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USMLE HY notes > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What is the treatment for bacterial meningitis in neonate ( < 28 days)
and what want to cover?

A

** “CVA”** for meningitis in first 28 days of life
Cefotaxime + Vancomycin + Ampicillin
Cefotaxime covers GBS/Strep pneumo/Neisseria
Vancomycin covers MRSA
Ampicillin covers Listeria

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2
Q

Why Ceftiraxone is C/I in neonates?

and what is the alternative?

A

causes biliary sludge

alternative: ampicillin + Gentamicin

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3
Q

Tx for meningitis in elderly pts ( > 50yo)?

A

** “CVA”** for meningitis in first 28 days of life + > 50 yrs
Cefotaxime + Vancomycin + Ampicillin
Cefotaxime covers GBS/Strep pneumo/Neisseria
Vancomycin covers MRSA
Ampicillin covers Listeria

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4
Q

Strep pneumo Meningitis, Tx?

A

Ceftriaxone + Vancomycin + Steroids (“CVS”)

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5
Q

MCC meningitis in adults 18-65 yo?

A

Strep.pneumo

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6
Q

Hospital-acquired or post-neurosurgical procedure bacterial meningitis

Pathogens and Tx?

A

Ceftazidime or cefepime + vancomycin

Psuadomoans + MRSA
Ceftazidime- the only 3rd generation the cover psuedomonas
Cefepime- 4th generation

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7
Q

Headache + nuchal rigidity + fever. LP shows gram-positive diplococci + neutrophil predominance

most likley pathogen?
Tx?

A

Strep. pneumo meningitis

Treatment- Ceftriaxone + Vancomycin + IV Steroids (“CVS”)

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8
Q

IV pt has severe headache + nuchal rigidity + papilledema.

Dx?
Tx?

A

Cryptococcal meningitis- Cryptococcus
Tx- Amphotericin B + flucytosine

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9
Q

Which pathogen ??
IV Pt present with meningtisis is charactirezid by ↑↑ significantly elevated opening pressure
WBC with lymphocyte predominance + ↓ glucose + ↑protein

and how do we the diagnosis?

A

Cryptococcus

Diagnosis test- CSF antigen test (highly sensitive and specific)&raquo_space; Latex agglutination assay or India ink stain

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10
Q

MOA amphotericin B?

A

binds ergosterol → makes holes in fungal membrane

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11
Q

MOA flucytosine?

A

Inhibits thymidylate synthase

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12
Q

What is the maintanace therapy in croptoccocus meningitis?

A

Fluconazole until symptoms resolve + CD4 >100 for >1y

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13
Q

HIV + CD4 < 250 + lives in AZ

patohgen and PPx

A

Coccidioidomycosis

prophylaxis- Itraconazole

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14
Q

HIV + CD4 < 200

Pathogen and ppx

A

Pneumocystis jirovecii

TMP-SMX or pentamidine (HY alternative) or dapsone (HY alternative) or atovaquone

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15
Q

HIV + CD4 < 150 + lives in KY
pathogen and prophylaxis

A

Histoplasmosis

PPx- Itraconazole

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16
Q

HIV + CD4 < 50
pathogen and propylaxis

A

Mycobacterium avium complex (MAC)

PPx- none

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17
Q

Pt on chemotherapy develops fever + WBC count is 2000
Neutropenic fever
possible microbe and Tx

A

Pseudomonas + MRSA

Tx: Ceftazidime (or Cefepime) + Vancomycin

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18
Q

Tx for pt with seizures due to neurocysticercosis

A

Phenytoin

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19
Q

HIV + headache + nuchal rigidity. LP shows lymphocytic pleocytosis. Imaging shows enhancement at base of brain (or in basilar cisterns)

Dx?

A

Tuberculous meningitis

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20
Q

most common cause of cellulitis?

Tx?

A

Staph aureus
Tx- Clindamycin or TMP-SMX or Cephalexin

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21
Q

Most common cause o Erysipelas?

A

Strep pyogenes
(GAS)

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22
Q

well-circumscribed + elevated + face + abnormal vitals

Cellulitis or erysipelas?

A

Erysipelas

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23
Q

blanching borders + on lower extremities + normal vitals

Cellulitis or erysipelas?

A

Cellulitis

24
Q

Recent hot-tub exposure with Folliculitis.
pathogen?

A

Pseudomonas folliculitis

25
Q

Empiric Tx for animal or human bites?

A

Amox-Clav

26
Q

Empiric Tx for community-acquired PNA?

A

Macrolide (Azithromycin) or Doxycycline

“(Medical Doctor)”

27
Q

Tx for HAP if pt is allergic to PCN?

A

Fleuroquinolone
(moxifloxacin or levofloxacin)

28
Q

Microbe if pt has HAP + CXR shows cavitary infiltrate?

