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NAPLEX 2022 > Bacterial Infections > Flashcards

Bacterial Infections Flashcards

1
Q

PURPOSE OF PRE-OPERATIVE ANTIBIOTICS

A

PREVENT SKIN BACTERIA FROM CAUSING INFECTION WHEN SKIN IS CUT INTO
(STAPH AND STREP)

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2
Q

WHEN DOES ONE START PRE-OPERATIVE ANTIBIOTICS?

A

USUALLY 60 MINUTES PRIOR TO START OF SURGERY
(QUINOLONE AND VANCO SHOULD BE STARTED 120 MIN PRIOR)

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3
Q

WHAT IS THE RECOMMENDED ABX FOR CARDIAAC OR VASCULAR SURGERIES?
WHAT IS THE ALTERNATIVE?

A

CEFAZOLIN
- VANCO OR CLINDA

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4
Q

WHAT IS THE RECOMMENDED ABX FOR HIP FRACTURE OR TOTAL JOINT SURGERIES?
WHAT IS THE ALTERNATIVE?

A

CEFAZOLIN
- VANCO OR CLINDA

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5
Q

WHAT IS THE RECOMMENDED ABX FOR COLON OR OTHER ABDOMINAL SURGERIES?
WHAT IS THE ALTERNATIVE?

A

CEFOTETAN, CEFOXITIN, AMP/SULBACTAM, ERTAPENEM
OR
METRONIDAZOLE + (CEFAZOLIN OR CEFTRIAXONE)
- CLINDA OR METRONIDAZOLE + (AMINOGLYCOSIDE OR QUINOLONE)

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6
Q

WHAT IS THE MOST COMMON BACTERIAL CAUSE FOR MENINGITIS?

A

STREP PNEUMO
N. MENINGITIDIS
H. FLU

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7
Q

FOR MENINGITIS TREATMENT, WHAT AGENT IS USED PRIOR OR WITH THE FIRST ABX DOSE AND WHY?

A

DEXAMETHASONE TO PREVENT NEUROLOGICAL COMPLICATIONS

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8
Q

IF THIS BUG IS THE CAUSE OF THE MENINGITIS, THEN IT MUST BE TREATED WITH AMPICILLIN

A

LISTERIA MONOCYTOGENES

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9
Q

MENINGITIS EMPIRIC TREATMENT FOR NEONATES

A

NEED TO COVER LISTERIA
AMPICILLIN + CEFOTAXIME
OR
GENTAMICIN

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10
Q

MENINGITIS EMPIRIC TREATMENT FOR AGE 1 MO TO 50 YRS

A

NEED DOUBLE STREP PNEUMO COVERAGE
CEFTRIAXONE OR CEFOTAXIME
+
VANCOMYCIN

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11
Q

MENINGITIS EMPIRIC TREATMENT FOR > 50 YRS OR IMMUNOCOMPROMISED

A

NEED TO COVER FOR LISTERIA AND DOUBLE COVER STREP PNEUMO
AMPICILLIN + (CEFTRIAXONE OR CEFOTAXIME) + VANCOMYCIN

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12
Q

WHAT IS THE FIRST LINE TREATMENT FOR AOM

A

AMOXICILLIN OR AUGMENTIN

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13
Q

WHAT IS THE PEDIATRIC DOSING FOR AMOXICILLIN AND AUGMENTIN

A

AMOXICILLIN: 80-90 MG/KG/DAY
AUGMENTIN: 90 MG/KG/DAY OF AMOX AND 6.4 MG/KG/DAY OF CLAV

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14
Q

WHAT BUG NEEDS TO BE COVERED IN AOM

A

STREP PNEUMO

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15
Q

WHAT IS THE TREATMENT OF CHOICE FOR PHARYNGITIS CAUSED BY STREP PYOGENES

A

PENICILLIN
AMOXICILLIN

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16
Q

ACUTE BRONCHITIS CAUSE AND TREATMENT

A

MOST COMMONLY VIRUS - SELF LIMITING, SUPPORTIVE TREATMENT
IF BORDETELLA PERTUSSIS - MACROLIDE OR SMX/TMP
BUT GENERALLY ABX NOT RECOMMENDED

