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MCCEE > ID > Flashcards

ID Flashcards

1
Q

Penicillin coverage?

A 
Penicillin (G, VK, benzathine):
Viridans group strept
Strept. Pyogenes
Oral anaerobes
Syphilis 
Leptospira

Ampicillin / amoxicillin:
Penicillins + E. Coli + Lyme dz

*Amoxcillin HELPS!
H. Influenzae
E. Coli
Listeria
Proteus
Salmonella
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2
Q

Penicillins are best initial Rx in what Dz?

A 
Otitis media 
Dental + endocarditis prophylaxis 
Lyme dz (only rash, joint, 7CN).
UTI in pregnant 
Listeria monocytogenes
Enterococcal infections
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3
Q

Penicillinase-resistant penicillins?

A

Oxacillin
Cloxacillin
Dicloxacillin
Naficillin

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4
Q

Beta-lactam AB groups?

A

Penicillins
Cephalosporins
Carbapenems
Aztreonam

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5
Q

Methicillin sensitive organism are sensitive to oxacillin. (T or F)

A

True. And vise versa.

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6
Q

Penicillins that cover pseudomonas?

A

Pipracillin
Ticarcillin
Azlocillin
Mezlocillin

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7
Q

Pseudomonas covering penicillin are eat initial Rx for what Dz?

A

Cholecystits and ascending cholangitis.
Pyelonephritis.
HAP and VAP.
Febrile neutropenia.

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8
Q

What cephalosporin covers MRSA?

A

Cetfaroline

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9
Q

Agents that cover MRSA?

A 
Vancomycin 
Daptomycin
Cetfaroline. 
Linezolid. 
Trdizolid. 
Tigecycline. 
Dalbavancin. 
Telavancin.
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10
Q

Cross-reaction between penicillin and cephalosporins (T or F)

A

True.

Very small

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11
Q

Organisms sensitive to all cephalosporins?

A 
Group A,B,C strept. 
Viridans group strept. 
E. Coli. 
Klebsiella. 
Proteus mirabilis.
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12
Q

Organisms resistant to all cephalosporins?

A

Listeria
MRSA
Enterococcus.

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13
Q

Patient with rash to penicillin?

A

Use cephalosporins.

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14
Q

Patient with anaphylaxis after penicillin?

A

Use non-Beta-lactam

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15
Q

What are the 1stG cephalosporins?

A

Cefazolin.
Cephalexin.
Cephradrine.
Cefadroxyl.

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16
Q

What are 2ndG cephalosporins?

A 
Cefotetan
Cefoxitin
Cefaclor
Cefprozil
Cefuroxime
Loracarbef
17
Q

1stG cephalosporins Rx?

A 
Staph (Methicillin sensitive)
Strept
G-ve bacilli not (Not pseudomonas)
Osteomyelitis + septic arthritis. 
Endocarditis 
Cellulitis.
18
Q

What cephalosporins cover anaerobes?

A

Cefotetan.

Cefoxitin

19
Q

Best initial Rx for PID?

A

Cefotetan / Cefoxitin + doxycycline.

20
Q

SE of cefotetan / Cefoxitin?

A

Bleeding

Disulfiram like reaction (w/ alcohol).

21
Q

What are the 3rdG cephalosporins?

A

Ceftriaxone
Cefotaxime
Ceftazidime

22
Q

When to avoid ceftriaxone?

A

Neonates > impaired biliary metabolism.

23
Q

When to use cefotaxime instead of ceftriaxone?

A

Neonates.

Spontaneous bacterial peritonitis.

24
Q

What 3G cephalosporins has pseudomonal coverage?

A

Ceftazidime

25
Q

What is infective endocarditis?

A

Valvular infection leading two fever and murmur.

26
Q

What are the risks to developing infective endocarditis?

A
  1. Prosthetic valve.
  2. Valvular disease.
  3. IV drug user.
27
Q

What are the complications of infective endocarditis?

A
  1. Splinter hemorrhage, janeway lesions, Osler nodes.
  2. Roth spots + conjunctival petechiae.
  3. Septic emboli to lung.
  4. Mycotic aneurysm of brain.
  5. Kidney = glomerulonephritis.
  6. Splenomegy
28
Q

What is the best initial test for infective endocarditis?

A
  1. Blood Cx

2. Echo (transthoracic 100% specific)

29
Q

Blood Cx of IE shows strept. Bovis or C. Septicum? (Next step)

A

R/o colonic pathology via colonoscopy?

30
Q

How to Dx IE if blood Cx is negative?

A
  1. Vegetations on echo
  2. 3 minor criteria:
    Fever > 38
    High risk patient (prosthetic valve / IV drug)
    Signs of embolic phenomena
31
Q

Best initial treatment for infective endocarditis?

A

Empiric therapy of vancomycin and gentamicin.

32
Q

When is surgery the answer for infective endocarditis?

A
  1. CHF
  2. AV block
  3. Fungal infection
  4. Abscess
  5. Recurrent emboli while on Rx
33
Q

What is the most common cause of culture negative infective endocarditis?

A

Coxiella.

34
Q

What are the e-Hack organisms of IE?

A 
Eikenella
H. Aphrophilus
H. Parainfluenza 
Actinobacillus
Kingella
35
Q

Rx of e-Hack IE?

A

Ceftriaxone

36
Q

When to prophylax against IE?

A

Heart defect + dental / resp surgery.

Heart defects:
Prosthetic valve. 
Hx of IE.
Cardiac transplant w/valve Dz
Untreated cyanotic heart dz.
37
Q

What to use for prophylaxis of IE?

A

Amoxicillin

If allergic: macrolide

MCCEE (3 decks)

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