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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
Q

INPATIENT CAP TREATMENT: PSEUDOMONAS AND/OR MRSA RISK FACTORS

A

PRIOR RESPIRATORY ISOLATION OF EITHER PATHOGEN
RECENT HOSPITALIZATION WITH RECEIVE OF IV ABX IN PAST 90 DAYS

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26
Q

COMMON PATHOGENS OF HAP AND VAP

A

NOSOCOMIAL PATHOGENS
MRSA
MDR GN RODS INCLUDING PSUEDOMONAS

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27
Q

HAP AND VAP EMPIRIC TREATMENT: WHAT SHOULD ALL PATIENTS GET

A

ABX FOR PSEUDOMONAS AND MSSA COVERAGE

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28
Q

HAP AND VAP EMPIRIC TREATMENT: WHAT SHOULD BE ADDED TO BASE REGIMEN IF RISK OF MRSA

A

VANCOMYCIN OR LINEZOLID

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29
Q

HAP AND VAP EMPIRIC TREATMENT: WHAT SHOULD BE DONE IF RISK FOR PSEUDOMONAS MDR PATHOGEN

A

2 ABX FOR PSEUDOMONAS
IN GENERAL, MDR RISK ALSO MEANS MRSA RISK AND PT TYPICALLY GETS 3 AGENT REGIMEN

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30
Q

WHICH VACCINE CAN GIVE A A FALSE POSITIVE ON THE TST

A

BCG VACCINE

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31
Q

WHAT IS THE PREFERRED REGIMEN FOR LATENT TB

A
  • INH AND RIFAPENTINE WEEKLY FOR 12 WEEKS VIA DIRECTLY OBSERVED THERAPY
  • RIFAMPIN DAILY FOR 4 MONTHS
  • ISONIAZID W/ RIFAMPIN FOR 3 MONTHS
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32
Q

WHAT IS AN ALTERNATIVE REGIMEN FOR LATENT TB TREATMENT?
WHO IS GENERALLY RECOMMENDED THIS REGIMEN?

A

INH DAILY FOR 6 OR 9 MONTHS

PREGNANT WOMEN

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33
Q

WHAT IS THE TREATMENT FOR ACTIVE TUBERCULOSIS?

A

2 PHASES (INTENSIVE AND CONTINUATION)
INTENSIVE 2 MONTHS: RIFAMPIN, ISONIAZID, PYRAZINAMID, ETHAMBUTOL (RIPE)
CONTINUATION 4 MONTHS: RIFAMPIN, ISONIAZID

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34
Q

COMMON PATHOGEN THAT CAUSES INFECTIVE ENDOCARDITIS

A

STAPH
STREP
ENTEROCOCCI

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35
Q

EMPIRIC TREATMENT FOR INFECTIVE ENDOCARDITIS

A

VANCOMYCIN AND CEFTRIAXONE
GENTAMICIN IS ADDED FOR SYNERGY WHEN INFECTION IS DIFFICULTE TO ERADICATE

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36
Q

WHAT ARE THE GENTAMICIN PEAK AND TROUGH LEVELS WHEN IT IS USED IN INFECTIVE ENDOCARDITIS

A

PEAK OF 3 - 4
TROUGH < 1

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37
Q

INFECTIVE ENDOCARDITIS DENTAL PROPHYLAXIS PREFERRED REGIMEN
(ALTERNATIVE)

A

AMOXICILLIN 2 GM 30-60 MIN PRIOR TO DENTAL PREOCEDURE
(CLINDA 600 OR AZITH/CLARITHROMYCIN 500 MG)

38
Q

SPONTANEOUS BACTERIAL PERITONITIS TREATMENT DRUG OF CHOICE

A

CEFTRIAXONE FOR 5-7 DAYS

39
Q

SPONTANEOUS BACTERIAL PERITONITIS PROPHYLAXIS DRUGS OF CHOICE

A

SMX/TMP OR CIPROFLOXACIN

40
Q

SECONDARY PERITONITIS LIKELY PATHOGENS

A

STREPTOCOCCI
ENTERIC GN
ANAEROBES (BACTEROIDESFRAGILIS

41
Q

SECONDARY INTRA ABDOMINAL MILD TO MODERATE INFECTIONS SHOULD COVER WHICH BUGS

A

PEK
ANAEROBES
STREPTOCOCCI ± ENTEROCOCCI

42
Q

SECONDARY INTRA ABDOMINAL SEVERE INFECTIONS SHOULD COVER WHICH BUGS

A

PEK
CAPES
PSEUDOMONAS
ANAEROBES
STREPTOCOCCI ± ENTEROCOCCI

43
Q

IMPETIGO COMMON CAUSE

A

MOST OFTEN MSSA
STREP, STAPH

44
Q

IMPETIGO COMMON TREATMENTS

A

TOPICAL MUPIROCIN
ORAL CEPHALEXIN (TO COVER MSSA)

