the allergic reaction disappears, then continue to use the original drug
2. Fill in the blanks (2 points each, 10 questions 40 points)
1. Replacement of antibacterial drugs: After __72___ hours of medication for patients with general infections (_48_ hours for severe infections), it can be decided whether the antibacterial drugs used need to be changed based on the clinical response or clinical microbiological examination results.
2. The preventive application of antimicrobial drugs, including __surgical perioperative prophylaxis__ application of antibacterial drugs and _internal medicine system non-surgical _preventive medication, the possibility of infection and preventive medication must be fully considered The effect, the emergence of drug-resistant bacteria, the occurrence of secondary infections, adverse drug reactions, drug prices and patient susceptibility are all factors that determine whether to apply it.
3. When patients undergo clean-contaminated surgery (Class II incision), the perioperative prophylactic medication time is also __24__ hours, which may be extended to __48__ hours if necessary.
4. According to the hierarchical use management of antibacterial drugs and the needs of the patient's condition, when the clinical treatment regimen requires third-line drug treatment, it must be confirmed by an expert recognized by the anti-infection or hospital pharmaceutical management committee. If not, it should be signed by a doctor with a senior professional title. Departments without a doctor with this level of professional title must be signed by the department director or have a consultation record with an infection specialist.
5. The "Measures for the Management of Clinical Application of Antimicrobial Drugs" were reviewed and approved by the Ministry of Health on February 13, 2012, and will come into effect on August 1, 2012.
6. Antimicrobial drugs are divided into three levels: __non-restricted use grade antibacterial drugs__, __restricted use grade antibacterial drugs__, and __special use grade antibacterial drugs__.
7. Special antibacterial drugs shall not be used in __ outpatient clinic__.
8. For topical application, fungicides that are less irritating, difficult to absorb, less likely to cause drug resistance and less likely to cause allergic reactions, such as __penicillins__, __cephalosporins__, etc. Drugs that are prone to allergic reactions should not be applied topically.
9. Perioperative prophylactic medication method: For patients undergoing clean surgery (Class I incision), in accordance with the relevant provisions of the "Guiding Principles for Clinical Application of Antimicrobial Drugs of the Ministry of Health", within _0.5-2_ hours before surgery, Or administer the drug at the beginning of anesthesia, so that when the surgical incision is exposed, the drug concentration in the local tissue has reached a level sufficient to kill the bacteria that invade the incision during the operation. If the operation time exceeds _3_ hours or the blood loss is greater than __1500ml__, a second dose can be given during the operation (no additional dose of the long half-life antibiotic ceftriaxone is required). The effective coverage time of antimicrobial drugs should include the entire surgical process and __4__ hours after the operation. The total preventive medication time should not exceed _24_ hours, which can be extended to __48__ hours in individual cases. For clean surgeries with a short operation time (<2 hours), preoperative medication can be administered once.
10. Only those diagnosed with bacterial infection can use __antibacterial drugs__ as indicated. Those with mild infections who can accept oral administration should choose antibacterial drugs that are fully absorbed orally, and do not need to use __intramuscular__ or __intravenous__ injection.
3. Short answer questions: (10 points each, ***20 points)
1. What are the basic principles of therapeutic application of antibacterial drugs?
Answer (1) Only those who are diagnosed with bacterial infection can use antibacterial drugs as indicated;
(2) Identify the pathogen of infection as early as possible, and select antibacterial drugs according to the type of pathogen and the results of bacterial drug sensitivity test;
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(3) Select drugs according to their antibacterial action characteristics and the characteristics of their internal processes;
(4) The antibacterial drug treatment plan should be formulated based on the patient’s condition, pathogenic bacteria types and antibacterial drug characteristics; < /p>
2. If a doctor encounters what circumstances, the medical institution should revoke his prescribing authority?
Answer: (1) If the antimicrobial drug test fails;
(2) ) After restricting the right to prescribe, excessive prescriptions are still made without valid reasons;
(3) Failure to prescribe antibacterial drugs in accordance with regulations, resulting in serious consequences;
(4) Failure to do so Using antibacterial drugs in accordance with regulations, causing serious consequences;
(5) Prescribing antibacterial drugs to obtain illegitimate benefits.
3. The harm of unreasonable use of antibacterial drugs;
Reduce clinical efficacy, affect prognosis
Prolong medical treatment and hospitalization time, increase medical expenses
Induces bacterial enzyme production and induces the production of drug-resistant strains
Increases adverse reactions, causes drug-induced diseases, and even death