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17
Q

ACUTE BACTERIAL EXACERBATION OF CHRONIC BRONCHITIS IN COPD TREATMENT

A

START AS SUPPORTIVE
START ABX FOR 5-7 DAYS IF WORSENING SX OR NEED TO BE MECHANICALLY VENTILATED

ABX: AUGMENTIN, AZITHROMYCIN, DOXY

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18
Q

CA-PNEUMONIA BACTERIAL CAUSES

A

S.PNEUMO
H.FLU
M.PNEUMO

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19
Q

HOW IS CAP OUTPATIENT TREATMENT DETERMINED

A

IF COMORBIDITIES, NEED ADDITIONAL COVERAGE

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20
Q

CAP OUTPATIENT TREATMENT

A

HIGH DOSE AMOXICILLIN, DOXYCYCLINE, OR MACROLIDE

IF COMORBIDITY, BETA-LACTAM + (DOXY OR MACROLIDE) OR CHOOSE A RESPIRATORY QUINOLONE FOR MONOTHERAPY

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21
Q

INPATIENT CAP TREATMENT: NON-ICU CARE

A

1) BETA-LACTAM (CEFTRIAX, CEFOTAXIME) + (MACROLIDE OR DOXY)

2) RESPIRATORY QUINOLONE MONOTHERAPY

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22
Q

INPATIENT CAP TREATMENT: ICU CARE

A

BETA-LACTAM (CEFTRIAX, CEFOTAXIME) + MACROLIDE OF RESP QUINOLONE

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23
Q

INPATIENT CAP TREATMENT: PSEUDOMONAS RISK.
WHAT AGENTS DO YOU ADD?

A

PIP/TAZO
CEFEPIME
MEROPENEM
AZTREONAM

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24
Q

INPATIENT CAP TREATMENT: MRSA RISK.
WHAT AGENTS DO YOU ADD?