45
Q

FOLLICULITIS/FURUNCLES/CARBUNCLES COMMON CAUSE

A

STAPH, USUALLY MRSA

46
Q

FOLLICULITIS/FURUNCLES/CARBUNCLES COMMON TREATMENT

A

INITIALLY TARGET MSSA: CEPHALEXIN
THEN MOVE ON TO TARGET MRSA: SMX/TMP OR DOXYCYCLINE

47
Q

CELLULITIS NON-PURULENT COMMON CAUSE

A

STREPTOCOCCI (INCLUDING S.PYOGENES)
STAPH

48
Q

CELLULITIS NON-PURULENT COMMON TREATMENT

A

NEED TO COVER STREPTOCOCCI ± MSSA
CEPHALEXIN
IF ALLERGIC, CLINDAMYCIN

49
Q

ABSCESS PURULENT COMMON CAUSE

A

CA-MRSA

50
Q

ABSCESS PURULENT INFECTION COMMON TREATMENT IF SYSTEMIC SIGNS

A

ORAL ABXX THAT COVER CA-MRSA
SMX/TMP OR DOXYCYCLINE

51
Q

SEVERE PURULENT SSTI COMMON TREATMENTS

A

NEED TO COVER MRSA
VANCOMYCIN, DAPTOMYCIN, LINEZOLID

52
Q

NECROTIZING FASCIITIS EMPIRIC THERAPY

A

VANCOMYCIN + BETA-LACTAM

53
Q

MODERATE - SEVERE DIABETIC FOOT INFECTIONS ARE OFTEN CAUSE BY WHAT BUG?

A

VERY BROAD AND POLYMICROBIA. NEED TO USE AGENTS THAT COVER MDR

54
Q

MODERATE - SEVERE DIABETIC FOOT INFECTION MONOTHERAPY OPTIONS

A

NO NEED TO COVER MRSA
AMP/SULBACTAM OR PIP/TAZO
CARBAPENEM (IMI/CILAS, MERO, ERTA)
MOXIFLOXACIN

55
Q

MODERATE - SEVERE DIABETIC FOOT INFECTIONS COMBINATION THERAPY OPTIONS

A

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
Q

COMMON BUG TO CAUSE OF ACUTE UNCOMPLICATED UTI

A

E.COLI

57
Q

DRUGS OF CHOICE FOR ACUTE UNCOMPLICATED UTI

A

NITROFURANTOIN 100 MG PO BID WITH FOOD X 5 DAYS
SMX/TMP DS 1 TAB PO BID X 3 DAYS
FOSFOMYCIN X1 DOSE

58
Q

DRUGS OF CHOICE FOR ACUTE UNCOMPLICATED UTI IF THE PATIENT IS PREGNANT

A

CEPHALEXIN
AMOXICILLIN

59
Q

DRUG OF CHOICE FOR ACUTE PYELONEPHRITIS FOR MODERATELY ILL OUTPATIENT

A

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
Q

DRUG OF CHOICE FOR COMPLICATED UTI

A

SIMILAR TO PYELONEPHRITIS
USE CARBAPENEM IF ESBL-PRODUCING BACTERIA PRESENT

61
Q

PHENAZOPYRIDINE DOSING

A

200 MG PO TID FOR 2 DAYS MAX
TAKE WITH PLENTY OF WATER AND FOOD

62
Q

BACTERIURIA IN PREGNANCY: TREATMENT

A

BETA-LACTAMS
- AUGMENTIN
- CEPHALOSPORINS

63
Q

COMMON CAUSE FO TRAVELERS’ DIARRHEA

A

E.COLI

64
Q

TRAVELERS’ DIARRHEA: WHAT IS PREFERRED IF DYSENTERY IS PRESENT?

A

AZITHROMYCIN
1000 MG PO X 1 DOSE OR
500 MG PO DAILY X 1 - 3 DAYS

65
Q

TRAVELERS’ DIARRHEA: WHAT IS PREFERRED IF DYSENTERY IS NOT PRESENT?

A

QUINOLONES OR RIFAXIMIN

66
Q

TRAVELERS’ DIARRHEA: WHAT SHOULD NOT BE USED IF DYSENTERY IS PRESENT?

