endocarditis

Question 1

cipro ADE

Answer 1

not if < 18

tendon problems

Question 2

Daptomycin ADE

Answer 2

a lipopeptide
myopathy and rhabdo
monitor: CPK (creatine phosphao kinase)

Question 3

Gentamicin ADE

Answer 3

a aminoglycoside
nephro and oto toxicity
neuromuscular blockade (paralysis)
dont use with other nephrotoxic: diuretics, NSAIDs

Question 4

Linezolid ADE

Answer 4

an oxazolidinone
optic and peripheral neuropathy
thrombocytopenia (low platelets)

Question 5

rifampin ADE

Answer 5

a TB drug

hepatotoxicity

Question 6

vancomycin ADE

Answer 6

glycopeptide (very good vanco glycopeptide)
nephrotoxicity
red man syndrome (rash u can prevent with antihistamine before or slow infusion 1-2 hrs)

Question 7

IE most common organisms

Answer 7

Staph (MC) treat with naficillin
Strept treat with pcn g or ceftriaxone
Entero treat with ampicillin

Question 8

IE MC in IV drug users

Answer 8

Tricupsid and Staph Aureus
tx with Naficillin (kidney) or Oxacillin (liver)
+/- aminoglycoside (genta/tobra)

Question 9

janeway lesions

Answer 9

macules on palms and soles
not tender
+ culture

Question 10

osler node

Answer 10

nodules on fingers and toes
tender
- culture

Question 11

empiric IE treatment

Answer 11

IV vancomycin 6 wks

Question 12

native strept PCN S and R

Answer 12

-PCN G or Ceft 4 wks
+ genta 2 wks
-vanco 6 wks if allergy

Question 13

native staph oxacillin S and R

Answer 13

naficillin 6 wks
oxacillin 6 wks
cefazolin (1st gen) 6 wks
vanco 6 wks if allergy
Dapto 6 wks if MSSA MRSA

Question 14

native staph oxacillin R

Answer 14

vanco 6 wks

dapto 6wks

Question 15

prosthetic strept PCN S and R

Answer 15

-PCN G or Ceft 6 wks
+ genta 2 wks
-vanco 6 wks if allergy

Question 16

prosthetic staph oxacillin S and R

Answer 16

-naficillin or Oxacillin
+ rifampin 6 wks
add genta for 2 wks treatment

-vanco + rifampin 6 wks if allergy
add genta for 2 wks treatment

Question 17

prosthetic staph oxacillin R

Answer 17

vanco + rifampin 6 wks

add genta 2 wks

Question 18

Native/Prosthetic entero

amp, pcn, vanco susceptible

Answer 18

amp or pcn g + genta
4 weeks if <3 months symptoms
6 weeks if >3 months symptoms

amp + ceft 6 wks if CrCl < 50

vanco + genta 6 wks if pcn allergy

Question 19

native/prosthetic entero

pcn resistant

Answer 19

amp-sulb + genta 6 wks

vanco + denta 6 wks

Question 20

native/prosthetic entero faceium

resistant to pcn, vanco, aminoglycoside

Answer 20

linezoid or Daptomycin 6 wks

Question 21

culture negative

native valve

Answer 21

vanco + cefepime if acute

vanco + amp-sulb subacute

Question 22

culture negative

<1 yr prosthetic

Answer 22

vanco + 
cefepim + 
rifampin + 
gentamicin 
all for 6 wks

Question 23

culture negative

>1 yr prosthetic

Answer 23

vanco + ceftriaxone 6 wks

Question 24

bartonella

Answer 24

suspected: ceft + genta +/- doxy 6 wks 2 wks

+ culture: doxy + genta 6 wks 2 wks