Pathogen?
Tx

A

MRSA
Tx- Clindamycin or Vanc or Linezolid

29
Q

Tx for 7 yo M with bullseye rash?

A

Lyme

Amoxicillin

Always give amoxicillin in children < 8yo – NO Doxycycline!

30
Q

Pt from North Carolina has severe headache + T of 39. PEx shows rash on palms and soles + PLT - 75,000
What is the most likely pathopen?
Tx?

A

Rocky Mountain Spotted Fever- Rickettsia rickettsii

Tx- Doxycycline

31
Q

23 yo non-pregnant woman has suprapubic pain + urinary frequency + urgency + burning on urination.

Dx?
Pathogen?
Tx?

A

Cystitis (UTI)
E.coli (most common)
Tx- Nitrofurantoin or ciprofloxacin or TMP-SMX or Fosfomycin

32
Q

Tx for UTI in pregnant women?

A

Nitrofurantoin or Fosfomycin

Do not give cipro or TMP-SMX d/t teratogenic effects

33
Q

Treatment for Pelylonephritis?

A

Ceftriaxone or fluoroquinolone 2nd best

do not give FQ to pregnant patients!

34
Q

Which Abx will not begiven to pregnent pt

A

cipro or TMP-SMX d/t teratogenic effects
Flueroquinolone

35
Q

31 yo F develops fever + uterine tenderness 2 days after having C-section

Dx?
Tx?

A

Endometritis

Tx- ECG = Endometritis tx with Clindamycin + Gentamicin

36
Q

33 yo F in active labor + T is 39 + fetal HR is 190 bpm

Dx?
Tx?

A

Chorioamnionitis- Fetal tachy + maternal fever

Tx- Ampicillin + Gentamicin

37
Q

Tx for Latent TB?

A

Isoniazid for 9 months + B6

38
Q

Treatment for PID inf.

A

Azithromycin (or Doxy) + Ceftriaxone
Chlamydia + Gonorrhea

39
Q

in PID
Tx if only Chlamydia is detected?
Tx if only Gonorrhea is detected?

A

Tx if only Chlamydia is detected- Azithromycin or Doxy
Tx if only Gonorrhea is detected- Azithromycin (or Doxy) + Ceftriaxone

40
Q

21 yo F has RUQ pain + history of PID

Dx?

A

Perihepatitis aka Fitz-Hugh-Curtis syndrome

41
Q

Female has off-white/gray vaginal discharge with fishy odor
Pathogen?
Labs?
Tx?

A

Gardnerella vaginosis
PH ? 4.5
Clue cells
Tx- Metronidazole or clindamycin

42
Q

Female has frothy yellow-green that is malodorous

Pathogen?
Labs?
Tx?

A

Trichomonas vaginosis
labs- PH > 4.5
Motile trichomonas
Tx- Metronidazole for patient + partner

43
Q

Pt on CTx (i.e. ICH) + neutropenia + eosinophilia + cough + hemoptysis

Pathogen?
Labs?
Tx?

A

Aspergillus
Histo- acute angle at 45 degree
Tx- Voriconazole

44
Q

Pt with uncontrolled DM + glucose in hundreds + facial pain

Pathogen?
Labs (Histo)?
Tx?

A

Mucor or Rhizopus
Histo- Budding at 90º angles
Tx- Surgical debridement + liposomal Amp B

45
Q

Tx for tinea

A

Tinea corporis = topical antifungal (“—azole”)
Tinea capitis and tinea unguium = terbinafine or griseofulvin (oral antifungals)

46
Q

Microbes a/w tinea?

A

Trichophyton, Microsporum, Epidermophyton

47
Q

Tx for syphilis in pt’s allergic to PCN?

A

Macrolide (AZT) or doxycycline

48
Q

Tx for syphilis in pt with PCN allergy who is pregnant or has neurosyphilis?

A

Desensitization then penicillin

49
Q

Tx for GI infections (e.g. diverticulitis, appendicitis, cholecystitis)?

A

“MAG” = Metronidazole + Amoxicillin + Gentamicin
“MC” = Metronidazole + Cipro

50
Q

Tx of gastroenteritis (e.g. Salmonella or Shigella)?

A

Fluoroquinolone or macrolide

51
Q

Tx options for malaria

A

Mefloquine - most common PPx
Atovaquone + Proguanil
Artemether + lumefantrine
Primaquine = to kill hypnozoites, which cause latent malaria

52
Q

Which Tx against maleria have high resistance?

A

Chloroquine

53
Q

Whic Tx for malaria can cuse latent maleria?

A

Primaquine

54
Q

What must be check before prescribing primaquine?

A

G6PD deficiency

55
Q

Microbes a/w hypnozoites?

A

Plasmodium vivax and Plasmodium ovale

56
Q

PPx for malaria?

A

Mefloquine

57
Q
A

USMLE HY notes (27 decks)

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