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ID Therapeutics :') > Exam 3- the big one > Flashcards

Exam 3- the big one Flashcards

1
Q

risk factors for strep. pneumonia

A

rusty colored sputum

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2
Q

risk factors for pts with h. influenzae & m. catarrholis

A

-common in pts with: COPD, EtOH abuse, cystic fibrosis, HIV, impaired humoral immunity

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3
Q

risk factors for pts with anaerobes

A

-LOC, post seizures, overdose (ant aspirations)

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4
Q

risk factors for pts with CA-MRSA

A

-severe CAP/ICU admission

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5
Q

tx of mycoplasma pneumonia

A

-doxy, macrolides, FQs

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6
Q

tx of chlamydophilia pneumonia

A

-doxy, macrolides, FQs

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7
Q

tx of legionella pnesmonia

A

Levofloxazin IV x10-21days

-alt= azithro

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8
Q

outpt CAP (healthy pts)

A

1- PO amoxicillin

  • PO doxy
  • PO macrolide (azithro)
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9
Q

outpt CAP (w/ comorbids)

A

-PO amox/clav OR cefpodox/cefdinir/cefurox) PLUS azithro

PO respiratory FQ (levo, moxi)

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10
Q

inpt non-severe tx of CAP

A

-IV beta lactam + macrolide OR resp, FQ (ex: amp/sulb/ceftriaxone)

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11
Q

inpt severe tx of CAP

A
  • IV beta lactam + macrolide or

- IV beta lactam + resp. FQ

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12
Q

what 2 abx do you check for QTc prolongations?

A

quinolones & azithromycin

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13
Q

emerpric TX of HAP–> S. pneumonia (MSSA)

A

1) ceftriaxone
2) ampicillin/sulbactam
reserve: levofloxacin, moxifloxican & ertapenem

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14
Q

HAP tx of MRSA

A
  • vancomycin

- linezolid (serotonin syndrome)

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15
Q

HAP tx of pseudomonas

A

1) cefepine
2) pip/tazo
others: ceftazidine, imiperem, meropenem, aztreonam, cipro (PO), levofloxacin, aminoglycosides
Last resort: colistin, polymyxin B

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16
Q

when do use ABX in sinusitis?

A
  • persistant symptoms >10 days
  • severe symptoms >3-4 days (fever >102, purulent nasal discharge, facial pain)
  • worsening symptoms after a typical viral upper respiratory infection (new onset of fever, headache, or inc nasal discharge)
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17
Q

Sinusitis tx

A 
#1: amox/clav (high dose if severe infection, daycare, age <2, >65, recent hospitalization, abx use in prior month & immunocompromised --> 2g PO BID or 90mg/kg po) 
others: FQs, clinda + cefpodoxine or cefuroxine (allergy), doxy
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18
Q

Pharyngitis -most common bacterial cause & symptoms

A

-group A strep: sudden onset of sore throat, age 5-25 yrs, fever, headache, tonsilopharyngeal inflammation, palatal petechiae, scarlatiniform rash

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19
Q

tx of pharyngitis

A

1: penicillin V or amoxicillin x10d

Mild allergy: cephalexin x10d
Severe allergy: clindamycin x10d, azithromycin x5d
unlikely adherence: benzathine penicillin IM x1

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20
Q

symptoms of viral pharyngitis

A

(rhinovirus) conjunctivitis, coryza, cough, diarrhea, hoarseness, discrete ulcerative stomatitis, viral erythema

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21
Q

what not to give with pharyngitis?

A

corticosteroids!

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22
Q

signs & symptoms of otitis media:

A

-fluid in the ear, inflammation of the mucosa of the middle ear, ear pain, ear drainage, hearing loss, non-specific: fever, lethargy or irritability

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23
Q

0titis media: when to give antibiotics:

