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Clin Med II - ID > deck_6776960 > Flashcards

deck_6776960 Flashcards

1
Q

what do the beta-lactams do?

A

inhibit cell wall synthesis

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2
Q

what are the sub-classes of beta-lactams?

A

penicillins

cephalosporins

carbapenems

monobactams

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3
Q

which classes of antibiotics inhibit bacterial protein synthesis?

A

macrolides (50s)

aminoglycosides (30s)

tetracyclines (30s)

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4
Q

what class of antibiotics inbhitis DNA gyrase?

A

quinolones

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5
Q

what are the major members of the Penicillin family?

A

penicillin, oxacillin, nafcillin, dicloxacillin

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6
Q

what is the coverage for penicillin?

A

gram positives

some anaerobes

NO STAPH COVERAGE

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7
Q

what can oxacillin/nafcillin/dicloxacillin cover that penicillin can not?

A

MSSA (staph aureus)

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8
Q

what is unasyn?

A

ampicillin/sulbactam

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9
Q

what are the similarities in coverage for augmentin and unasyn?

A

both cover gram positive, gram negtive and some anaerobes

***Neither covers pseudomonas

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10
Q

How is unasyn administered?

A

IV

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11
Q

what can you use from the penicillin family to cover pseudomonas?

A

piperacillin

pip/tazo (zosyn)

Ticar/clav (timentin)

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12
Q

what are the 1st gen cephalosporins and what do they cover?

A

cefazolin (Ancef)

cephalexin (Keflex)

cover gram positive

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13
Q

what are the second generation cephalosporins and what do they cover?

A

cefuroxime, cefoxitin

gream neg, and some gram positive

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14
Q

what are the 3rd generation cephaolsporins and what do they cover?

A

ceftriaxone (Rocephin)

ceftadzidime

gram positive and gram negative and ceftazadime has pseudomonas coverage

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15
Q

what are the 4th generation cephalosporins and what do they cover?

A

Cefepime, covers gram positive and gram negative, plus MSSA and pseudomonas

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16
Q

what are the 5th generation cephalosporins and what do they cover?

A

ceftaroline (MRSA but NOT pseudomonas)

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17
Q

which of the carbapenems cover anerobes, including pseudomonas and other resistant organisms?

A

meropenem

imipenem

(both are IV only)

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18
Q

what are the common macrolides?

A

erythromycin

clarithromycin

azithromycin

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19
Q

what do the macrolides cover?

A

gram positive

gram negative diplococci and coccobacilli

atypicals

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20
Q

what do the quinolones cover?

A

gram positive (levo more than cipro)

gram negative (good coverage)

atypicals

pseudomonas (levo and cipro ONLY)

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21
Q

what do the aminoglycosides typically cover?

A

gram negatives including pseudomonas

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22
Q

which tetracycline is good for resistant gram negatives?

A

tigecycline

23
Q

which tetracycline is used for tick borne disease?

A

doxycycline

24
Q

many of the tetracyclines are good coverage for what organisms?

A

atypicals

MSSA

P. acnes (doxy esp.)

25
Q

which abx give good anerobic coverage?

A

clindamycin

metronidazole

augmentin

unasyn

zosyn

carbapenems

26
Q

what is the first line drug choice for treating MRSA?

A

Vancomycin

Linezolid

tidezolid

daptomycin

27
Q

what can be used to treat vancomycin resistant enterococci (VRE)?

A

linezoid, tidezolid

daptomycin (but not in the lungs!)

28
Q

What can you treat PCP or toxoplasmosis with?

A

Bactrim (TMP/SMX)

29
Q

A 6 y/o presents with sore throat with a strawberry appearance and fever, no cough, headache and with a rapid strep test. How would you like to treat this patient?

A

penicillin x 10 days

amoxacillin (kids)

clindamycin, azithromycin (PCN allergy)

30
Q

what are the complications of Group A strep infections?

