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CMBM 3 > Case Studies (Buxton/Habal) > Flashcards

Case Studies (Buxton/Habal) Flashcards

1
Q

What organism causes strep throat?

A

Staph pyogenes (GAS)

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2
Q

Which antibiotics are used for the treatment of Strep throat?

A

amoxicilliin

penicillin (give upset stomach)

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3
Q

What is the mechanism of action for amoxicillin?

A

inhibit transpeptidase which inhibits cell wall synthesis

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4
Q

What symptoms might be present with strep throat?

A

fever
exudative pharyngitis
headache

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5
Q

Which organisms cause otitis media?

A

H. flu
Moraxella
resistant Strep pneumo

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6
Q

Why are H. flu and Moraxella resistant to amoxicillin?

A

they produce b lactamase

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7
Q

Why would Clavulanate be paired with amoxicillin?

A

it is a b-lactamase inhibitor

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8
Q

Which organism would cause a post-surgical skin infection?

A

Staph

Strep

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9
Q

Which antibiotics are often used to treat Staph and Strep?

A

Nafcillin (anti Staph)
1st/2nd generation cephalosporin
1st- Cefazolin - IV
2nd - Cefuroxime - IV

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10
Q

What is the mechanism of action of Nafcillin and cephalosporins?

A

Cell wall inhibitors that act by binding to D-ala-D-ala bonds to prevent cross linking

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11
Q

Is there antibiotic resistance with Nafcillin and cephalosporin? mechanism:

A

Yes, altered PBPs

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12
Q

Diagnsosis of acute uncomplicated cystitis. What is the most likely cause?

A

E coli

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13
Q

Which drugs could be used to treat UTIs?

A 
1st/2nd gen cephalosporin:
cephalexin (oral)
cefuroxime (oral)
TMP/SMX
Cipro (Fluoroquinolone)
ampicillin
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14
Q

What is mechanism of action for cephalosporins TMP/SMX, Cipro or ampicillin?

A

cell wall synthesis inhibitors

inhibits DNA gyrase (?)

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15
Q

If pregnant, which drugs would you not give for UTI?

A

TMP/SMX

Fluoroquinolones

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16
Q

Which organisms cause native valve endocarditis?

A

Staph Aureus
Staph Epidermidis
Strep Viridans

17
Q

What are some empiric therapies for Staph Aureus, Staph Epiderminid, or Strep Viridans

A

ceftriaxone

vancomycin ??

18
Q

What is the most likely definitive treatment for a viridans group streptococci that is susceptible to all tested antibiotics?

A

Penicillin G + Gentamycin (for anaerobic gram negative)

ceftriaxone (3rd?)

19
Q

Developed community acquired bacterial pneumonia. What are the top 6 causes?

A 
Strep pneumo
H. influenza
Legionella pneumophilia
Chlamydia pneumo
Moraxella
mycoplasma pneuomoni
20
Q

What are some likely empiric regimens for CA bacterial pneumonia?

A

ceftriaxone + azithromycin (or another macrolide…clarithromycin, erythromycin )
fluoroquinalone

21
Q

How does ceftriaxone and azithromycin work?

A

Ceftriaxone - inhibits cell wall synthesis

Macrolides - inhibit protein synthesis

22
Q

How is antibiotic resistance determined in the lab?

A

AGAR disc diffusion

23
Q

Student develops sepsis from ruptured appendix. Which organism could be involved?

A

Enterococcus
E. coli
Klebsiella
bacteroids

24
Q

Which antibiotics are commonly used when you need a broad spectrum antibiotic against gram positive and gram negative aerobes and anaerobic bacteria?

A

piperacillin
ticarcillin
carbenicillin

+ tazobactam

25
Q

Woman develops PID. What are the most common organisms causing PID?

A

N. gonorrhea
Chlamydia
trachomatic
bacteroides

26
Q

Which antibiotics are most likely used to treat PID?

A

3rd gen cephalosporin
- ceftriaxone (for N gonorrhea or bacteroides

Tetracycline/doxycycline (for C. trachomatis)

27
Q

Man acquired HA pneumonia. MRSA was isolated from aspirated sputum. Which drug could be used to treat this patient?

A

vancomycin

28
Q

What is the mechanism of antibiotic resistance for MRSA?

A

mutated/altered PBP

29
Q

Man developed sepsis after hospitalization for prostate cancer surgery. Cultures grew Pseudomonas aeruginosa. Is this CA or HA acquired infection?

A

HA Pseudomonas aeruginosa

30
Q

What are the drugs that could be used for a HA Pseudomonas aeruginosa?

A

Carbapenums, or piperacillin + tazobactum

3rd/4th gen cephalosporin
Ceftriaxone
Cefepime

31
Q

What drug should not be used if the patient has kidney disease?

A

fluoroquinolones (inhibit DNA gyrase)

cipro

32
Q

What drug would be used if he was allergic to penicillin?

A

macrolides??

33
Q

Inmate developed fever, weakness chills, weight loss and cough productive bloody sputum. What is the most likely etiology?

A

Mycobacterium tuberculosis (TB)

34
Q

What is the antibiotic regimen for TB?

A

RIPE

CMBM 3 (28 decks)

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