A

LOPERAMIDE AND OTHER ANTIMOTILITY AGENTS

67
Q

HOW IS C.DIF TREATMENT DETERMINED

A

BASED ON IF IT IS FIRST INFECTION OR A RECURRENCE

68
Q

C.DIFF GENERAL RECOMMENDATIONS

A
  • STOP ABX AS SOON AS SUSPECTED
  • DO NOT USE ANTI-DIARRHEAL MEDS
  • ISOLATE PT
  • WASH HANDS (ALCOHOL DOES NOT WORK)
  • DIAGNOSIS WITH CULTURE
69
Q

C.DIFF 1ST EPISODE TREATMENT

A
  • 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
Q

FULMINANT C.DIFF TREATMENT

A

VANCO 500 MG PO/NG/PR QID +
METRO 500 MG IV Q8H

71
Q

C.DIFF 2ND EPISODE TREATMENT
(1ST RECURRENCE)

A

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
Q

C.DIFF SUBSEQUENT EPISODE TREATMENT
(2ND RECURRENCE AND ON)

A
  • TAPERED AND PULSED VACO
  • VANCO X 10 DAYS, THEN RIFAXIMIN X 20 DAYS
  • FDX X 10 DAYS
  • FECAL MICROBIOTA TRANSPLANT
73
Q

USUAL SYMPTOMS OF CHLAMYDIA

A

GENITAL DISCHARGE OR NO SYMPTOMS

74
Q

USUAL SYMPTOMS OF GONORRHEA

A

GENITAL DISCHARGE OR NO SYMPTOMS

75
Q

USUAL SYMPTOMS OF SYPHILLIS

A

PAINLESS, SMOOTH GENITAL SORES

76
Q

USUAL SYMPTOMS OF HPV

A

GENITAL WARTS OR NO SYMPTOMS

77
Q

USUAL SYMPTOMS OF BACTERIAL VAGINOSIS

A

VAGINAL DISCHARGE WITH FISH ODOR AND PH > 4.5
OR NO PAIN

78
Q

USUAL SYMPTOMS OF TRICHOMONIASIS

A

YELLOW/GREE FROTHY VAGINAL DISCHARGE
SORENESS
PAIN WITH INTERCOURSE

79
Q

SYPHILLIS PRIMARY, SECONDAY, OR EARLY LATENT DRUG OF CHOICE AND DOSING

A

PEN G BENZATHINE (BICILLIN L-A)
2.4 MILLION UNITS IM X 1 DOSE

80
Q

SYPHILLIS PRIMARY, SECONDAY, OR EARLY LATENT ALTERNATIVE AGENT
(WHO SHOULD NOT RECEIVE THIS ALTERNATIVE AGENT)

A

DOXYCYCLINE

PREGNANT OR HIV POSITIVE SHOULD BE PENICILLIN DESENSITIZED AND TREATED WITH BICILLIN L-A

81
Q

SYPHILLIS LATE LATENT DRUG OF CHOICE AND DOSING

A

PEN G BENZATHINE (BICILLIN L-A) 2.4 MILLION UNITS IM WEEKLY X 3 WEEKS

82
Q

NEUROSYPHILLIS DRUG OF CHOICE

A

PENICILLIN G AQUEOUS CRYSTALLINE

OR PENICILLIN G PROCAINE

83
Q

GONORRHEA DRUG OF CHOICE AND DOSING

A

CEFTRIAXONE 500 MG IM X 1 DOSE

84
Q

IF PATIENT HAS GONORRHEA, WHAT SHOULD ALSO BE TREATED FOR UNLESS EXCLUDED?

A

CHLAMYDIA

85
Q

CHLAMYDIA DRUG OF CHOICE AND DOSING

A

DOXY 100 MG PO BID X 7 DAYS
AZITH 1 GM PO X 1 DOSE

86
Q

BACTERIAL VAGINOSIS DRUG OF CHOICE

A

METRONIDAZOLE PO OR VAGINALLY

87
Q

WHAT SHOULD PTS WITH BV NOT DO

A

DOUCHE

88
Q

TRICHOMONIASIS DRUG OF CHOICE AND DOSING

A

METRONIDAZOLE 2 GM PO X 1

89
Q

WHAT DOES THE CDC RECOMMEND FOR PREGNANT PTS WITH TRICH?

A

METRONIDAZOLE FOR TRICH NO MATTER THE TRIMESTER

90
Q

GENITAL WARTS (HPV) DRUG OF CHOICE

A

IMIQUIMOD CREAM

91
Q

WHAT ARE THE NAMES OF THE DIFFERENT RICHETTSIAL INFECTIONS

A

ROCKY MOUNTAIN SPOTTED FEVER
TYPHUS
LYME DISEASE
EHRLICHLOSIS
TULAREMIA

92
Q

WHAT IS THE DRUG OF CHOICE FOR MOST RICKETTSIAL INFECTIONS

A

DOXYCYCLINE (EVEN IN PERIATRIC PATIENTS)

NAPLEX 2022 (37 decks)

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