A 74-year old female was admitted to the hospital 4 days ago for an elective procedure and has been ventilated since surgery. Today the medical team notes the patient has a fever, decreased oxygenation, and is requiring frequent suctioning of purulent respiratory secretions.  A CXR reveals a RLL infiltrate, and a diagnosis of ventilator-associated pneumonia is made. No recent antibiotic use or hospitalizations.  VS: 101.5˚F, HR 106, RR 30, BP 112/66; LABs: BUN 24, SCr 2.2, WBC 14.2 Hospital antibiogram reveals the following susceptibility rates to P. aeruginosa: Cefepime: 86%                                                Meropenem: 96% Ceftazidime: 89%                                           Piperacillin/tazobactam: 93% Ciprofloxacin: 84%                                         Tobramycin: 92% Amikacin: 95%   Hospital antibiogram reveals the following in regards to S. aureus: Methicillin susceptible: 75% of S. aureus isolates Methicillin-resistance: 25% of S. aureus isolates   You are consulted on an empiric antibiotic regimen.  After speaking with the nurse to ensure appropriate cultures have been sent, which of the following is the best recommendation?  

BW is a 44-yo transgender male who presents to his PCP with a cough productive of purulent sputum and pain on inspiration.  BW reports a history of fever, shortness of breath, and malaise.  CXR reveals a right upper lobe infiltrate.  The patient is diagnosed with community-acquired pneumonia and determined he will be treated on an outpatient basis. No hospitalizations or antibiotic exposure in the past 3 months. PMH: gender dysphoria. Meds: testosterone, spironolactone. Which of the following is the best recommendation?

PF is a 69-year old female who presents to the ED with difficulty breathing, and a productive purulent cough. CXR reveals ground glass opacities, and the patient is diagnosed with pneumonia.  PMH: HTN, rheumatoid arthritis, no recent hospital admissions or antibiotic use. VS: Temp 101.4˚F, BP 108/54, HR 104, RR 40; LABs: BUN 26 mg/dL, SCr 1.7.   Which of the following is the best recommendation?

For each compound, first identify the compound as binary ionic (B), ternary ionic (T), molecular (M) or acid (A).  Then write the correct formula for the compound.  Please number your answers and when necessary, use the subscript key in the toolbar (click the “arrow down” on the key in the toolbar to change to the subscript key) To return to normal case, click on the subscript key again. (If you don’t see the subscript key in the toolbar, click on the three vertical dots to expand the toolbar) Alternatively, write the answers on your paper.  1.  hydrochloric acid 2.  calcium nitrate 3.  barium phosphate 4.  dinitrogen trioxide 5.  tin (II) nitride  

For each compound, first identify the compound as binary ionic (B), ternary ionic (T), molecular (M) or acid (A).  Then write the correct formula for the compound.  Please number your answers and when necessary, use the subscript key in the toolbar (click the “arrow down” on the key in the toolbar to change to the subscript key) To return to normal case, click on the subscript key again. (If you don’t see the subscript key in the toolbar, click on the three vertical dots to expand the toolbar) Alternatively, write the answers on your paper.  1.  hydrochloric acid 2.  magnesium nitrate 3.  potassium carbonate 4.  trinitrogen octachloride 5.  nickel (II) phosphide  

The diagram shows schematically the electric field of an electromagnetic wave corresponding to light traveling in air () and after entering a piece of an unknown material. Using the diagram, estimate the index of refraction of this material.

BCH 4024 OC 3426 SP26 E2 Q39: What are the names of the reactant, the product and the enzyme, respectively, in the following reaction?

This type of inflammatory fluid/material shown in the image below is made up of macrophages. This type of inflammation is often present with parasitic and fungal infections. What type of inflammatory fluid/material is this?

BCH 4024 OC 3426 SP26 E2 Q43: A patient presents with poorly functioning PDH complex E3, and alpha-ketoglutarate dehydrogenase complex E3, as well as poorly functioning succinate dehydrogenase/Complex II enzyme (among others). You suspect a vitamin deficiency. Which of the following vitamin supplements would be of the most benefit to your patient?

BCH 4024 OC 3426 SP26 E2 Q47: Mitchell’s chemiosmotic theory suggested that a high concentration of protons outside the mitochondrial membrane _______________________________.