board review micro treatment Flashcards
tx for chancroid (spirochete)
presents as painful ulcer and painful lymphadenopathy w/ purulent drainage caused by H ducreyi
azithromycin
TX: lymphogranuloma venereum (chylamydia trachomatis serovars L1-L3)
painless genital ulcers (heal spontaenously) spread to inguinal LN –> buboes that suppurate and become painful –> draining sinuses, procitis and rectal strictures
doxycycine
Q on boards
tx for neurosyphilis if pt has PCN allergy?
desensitize and treat w/ PCN
treatment for staph epi
remove foreign body (central linie)
vancomycin
tx for impetigo (pyoderma)
caused by strept pyogenes or staph
mupirocin ointment
inhibits bacterial protein synthesise
prophylaxis to pregnant women test positive for Grp B strept
ampicillin.
Q
enterococci (Grp D strept)
are resistance to?
to how do you treat?
resistant to cephalosporin
TX: ampicillin/penicilin or vancomycin are only inhibitory- add aminoglycoside for synergy (bactericidal activity)
enterococcal resistance
is mediated by?
forming aminoglycoside-modifying enzymes that transfer chemical grps (actyl,, adenyl) to aminoglycoside molecule –> impairment of antibiotics binding to ribosomal subunits.
know this
(like enterococcus) is resistant to all ?
cephalosporins
tx for clostridium?
C diff
1st line metronidazole.
in recurrent cases, use metronidazole again. to treat the activated spores.\
if relapse (fidaxomicin)
resistant oral* vancomycin.
C perfrigens treatment
food poisoning?
necrotizing fasciitis - (lecithinase and hyaluronidase) tx?
PCN
NF: surgical consult + vancomycin, PCN , clindaycin
boards
child and adults with S. pnemonia meningitis
ceftriaxone and vancomycin
boards meningitis tx.
meningococcal meningitis
N. meningococcal meningitis: high doses of penicillin and
contacts receive rifampin prophylaxis
boards
cryptococcus neoformans meningitis tx
IV amphotericin B
exacerbation of COPD and a common cause of sinusitis
diagnosis is moraxella catarrhalis
tx?
amoxacillin clavulanic acid.
for
klebsiellla pneumonia
3rd gen cephalosporin
how do bacteria such as ecoli develop resistance to ampicillin, amoxicillin , or aminopenicllins
penicillinase in bacteria (a type of* B-lactamase)
cleaves B lactam ring
what antibacterial agents inhibit
bacterial CELL WALL synthesis inhibiton
penicillins
cephalosporins
aztreonam
vancomycin
impipnem meropenem
which antibacterial drus
inhibit bacterial protein synthesis inhibition
aminoglycosides
chloramphenicol
tetracyclines
macrolides
linezolid
which antimicrobial agents
inhbit DNA replication
fluoroquinolones
rifampin
which antibacterial agents
inhibit nucleic acid synthesis
trimethoprim
flucytosine
which antibacterial agent inhibit folic acid
sulfonamides
trimethoprim
pyrimethamine
fungi have a complex carbohydrate cell walls
formed mainly by chitin, glucans and mannans
what antifungal site of action is
glucan
caspofungin (echinocandins)
Q on boards
pt presents with atypical pneumonia
works in a pet shop/ veterinarian
diagnosis: psittacosis (chylamydia psittaci)
tx?
doxycyline
Q
how would you treat para - coccidioidomycosis if
antigfungals arent an option
sulfaonamides
(sulfadiazine)
on boards
treatment for Malassezia furfur tenia versicolor
topical selenium sulflide
if infection keeps coming back treat with ketoconazole
question on boards
how do you treat aspergilloma
surgical removal of the aspergilomma
nots antifungals
Q on boards
how do you treat allergic bronchopulmonary aspergillosis (ABPA)
: hyperswensitivity response associated w/ asthma and cystic fibrosis; may cause bronchiecasis and eosinophilia
wheezing, ,fever, migratory pulmonary infiltrates (inc IgE)
steriods***
question on boards
you have a pt that has been on chemo for a long term
he is stable with neutropenia
all of the sudden he develops fever, cough,
take chest xray and see patchy infiltrate
diagnosis
**how you treat?
invasive pulmonary aspergillosis
(necrotizing bronchopenumonia in immunocompromised)
VORICONAZOLE
Q on boards
given pt on amphotericin B
and devleops QT prolongation –> torsades de pointe –> arythmia seen on ecg
and loses consciousness.
what it the cause>
hypokalemia and hypomagenesmia
uworld explaination
renal toxicity from amp B –> renal vasoconstriction, dec GFR,
direct toxic effect on renal epithelial cells –> aTN, renal tubular acidosiis
severe hypokal, hypo mag (reflecting inc distal tubular membrane permeability)
if ciprofloxacin and doxycyline arent avaiable to treat
anthrax what can you give?