A
  • 6mo-12yr + mod-severe pain or temp 102.2

- 6mo- 23mo + non-severe bilateral acute OM

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24
Q

Otitis media: when to consider antibiotics

A
  • 6mo-23 mo + non-severe unilateral

- 2-12yr + acute non-severe acute OM

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25
initial 1st line for OM
-amoxicillin -amox/clav IF purulent conjunctivitis or recurrent unresponsive to amox ALT: cefdinir, cefuroxime, cefodoxime, ceftriaxone (IM)
26
if initial tx fails after 48-72 hrs for OM
1st line: amox/clav or ceftriaxone | alt: ceftriaxone or clindamycin
27
when to use ABX in COPD exacerbation: (3)
- inc in dyspnea - inc in sputum production - inc in sputum purulence (hallmark sign)
28
what abs are used in COPD exacerbation?
-azithromycin, doxycycline or amox/clav for 5-7 days
29
symptoms of meningitis
top 3: fever, change in mental status, rigid body | -headache, nausea, lethargy
30
2-50 yrs meningitis bacteria & tx
S. pneumoniae, N. meningitides | -vanco + ceftriaxone
31
> 50 yrs meningitic bacter & tx
S. pneumoniae, N. meningitides, L. monocytogens, aerobic - bacilli -vanco + 3rd gen ceph & ampicillin
32
abx with good BBB penetration
- FQs | - linezolid
33
abx with BBB penetration w/ inflammation
- ampicillin - ceftroaxone - vanco
34
abx to treat n. meningitides
-pen G or ampicillin --> 3rd gen ceph
35
abx to treat H. influenzae (meningitis)
-ampicillin --> 3rd gen ceph
36
abx to treat L. monoytogenes (meningitis)
-ampicillin or pen G
37
when to use dexamethasone
-adjunctive therapy in children and infants with h. influenzae or adults with pneumococcal meningitis
38
risk factors for endocarditis
-congenital heart disease, prolonged vascular access, IV drug use, prosthetic material, valve dysfunction & inc age
39
clinical presentation of endocarditis
fever, chills, weakness, weight loss, malaise, heart murmers, acute disease (peripheral manifestations oslers nodes, janeways lesions, roths spots, septic emboli)
40
modified duke criteria (endocarditis)
1) positive blood culture --> at least 2 separate blood cultures drawn > 12hrs apart 2) positive echocardiogram
41
tx for Viridans group strep pen G MIC < .12
- pen G + gentamicin - ceftriaxone + gentamicin (allergic: vanco)
42
tx for viridans group strep pen G MIC > .12
-ceftriaxone
43
MRSA abx for endocarditis
1) vancomycin | - daptomycin
44
MSSA abx for endocarditis
1) naficillin | - cefazolin
45
staph aureus- prosthetic valve MRSA
-vanco + rifampin + gentamicin
46
staph aureus- prosthetic valve- MSSA
-nafcillin + gentamicin
47
enterococcus abx tx for endocarditis
-ampicillin + ceftriaxone | pen resistant: vanco + gentamicin
48
morbidity rate
diseased state, disability or poor health due to any cause, incidence of risk of developing a new medical condition
49
mortality rate
of deaths in a particular population, scaled to the size of that population, per unit of time
50
disability adjusted life year (DALY)
measure of the time lived with disability & the time lost due to premature mortality
51
quality adjusted life year (QALY)
combines expected survival & expected quality of life into single number, measure of the value that individuals place on expected years or survival
52
uncomplicated malaria txs & duration
-artemether + lumefantrine -aretesunate + amodiaquine -artesunate + mefloquine -duhydroartemisin + piperaquine -artesunate + sulfadoxine-pyrinethamine 3 day duration
53
AEs of artesunate
-hypersensitivity, mild GI, rare QT, rare hepatotoxicity (IV & PO)
54
how is ebola transmitted?
- infected body fluids, through damaged skin, mucosa & parentally via: - blood - stool - saliva - sweat - urine - vomit - breast milk - tears & seamen
55
how to prevent ebola?
- use PPE - stay 2 meters/6ft away - no symptoms = not contagious BUT still in the seamen
56
tx of uncomplicated of p. falciparium
-artemether + lumefantrine -artesunate +. amodiaquine -artesunate + mefloquine -dihydroartemisin + piperaquine -artersuante + sulfadoxine-pyrinethamine (3 day duration)
57
drugs with good oral bioavailability
- macrolides - fqs - metronidazole - doxycycline - linezolid - bactrim
58
what drug is only used for UTI (and enterococci & pseudomonas)
fosfomycin
59
what are the restricted antimicrobials (3)
-daptomycin, meropenem & tigcycline
60
when do you treat asymptomatic UTIS?
- prego | - new kidney transplant or planned urologic procedure
61
when do you give Remdesivir?
hospitalized pts with o@ <94% and on low-flow oxygen for ~5 days
62
when do you give dexamethasone?
-give to pts requiring ANY oxygen supp, with remdesiver
63
when do you give tocilizumab?
2+ yrs old, hospitlaized who are receiving systemic corticosteroids + require ANY type of O2 support
64
when do you give baricitinib?
- PO | - pt is on O2 and corticosteroid w/ increasing inflammation and rapidly decreasing O2 needs
65
when do you give sotrovimab?
- when pt is mild to moderate covid test + who are at high risk for progression to severe covid - give as single IV infusion
66
when do you give molupiravir?
oral | -mild to moderate illness >18 y/o, not breastfeeding & have at least 1 risk factor
67
when do you give nirmatreiver?
oral | ->12 y/o, pt must have at least 1 risk factor
68
what is 3TC
lamividine
69
ABC
abacavir
70
ATV
atazanavir
71
BIC
dictegravir
72
DOR
doravirine
73
DRV
darunavir
74
DTG
dolutegravir
75
EFV
efanirenz
76
EVG
elvitegravir
77
FTC
emitrictabine
78
LA CAB
long-acting cabotegravir
79
RAL
raltegravir
80
RPV
ripivirine
81
RTV
ritonavir
82
TDF
tenofovr

ID Therapeutics :') (3 decks)

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