ch 70

Question 1

1st choice uncomplicated UTI

Answer 1

Amoxicillin

Question 2

1st choice Neisseria Meningitides (meningococcus)

Answer 2

3rd gen cephalosporin

Question 3

1st choice E.Coli

Answer 3

Cefotaxime, ceftazidime, cefepime, ceftriaxone

Question 4

klebsiella pneumoniae

Answer 4

cefotaxime, ceftriaxone, cefapime and ceftazidime

Question 5

Salmonella

Answer 5

ceftriaxone

Question 6

what antibiotics inhibit bacterial wall synthesis or activate enzymes that disrupt the cell wall

Answer 6

Penicillins
cephalosporins
imipenem
vancomycin
caspofungin

Question 7

what antibiotics increase cell membrane permeability

Answer 7

amphotericin B
daptomycin
itraconazole

Question 8

what antibiotics cause lethal inhibition of bacterial protein sythesis

Answer 8

aminoglycosides (gentamycin)

Question 9

what antibiotics cause nonlethal inhibition of protein synthesis

Answer 9

tetracyclines
Clindamycin
erythromycin
Linezolid

Question 10

what abx inhibit bacterial synthesis of DNA and RNA or disrupt DNA function

Answer 10

rifampin, metronidazole, fluoroquinolones

Question 11

drugs that are directly lethal to bacteria at clinically achievable concentrations

Answer 11

bacteriocidal

Question 12

drugs that can slow bacterial growth but do not cause cell death

Answer 12

bacteriostatic

Question 13

bacteriocidal and bacteriostatic

which needs a working immune system to work

Answer 13

bacteriostatic

Question 14

what are the 4 ways for bugs to resist drugs

Answer 14

decrease drug concentration at site of action

alter the structure of drug target molecules (changes receptors)

produce a drug antagonist

cause drug inactivation

Question 15

example of a bug producing a drug antagonist

Answer 15

synthesize increased number of PABA

against sulfa drugs

Question 16

example of drug inactivation

Answer 16

increased production of penicillinase that inactivates penicillin

also for cephalosporins, carbapenems, fluoroquinolones

Question 17

what mechanism for acquiring resistance happens primarily among gram neg bacteria

Answer 17

conjugation

Question 18

what mechanism for acquiring resistance confers resistance to only one drug

Answer 18

Spontaneous mutation

Question 19

what mechanism for acquiring resistance that confers multiple-drug resistance

Answer 19

conjugation

Question 20

explain antibiotic use and emergence of drug resistant microbes

Answer 20

You have natural microbes that keep each other in check, using a broad spectrum may kill off some that was keeping other bacteria in check. You kill them and the resistant bacteria take over

Question 21

a new infection that appears during the course of treatment for primary infection

Answer 21

superinfection

ie) vaginal candida in female treated with a broad spectrum drugs, superinfections are more likely in pt receiving broad spectrum

Question 22

NDM-1 gene

Answer 22

falls under drug inactivation

code for additional resistance determinants including drug efflux pumps and enzymes that can inactivate (pg 654)

Question 23

name that bug (2)

Bacterial meningitis

Answer 23

Strep pneumoniae -

Neisseria meningitides - 3rd gen cephalosporin

Question 24

name that bug (2)

Acute Sinusitis

Answer 24

S. pneumoniae

H. influenzae

Question 25

name that bug (1) Pharyngitis

Answer 25

Strep Pyogenes

Question 26

name that bug -4 Community acquired pneumonia

Answer 26

S. pneumoniae Mycoplasma spp. H. influenzae Staph aureus

Question 27

name that bug (3) Hospital acquired pneumonia

Answer 27

Pseudomonas spp Klebsiella spp S. aureus

Question 28

name that bug (4) Endocarditis

Answer 28

Streptococcus viridans coagulase-negative Staph spp S aureus

Question 29

name that bug (2) cholangitis

Answer 29

Enterobacteriaceae anaerobes

Question 30

name that bug (2) UTI, pyleonephritis

Answer 30

E. coli Enterobacteriaceae

Question 31

name that bug (1) osteomyelitis

Answer 31

S. aureus

Question 32

name that bug (2) cellulitis

Answer 32

S. aureus Streptococcus spp

Question 33

to be effective, an antibiotic must be present at the site of infection in a concentration greater than the

Answer 33

minimal inhibitory concentration (MIC)

Question 34

treatment for streptococcus pyogenes

Answer 34

Penicillin G

Question 35

genetic factor that can affect antibiotics

Answer 35

G6PD deficiency - more common in those of African and Mediterranean descent - hemolysis due to deficiency in G6PD for RBCs (ex sulfonamides) genetics can also effect drug metabolism

Question 36

infants and antimicrobial

Answer 36

highly vulnerable to drug tox due to poorly developed kidney and liver function

Question 37

what antibiotic class can produce kernicterus in infants

Answer 37

sulfonamides kernicterus is severe neurologic disorder caused by displacement of bili from plasma proteins

Question 38

Children/adolescents - what antibiotic can cause discoloration in developing teeth

Answer 38

tetracyclines

Question 39

gentamycin in pregnancy

Answer 39

irreversible hearing loss to infant

Question 40

breastfeeding - levels in milk cause kernicterous

Answer 40

Sulfonamides

Question 41

treat for E.Coli

Answer 41

cefotaxime ceftazidime cefepime ceftriaxone

Question 42

Treat for Klebsiella pneumoniae

Answer 42

Cefotaxime Ceftriaxone Cefepime Ceftazidime

Question 43

Salmonella treatment

Answer 43

Ceftriaxone and a fluoroquinolone if other than Salmonella typhi also add a cefotaxime

Question 44

shigella treatment

Answer 44

A fluoroquinolone

Question 45

Bordetella pertussis (whooping cough) treatment

Answer 45

Azithromycin clarithromycin erythromycin

Question 46

If you are going into surgery for a perf appy, open fractures, animal bites - abx is treatment or prophylaxis

Answer 46

treatment

Question 47

treatment for meningitis, epiglottitis, arthritis, and other serious infections with H. Influenzae

Answer 47

Cefotaxime | ceftriaxone

Question 48

Upper resp infection and bronchitis secondary to H. influenzae

Answer 48

Trimethoprim /sulfamethoxazole

Question 49

H. pylori treatment

Answer 49

clarithromycin plus amoxicillin plus esmeprazole (PPI)

Question 50

treatment for psudomonas aeruginosa for UTI

Answer 50

Ciprofloxacin

Question 51

treatment for mycoplasma pneumoniae

Answer 51

erythromycin clarithromycin azithromycin one of above plus Tetracycline

Question 52

treatment for chlamydia psittaci

Answer 52

Doxycycline

Question 53

what abx has antimicrobial action Antimetabolites

Answer 53

Flucytosine sulfonamides Trimethoprim