1. The most common infectious cause of diarrhea in elderly long-term care residents is:
a. Rotavirus b. Salmonella c. Clostridium difficile d. E. coli
2. Which of the following would NOT be appropriate in a patient with confirmed Clostridium difficile diarrhea?
a. Stop any non-essential antibiotics b. Give anti-motility drugs for symptomatic relief c. Oral metronidazole d. Place patient in contact precautions
3. Which of the following antibiotics are associated with Clostridium difficile infection?
a. Cephalosporins b. Clindamycin c. Fluoroquinolones d. All of the above
4. Which of the following are effective ways to prevent or contain outbreaks of Clostridium difficile infection?
a. Judicious use of antibiotics b. Using alcohol-based hand cleansers instead of soap and water c. Screening for carriers of C. difficile, and treating carriers with metronidazole d. All of the above
True or False:
5. Clostridium difficile is increasing in frequency and severity over the past several years.
True False
6. The majority of people who have Clostridium difficile in their stool become ill from it.
7. Clostridium difficile infection only occurs in people who have received recent antibiotics.
Case:
You are called about a 66 year old female long-term care resident who has had 5 episodes of loose diarrhea daily for the past 3 days. She now has a fever to 100.3 degrees, and is complaining of cramping lower abdominal pain. Her history is significant for a recent urinary tract infection, caused by E. coli, for which she is currently on levofloxacin.
8. Which of the following tests would be most useful?
a. Repeat urine culture b. Send stool sample for parasite exam c. Send stool sample for Clostridium dificile testing d. Send stool sample for giardia testing
