Antibiotics & ID

Question 1

Vancomycin

Answer 1

Mx: prevents cross linking of cell wall in gram POSITiVe bacteria though inhibition of amino glycosidase?

SE: red man syndrome.

Question 2

What are the four main classes in inhibiting protein synthesis?

Answer 2

30s:
Tetracycline- doxycycline (r)
Aminoglycoside- gentamicin (i)

50s:
Macrolide- erythromycin (r)
Chloramphenicol (i)

+ RNA synth- Rifampicin

Question 3

Side effects of doxycycline and mx of action.

Answer 3

Used to treat respiratory conditions? malaria, acne. Reversible binds to 30s ribosome.

SE: photosensitive rash, absorption of calcium compromised.

Question 4

Side effects of gentamicin and mx of action.

Answer 4

Used to treat gram negative bacteria. Irreversibly binds to 30s ribosomes.

Ototoxicity and nephrotoxicity.

Question 5

Side effects of erythromycin and mx of action.

Answer 5

Erythromycin causes prolonged QT intervals, respiratory_____ and ——

Reversibly inhibits 50s ribosomes.
Side effects of rash. Renal toxicity.

Question 6

Side effects of chloramphenicol and mx of action.

Answer 6

Irreversibly inhibits 50s ribosomes,

Grey baby syndrome.

Question 7

Side effects of CIPROFLOXACIN and mx of action.

Answer 7

Ciprofloxacin belongs to the class of fluoroquinolones.

Contraindications include, tendon and cartilage damage. Photosensitive rash.

For infective diarrhoea ,

Question 8

What are the two main classes under beta lactams? Give a drug in each class

Answer 8

Penicillin- amoxicillin

Cephalosporins- cephalexin.

Question 9

Perforated viscus. Empirical treatment

Answer 9

G -ve cover Gentamicin
G+ve cover Ampicillin or amoxicillin IV
Anaerobe cover Metronidazole

Question 10

Tazocin

Answer 10

For nosocomial infections.

Tazocin = Piperacillin + tazobactam

Question 11

Viral encephalitis empirical treatment

Answer 11

Only one virus that is treatable: HSV

Acyclovir

Question 12

Bacterial meningitis (Neisseria meningococcal) sign + empirical treatment.

Answer 12

S: Non blanching petechial rash
Rx: Ceftriaxone (Thought) gentamicin for G -ve + dexamethasone

Question 13

Bacterial encephalitis (strep pneumoniae or haemophillus) empirical treatment.

Answer 13

Benzo penicillin

Question 14

Side effects of penicillin and mx of action.

Answer 14

Hypersensitivity and rash

- prevents cell wall synthesis by inhibiting transpeptidase enzyme.

Question 14

Bacterial encephalitis in a child. Organism of interest and treatment:

Answer 14

Lissteria meningitides - gram +ve treat with BenPen.

Can cross fetal placenta

Question 16

Empirical treatment for Pyelonephritis (moderate and severe)

Answer 16

Moderate: Trimethoprim or Augmentin
Severe: Gentamicin and Ampicillin, if renal impairment cephtriaxone

Question 17

Bugs that cause pyelonephritis ?(check)

Answer 17

E.Coli
Klebsiella
Staph sapprophidocus (honeymoon cystitis)
Proteus

Question 18

Treatment of cystitis and contraindications

Answer 18

Trimethoprim (dihydropyridine, low folate, pregnancy)

If contraindicated, cephalexin (1st gen)

Question 19

Empirical treatment for gonorrhoea and chlamydia

Answer 19

Neisseria gonnorhoea (intracellular obligate with purulent discharge) and Chlamydia trochomatas (mucous discharge) are treated the sane as the two can not be distinguished clinically.

IV ceftriaxone and gent?

Question 20

Empirical treatment of strep throat

Answer 20

Phenoxy methyl penicillin

If allergic to penicillin, ezithromycin

Question 21

Empirical treatment for cellulitis

Answer 21

Staph aureus : flucloxacillin

Question 22

Empirical treatment for osteomyelitis

Answer 22

Staph aureus : flucloxacillin

Question 23

Empirical treatment for septic arthritis

Answer 23

Staph aureus : flucloxacillin

Vancomycin if Mrsa

Question 24

Gas gangrene, bloody diarrhoea, pseudomembranous colitis are associated with what bacteria? Rx?

Answer 24

Clostridium difficile (nosocomial)
1st line: metronidazole
2nd line: vancomycin (poor bioavailability, stays in gut)

Question 25

Sepsis of unknown origin treatment OR perforated viscus

Answer 25

Flucoxacillin, gentamicin, metronidazole

Question 26

Treatment for H. Pylori

Answer 26

PPI (Esomeprazole)
Amoxicillin / metronidazole
Clarithromycin
+ bismuth

Question 27

Diarrhoea post travel to Russia,

Foul egg smelling breath

Answer 27

Giardiasis
Treat with metro?
Investigation ova,cyst, parasite test

Question 28

Ascending paralysis post food poisoning

Answer 28

Campylobacter jejuni

Question 29

Treatment of tuberculosis AND side effect of each drug

Answer 29

Rifampicin- orange discolouration of urine and tears, drop in platelets, flu symptoms, inactivation of pill
Isoniazid - peripheral neuropathy, give PYRIDOXINE (Vit B12), increase LFT, drop WCC
Pyrazinamide - hepatitis, arthralgia (CI: acute gout, porphyria)
Ethambutol: optic neuritis ( colour vision affected first)

Question 30

Treatment of HACEK /G negatives
Treatment for Staph
Treatment for Strep
Treatment for enterococcus
Treat for anaerobes

Answer 30

Gentamicin 
Flucoxacillin
Benpen 
Ampicillin 
Metronidazole

Question 31

Empirical treatment for infective endocarditis

Answer 31

Flucloxacillin (staph)
Benzopencillin (strep and enterococcus)
Gentamicin (synergistic)

Question 32

Most common pathogen IE

Answer 32

Strep viridans
Strep bovis
Staph aureus
Enterococcus faecalis

Question 33

Empirical for gastrointestinal pre operation prophylaxis eg appendectomy

Answer 33

Cephaozolin
Metronidazole

Just cephazolin if upper GIT