A

ADD VANCOMYCIN OR LINEZOLID

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25
INPATIENT CAP TREATMENT: PSEUDOMONAS AND/OR MRSA RISK FACTORS
PRIOR RESPIRATORY ISOLATION OF EITHER PATHOGEN RECENT HOSPITALIZATION WITH RECEIVE OF IV ABX IN PAST 90 DAYS
26
COMMON PATHOGENS OF HAP AND VAP
NOSOCOMIAL PATHOGENS MRSA MDR GN RODS INCLUDING PSUEDOMONAS
27
HAP AND VAP EMPIRIC TREATMENT: WHAT SHOULD ALL PATIENTS GET
ABX FOR PSEUDOMONAS AND MSSA COVERAGE
28
HAP AND VAP EMPIRIC TREATMENT: WHAT SHOULD BE ADDED TO BASE REGIMEN IF RISK OF MRSA
VANCOMYCIN OR LINEZOLID
29
HAP AND VAP EMPIRIC TREATMENT: WHAT SHOULD BE DONE IF RISK FOR PSEUDOMONAS MDR PATHOGEN
2 ABX FOR PSEUDOMONAS IN GENERAL, MDR RISK ALSO MEANS MRSA RISK AND PT TYPICALLY GETS 3 AGENT REGIMEN
30
WHICH VACCINE CAN GIVE A A FALSE POSITIVE ON THE TST
BCG VACCINE
31
WHAT IS THE PREFERRED REGIMEN FOR LATENT TB
- INH AND RIFAPENTINE WEEKLY FOR 12 WEEKS VIA DIRECTLY OBSERVED THERAPY - RIFAMPIN DAILY FOR 4 MONTHS - ISONIAZID W/ RIFAMPIN FOR 3 MONTHS
32
WHAT IS AN ALTERNATIVE REGIMEN FOR LATENT TB TREATMENT? WHO IS GENERALLY RECOMMENDED THIS REGIMEN?
INH DAILY FOR 6 OR 9 MONTHS PREGNANT WOMEN
33
WHAT IS THE TREATMENT FOR ACTIVE TUBERCULOSIS?
2 PHASES (INTENSIVE AND CONTINUATION) INTENSIVE 2 MONTHS: RIFAMPIN, ISONIAZID, PYRAZINAMID, ETHAMBUTOL (RIPE) CONTINUATION 4 MONTHS: RIFAMPIN, ISONIAZID
34
COMMON PATHOGEN THAT CAUSES INFECTIVE ENDOCARDITIS
STAPH STREP ENTEROCOCCI
35
EMPIRIC TREATMENT FOR INFECTIVE ENDOCARDITIS
VANCOMYCIN AND CEFTRIAXONE GENTAMICIN IS ADDED FOR SYNERGY WHEN INFECTION IS DIFFICULTE TO ERADICATE
36
WHAT ARE THE GENTAMICIN PEAK AND TROUGH LEVELS WHEN IT IS USED IN INFECTIVE ENDOCARDITIS
PEAK OF 3 - 4 TROUGH < 1
37
INFECTIVE ENDOCARDITIS DENTAL PROPHYLAXIS PREFERRED REGIMEN (ALTERNATIVE)
AMOXICILLIN 2 GM 30-60 MIN PRIOR TO DENTAL PREOCEDURE (CLINDA 600 OR AZITH/CLARITHROMYCIN 500 MG)
38
SPONTANEOUS BACTERIAL PERITONITIS TREATMENT DRUG OF CHOICE
CEFTRIAXONE FOR 5-7 DAYS
39
SPONTANEOUS BACTERIAL PERITONITIS PROPHYLAXIS DRUGS OF CHOICE
SMX/TMP OR CIPROFLOXACIN
40
SECONDARY PERITONITIS LIKELY PATHOGENS
STREPTOCOCCI ENTERIC GN ANAEROBES (BACTEROIDESFRAGILIS
41
SECONDARY INTRA ABDOMINAL MILD TO MODERATE INFECTIONS SHOULD COVER WHICH BUGS
PEK ANAEROBES STREPTOCOCCI ± ENTEROCOCCI
42
SECONDARY INTRA ABDOMINAL SEVERE INFECTIONS SHOULD COVER WHICH BUGS
PEK CAPES PSEUDOMONAS ANAEROBES STREPTOCOCCI ± ENTEROCOCCI
43
IMPETIGO COMMON CAUSE
MOST OFTEN MSSA STREP, STAPH
44
IMPETIGO COMMON TREATMENTS
TOPICAL MUPIROCIN ORAL CEPHALEXIN (TO COVER MSSA)
45
FOLLICULITIS/FURUNCLES/CARBUNCLES COMMON CAUSE
STAPH, USUALLY MRSA
46