A

scarlet fever

rheumatic fever (why we treat)

glomerulonephritis

31
Q

31 y/o female patient at 25 weeks gesttation presents to ob/gyn with dysuria and urinary frequency, afebrile. UA clean catch dips positive. Now what?

A

Don’t gram stain - waste of time

Nitrofurantoin is the drug of choice here

32
Q

what’s the problem with prescribing Bactrim to a pregnant woman with a UTI?

A

it interferes with folate metabolism

33
Q

what can you prescribe in any patient with a UTI? What additional options are available for a nonpregnant patient?

A

oral cephalosporin

nitrofurantoin?

Amox/Clav (augmentin)

Nonpregnant: Bactrim, Doxy, Quinolones

34
Q

what are the most common bacteria in acute otitis media?

A

Strep pneumo

H. influenza

M. catarrhalis

35
Q

what is the first line drug in acute otitis media?

A

Amoxicillin (assuming no penicillin allergy)

36
Q

what if you see AOM in a child who just had finished antibitoics?

A

augmention

oral cephalosporins

37
Q

what antibiotic would be your first choice in community-acquired pneumonia with diffuse infiltrates (atypical pneumonia)?

A

azithromycin (macrolides)

(could also do doxy, quinolones that are anti-pneumococcus like levoflox, augmentin + macrolide)

38
Q

what is a good treatment for bacterial meningitis a person 1mo -50 years old with unknown organism?

A

ceftriaxone + vancomycin (covers positive and negative including resistant strep. pneumo)

consider whether to add dexamethasone

add ampicillin for listeria in >50 or immunocompromised

39
Q

what are the typical organisms that cause bacterial meningitis in neonates?

A

Group B strep

E. Coli

Listeria

40
Q

what are the antibiotics used in baterial meningitis in neonates?

A

ampicillin plus ceftaxime plus gentamicin

41
Q

what are the common pathogens of post-op wound infections?

A

Staph aureus

Group A, B, C, G streps

Enterococcus

(add gram negatives if near the abdomen)

42
Q

what is a good first-choice antibiotic for a surgical site infection?

A

Augmentin

1st gen cephalosporin

dicloxacillin

clindamycin (good if pen/ceph. allergic)

43
Q

what’s the treatment for chlamydia again?

A

azithromycin 1 gram

OR Doxycycline (according to her)

44
Q

what is good for treating bacterial vaginosis or trichomonas?

A

metronidazole

45
Q

If you have a positive RPR, what do you use to treat for syphilis?

A

Penicillin G IM

46
Q

what do you use to treat LGV (lynphogranuloma venereum) or granculoma inguinale (Donovanosis)?

A

doxycycline or azithroymcin

47
Q

what are the most common causative organisms in hospital acquired pneumonia?

A

staph aureus

gram negative rods (pseudomonas/coliforms)

anerobes

strep pneumo

enterococci

48
Q

what is a good choice of antibiotic to cover empiric treatment for hospital acquired pneumonia?

A

pip/tazo +/- vanc or +/- aminoglycoside or quinolone

or cefepime

impipenem or meropenem

49
Q

what can you use to treat C. diff?

A

metronidazole

or oral vancomycin

50
Q

patient with signs of early sepsis from a decubitus ulcer (extended hospitalization) shows up at the ER. What do you give him

A

IVF + meropenem + vancomycin

51
Q

how do you want to treat acute bacterial sinusitis?

A

augmentin +

saline irrigation and decongestants

quinolones are an option

or doxy (for PCN allergy)

52
Q

when should you treat for acute bacterial sinusitis?

A

symptoms > or equal to 10 days

severe symptoms (fever, facial pain) > 3-4 days

symptoms after URI

53
Q

how do you diagnose bronchitis?

A

clinical - history and PE (bilateral rhonchi)

54
Q

what is the therapy for bronchitis?

A

antitussive, NSAIDS and inhaled bronchodilator

if it fails to respond, then investigate bacterial

Clin Med II - ID (4 decks)

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