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Bacterial Flashcards

1
Q

What are the “Four C’s” (antibiotics) that increase the risk of C. diff infection ?

A

Co-amoxiclav (and other broad spectrum penicillins e.g. amoxicillin and ampicillin)

Cephalosporins

Clindamycin

Ciprofloxacin (and other Quinolones)

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2
Q

True or false: food poisoning is a notifiable disease

A

TRUE

Other notifiable diseases include anthrax, measles, cholera and small pox

See BNF for full list

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3
Q

Which class of antibiotics are usually used in patients allergic to penicillin as an alternative

A

Macrolides e.g. erythromycin

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4
Q

Choice of antibiotic for animal/human bites in patients allergic to penicillin ?

A

Doxycycline + metronidazole

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5
Q

Which group of antibiotic(s) are used to treat septicaemia

A

Broad spectrum antipseudomonal penicillin e.g. Tazocin

Piperacillin with Tazobactam

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6
Q

Which antibiotic is used in meningococcal septicaemia

A

Benzylpenicillin

Cefotaxime in penicillin allergy

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7
Q

First line for skin and soft tissue infections

A

Flucloxacillin

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8
Q

True or false: flucloxacillin is first line for both otitis externa and otitis media

A

False

Otitis media: Amoxicillin first line

Otitis externa: Flucloxacillin first line

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9
Q

Antibiotic of choice for C diff infection

A

Metronidazole

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10
Q

Antibiotic(s) of choice for genital chlamydia

2 points

A

Azithromycin (single dose)

Doxycycline (2 stat then 1 OD. 7 day course)

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11
Q

Antibiotic choice for osteomyelitis

A

Flucloxacillin

Clindamycin if penicillin allergy

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12
Q

Which 3 antibiotics can be used first line for an infective exacerbation of COPD

A

Amoxicillin

Doxycycline

Clarithromycin

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13
Q

Imipenem and and Ertapenem are examples of which class of antibiotics

A

Carbapenems

Broad spectrum Beta lactams
Activity against many Gram +ves, -ves and anaerobes

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14
Q

Which macrolide is generally preferred in pregnancy

A

Erythromycin

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15
Q

First line treatment for genital chlamydia (2 options)

A

Doxycycline (7 day course)

Or Azithromycin (single dose)

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16
Q

Which antibiotic is first line for osteomyelitis in penicillin allergy

A

Clindamycin

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17
Q

True or false: antibacterials should be given for acute sinusitis

A

FALSE

It is usually self limiting. Antibiotics are rarely indicated unless the patient is systemically unwell and symptoms have been present for > 10 days

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18
Q

Which tool is used to assess the severity of community acquired pneumonia?

A

CRB-65

In hospital, CURB-65 used (as they have facilities to monitor urea)

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19
Q

Antibiotic of choice for Lyme disease ?

A

Doxycycline is 1st line

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20
Q

Treatment with gentamicin should ideally not exceed ______ in length

21
Q

Which penicillin is used to treat syphilis

A

Benzathine Benzylpenicillin

22
Q

Are penicillins bacteriostatic or bactericidal

A

Bactericidal

23
Q

Which class of antibiotic is known to cause QT prolongation and tendon damage ?

A

(Fluoro) Quinolones

24
Q

True or false: tetracyclines are safe for use in pregnancy

A

FALSE
They should be avoided as they effect skeletal development and cause tooth discolouration

Avoid in under 12s due

May cause maternal hepatotoxicityn

25
Q

What is the most common bacterial cause of UTI

26
Q

True or false: UTIs are considered recurrent if a patient has 2 in the last 6 months

A

TRUE

Also if the patient has had 3 or more in the last 12 months

27
Q

Antibiotic of choice for UTI in a pregnant woman ?

A

Nitrofurantoin

AVOID TRIMETHOPRIM

28
Q

This class of antibiotic is not known to increase the anticoagulant effect of warfarin

A

Cephalosporins

29
Q

True or false

Tetracyclines need to be stopped if the patient develops headaches or visual disturbances

A

TRUE

Seek medical attention. This could be a sign of benign intracranial hypertension

30
Q

True or false:

Clindamycin is safe to continue if the patient develops diarrhoea

A

FALSE

This could indicate antibiotic associated colitis.
Clindamycin is one of the 4 Cs

31
Q

Counselling points for doxycycline?

4 points

A
  1. Swallowed whole with plenty of fluid, while sitting or standing.
  2. Taken during meals.
  3. Do not take indigestion remedies, Ca or Zn products within 2 hours of doxycycline.
  4. May cause photosensitivity - avoid sunlight. Wear broad spec sunscreen
32
Q

Which drugs increase the risk of tendon rupture with Quinolones

A

Corticosteroids

33
Q

How to beta lactam antibiotics work

A

They inhibit the enzymes that cross link peptidoglycan which weakens cell walls

Causes swelling, lysis and death

Bactericidal

34
Q

Which group of beta lactam antibiotics are only available IV

A

Carbapenems eg meropenem

35
Q

True or false

Carbapenems are cautioned in epilepsy

A

TRUE

They are known to cause CNS toxicity (including seizures) at high doses or in renally impaired patients

36
Q

Which antibiotics may cause cholestatic jaundice

3 points

A

Macrolides

Co-amoxiclav

Flucloxacillin

37
Q

True or false:

Macrolides are enzyme inhibitors

A

FALSE

All except azithromycin are enzyme inhibitors

38
Q

Is metronidazole bactericidal or bacteriostatic

A

Bactericidal

39
Q

Which antibiotic should be taken with food or milk to minimise the GI effects

A

Nitrofurantoin

40
Q

Which classes of antibiotics increase the anticoagulant effect of warfarin
(3 points)

How?

A

Penicillins
Tetracyclines
Trimethoprim

Kill vitamin K producing flora

41
Q

Which class of antibiotics increase the risk of methotrexate toxicity

A

Penicillins

They reduce the renal excretion of methotrexate = increased risk of toxicity

42
Q

Which quinolone can be used for pseudomonas infections

A

Ciprofloxacin

43
Q

Is trimethoprim bactericidal or bacteriostatic

A

Bacteriostatic

44
Q

Which drug used in the treatment of TB is not known to be hepatotoxic

A

Ethambutol

Associated with ocular toxicity though !

45
Q

Therapeutic levels for gentamicin:

a) peak
b) trough

Also values in endocarditis

A

A) Peak
5-10 mg/L
3-5 mg/L in endocarditis

B) Trough
<2 mg/L
< 1 mg/L in endocarditis

46
Q

Which antibiotic is known to cause taste disturbances?

A

Metronidazole

Causes a metallic taste in the mouth

47
Q

Which antibiotics are treatment options in pyelonephritis ? Include duration of treatment
(4 points)

A

Cefalexin for 7 - 10 days [preferred in pregnancy]
Co-amoxiclav for 7 - 10 days
Trimethoprim for 14 days
Ciprofloxacin for 7 days

48
Q

Antibiotic for meningococcal septicaemia in penicillin allergy?

A

Cefotaxime

49
Q

What does CURB-65 stand for ? What is it used for

A

Pneumonia severity score in hospital (CRB-65 in community as can’t measure urea)

C = (new onset) Confusion 
U = Urea > 7
R = Respiratory rate > 30 breaths/min
B = (low) Blood pressure < 90 sys or < 60 dia
65 = Age 65 or older

Infections (4 decks)

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