FOLLICULITIS/FURUNCLES/CARBUNCLES COMMON TREATMENT
INITIALLY TARGET MSSA: CEPHALEXIN THEN MOVE ON TO TARGET MRSA: SMX/TMP OR DOXYCYCLINE
47
CELLULITIS NON-PURULENT COMMON CAUSE
STREPTOCOCCI (INCLUDING S.PYOGENES) STAPH
48
CELLULITIS NON-PURULENT COMMON TREATMENT
NEED TO COVER STREPTOCOCCI ± MSSA CEPHALEXIN IF ALLERGIC, CLINDAMYCIN
49
ABSCESS PURULENT COMMON CAUSE
CA-MRSA
50
ABSCESS PURULENT INFECTION COMMON TREATMENT IF SYSTEMIC SIGNS
ORAL ABXX THAT COVER CA-MRSA SMX/TMP OR DOXYCYCLINE
51
SEVERE PURULENT SSTI COMMON TREATMENTS
NEED TO COVER MRSA VANCOMYCIN, DAPTOMYCIN, LINEZOLID
52
NECROTIZING FASCIITIS EMPIRIC THERAPY
VANCOMYCIN + BETA-LACTAM
53
MODERATE - SEVERE DIABETIC FOOT INFECTIONS ARE OFTEN CAUSE BY WHAT BUG?
VERY BROAD AND POLYMICROBIA. NEED TO USE AGENTS THAT COVER MDR
54
MODERATE - SEVERE DIABETIC FOOT INFECTION MONOTHERAPY OPTIONS
NO NEED TO COVER MRSA AMP/SULBACTAM OR PIP/TAZO CARBAPENEM (IMI/CILAS, MERO, ERTA) MOXIFLOXACIN
55
MODERATE - SEVERE DIABETIC FOOT INFECTIONS COMBINATION THERAPY OPTIONS
NEED TO TARGET MRSA OR PSEUDOMONAS VANCOMYCIN + ONE OF THE FOLLOWING - CEFTAZIDIME, CEFEPIME - PIP/TAZO - AZTREONAM OR CARBAPENEM (NO ERTA) - CONSIDER ADDING METRONIDAZOLE FOR ANAEROBIC COVERAGE
56
COMMON BUG TO CAUSE OF ACUTE UNCOMPLICATED UTI
E.COLI
57
DRUGS OF CHOICE FOR ACUTE UNCOMPLICATED UTI
NITROFURANTOIN 100 MG PO BID WITH FOOD X 5 DAYS SMX/TMP DS 1 TAB PO BID X 3 DAYS FOSFOMYCIN X1 DOSE
58
DRUGS OF CHOICE FOR ACUTE UNCOMPLICATED UTI IF THE PATIENT IS PREGNANT
CEPHALEXIN AMOXICILLIN
59
DRUG OF CHOICE FOR ACUTE PYELONEPHRITIS FOR MODERATELY ILL OUTPATIENT
DEPENDS ON COMMUNITY QUINOLONE RESISTANCE - IF LOW = CIPRO OR LEVO - IF HIGH = 1 DOSE OF CEFTRIAX, ERTA, OR AMINOGLYCOSIDE, THEN LEVO OR CIPRO OTHERS OPTIONS - SMX/TMP, BETA LACTAM
60
DRUG OF CHOICE FOR COMPLICATED UTI
SIMILAR TO PYELONEPHRITIS USE CARBAPENEM IF ESBL-PRODUCING BACTERIA PRESENT
61
PHENAZOPYRIDINE DOSING
200 MG PO TID FOR 2 DAYS MAX TAKE WITH PLENTY OF WATER AND FOOD
62
BACTERIURIA IN PREGNANCY: TREATMENT
BETA-LACTAMS - AUGMENTIN - CEPHALOSPORINS
63
COMMON CAUSE FO TRAVELERS' DIARRHEA
E.COLI
64
TRAVELERS' DIARRHEA: WHAT IS PREFERRED IF DYSENTERY IS PRESENT?
AZITHROMYCIN 1000 MG PO X 1 DOSE OR 500 MG PO DAILY X 1 - 3 DAYS
65
TRAVELERS' DIARRHEA: WHAT IS PREFERRED IF DYSENTERY IS NOT PRESENT?
QUINOLONES OR RIFAXIMIN
66
TRAVELERS' DIARRHEA: WHAT SHOULD NOT BE USED IF DYSENTERY IS PRESENT?
LOPERAMIDE AND OTHER ANTIMOTILITY AGENTS
67
HOW IS C.DIF TREATMENT DETERMINED
BASED ON IF IT IS FIRST INFECTION OR A RECURRENCE
68
C.DIFF GENERAL RECOMMENDATIONS
- STOP ABX AS SOON AS SUSPECTED - DO NOT USE ANTI-DIARRHEAL MEDS - ISOLATE PT - WASH HANDS (ALCOHOL DOES NOT WORK) - DIAGNOSIS WITH CULTURE
69
C.DIFF 1ST EPISODE TREATMENT
- VACO 125 MG PO QID X 10 DAYS - FDX 200 MG PO BID X 10 DAYS IF NON SEVERE: - METRONIDAZOLE 500 MG PO TID X 10 DAYS
70
FULMINANT C.DIFF TREATMENT
VANCO 500 MG PO/NG/PR QID + METRO 500 MG IV Q8H
71
C.DIFF 2ND EPISODE TREATMENT (1ST RECURRENCE)
USE AGENT DIFFERENT FROM WHAT WAS USED THE FIRST TIME IF METRO -> VANCO IF VANCO -> FDX OR TAPERED AND PULSED VACO IF FDX -> TAPERED AND PULSED VANCO
72
C.DIFF SUBSEQUENT EPISODE TREATMENT (2ND RECURRENCE AND ON)
- TAPERED AND PULSED VACO - VANCO X 10 DAYS, THEN RIFAXIMIN X 20 DAYS - FDX X 10 DAYS - FECAL MICROBIOTA TRANSPLANT
73
USUAL SYMPTOMS OF CHLAMYDIA
GENITAL DISCHARGE OR NO SYMPTOMS
74
USUAL SYMPTOMS OF GONORRHEA
GENITAL DISCHARGE OR NO SYMPTOMS
75
USUAL SYMPTOMS OF SYPHILLIS
PAINLESS, SMOOTH GENITAL SORES
76
USUAL SYMPTOMS OF HPV
GENITAL WARTS OR NO SYMPTOMS
77
USUAL SYMPTOMS OF BACTERIAL VAGINOSIS
VAGINAL DISCHARGE WITH FISH ODOR AND PH > 4.5 OR NO PAIN
78
USUAL SYMPTOMS OF TRICHOMONIASIS
YELLOW/GREE FROTHY VAGINAL DISCHARGE SORENESS PAIN WITH INTERCOURSE
79
SYPHILLIS PRIMARY, SECONDAY, OR EARLY LATENT DRUG OF CHOICE AND DOSING
PEN G BENZATHINE (BICILLIN L-A) 2.4 MILLION UNITS IM X 1 DOSE
80
SYPHILLIS PRIMARY, SECONDAY, OR EARLY LATENT ALTERNATIVE AGENT (WHO SHOULD NOT RECEIVE THIS ALTERNATIVE AGENT)
DOXYCYCLINE PREGNANT OR HIV POSITIVE SHOULD BE PENICILLIN DESENSITIZED AND TREATED WITH BICILLIN L-A
81
SYPHILLIS LATE LATENT DRUG OF CHOICE AND DOSING
PEN G BENZATHINE (BICILLIN L-A) 2.4 MILLION UNITS IM WEEKLY X 3 WEEKS
82
NEUROSYPHILLIS DRUG OF CHOICE
PENICILLIN G AQUEOUS CRYSTALLINE OR PENICILLIN G PROCAINE
83
GONORRHEA DRUG OF CHOICE AND DOSING
CEFTRIAXONE 500 MG IM X 1 DOSE
84
IF PATIENT HAS GONORRHEA, WHAT SHOULD ALSO BE TREATED FOR UNLESS EXCLUDED?
CHLAMYDIA
85
CHLAMYDIA DRUG OF CHOICE AND DOSING
DOXY 100 MG PO BID X 7 DAYS AZITH 1 GM PO X 1 DOSE
86
BACTERIAL VAGINOSIS DRUG OF CHOICE
METRONIDAZOLE PO OR VAGINALLY
87
WHAT SHOULD PTS WITH BV NOT DO
DOUCHE
88
TRICHOMONIASIS DRUG OF CHOICE AND DOSING
METRONIDAZOLE 2 GM PO X 1
89
WHAT DOES THE CDC RECOMMEND FOR PREGNANT PTS WITH TRICH?
METRONIDAZOLE FOR TRICH NO MATTER THE TRIMESTER
90
GENITAL WARTS (HPV) DRUG OF CHOICE
IMIQUIMOD CREAM
91
WHAT ARE THE NAMES OF THE DIFFERENT RICHETTSIAL INFECTIONS
ROCKY MOUNTAIN SPOTTED FEVER TYPHUS LYME DISEASE EHRLICHLOSIS TULAREMIA
92
WHAT IS THE DRUG OF CHOICE FOR MOST RICKETTSIAL INFECTIONS
DOXYCYCLINE (EVEN IN PERIATRIC PATIENTS)

NAPLEX 2022 (37 decks)

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