id quick COPY

Question 1

What is the most common pathogen for strep pharyngitis?

Answer 1

Group A beta-hemolytic streptococcus

Question 2

What is first-line for treating strep pharyngitis?

Answer 2

Children and adults: penicillin

Erythromycin 2nd line for both

Question 3

What are the most common pathogens for sinusitis?

Answer 3

S. pneumoniae
H. influenzae
M. catarrhalis
S. aureus

Question 4

What is first-line for treating sinusitis?

Answer 4

Children and adults: amox

2nd line for both: amox-clav

Question 5

What organisms cause Acute Otitis Media?

Answer 5

S. pneumoniae 
H. influenzae 
M. catarrhalis 
Group A Strep 
S. aureus

Question 6

Rx for acute OM

Answer 6

if treating:

amox, then amox-clav (both adult and ped)

Question 7

Otitis externa: organisms

Answer 7

P. aeruginosa
Coliforms
S. aureus

Question 8

Otitis externa: Rx

Answer 8

Cortisporin® otic solution 4 drops tid or qid (3 drops tid or qid for children) TM defect: Ciprodex® otic suspension 4 drops bid x 5 d
Necrotizing (i.e. bone involvement): ciprofloxacin 750 mg PO bid x 4-8 wk

Question 9

Bronchitis: organisms

Answer 9

viral

Question 10

Bronchitis: Tx

Answer 10

None – viral

Question 11

Pneumonia: CAP, no comorbidity: organisms

Answer 11

S. pneumoniae
M. pneumoniae
C. pneumoniae

Question 12

Pneumonia: CAP, no comorbidity: Rx

Answer 12

First line:
Amoxicillin
erythromycin
clarithromycin
azithromycin

Question 13

Pneumonia: CAP, with comorbidity: organisms

Answer 13

S. pneumoniae
M. pneumoniae
C. pneumoniae
H. influenzae

Question 14

Pneumonia: CAP, no comorbidity: Rx

Answer 14

amox, amox/clav, cefuroxime, cefprozil
PLUS clarithromycin, azithromycin, doxycycline
OR levofloxacin, moxifloxacin [unclear if these are solo or adjunct to line 1]

Question 15

Dental infections: Rx

Answer 15

penicillin or clindamycin

Question 16

Diarrhea: organisms?

Answer 16

Enterotoxigenic E. coli (ETEC) Campylobacter
Salmonella
Shigella
Viruses Protozoa

Question 17

Diarrhea: Rx?

Answer 17

symptomatic if mild

If mod-severe: fluoroquinolones (olfloxacin, norfloxacin, ciprofloxacin, levofloxacin)
If kids: Azithromycin – safe, tolerable, easily administered

If coming from south/southeast Asia, may have quinolon-resisitant campylobacter: use azithromycin

Question 18

Diarrhea post-Abx: organisms?

Answer 18

C difficile

Question 19

Diarrhea post-Abx: Rx?

Answer 19

mild-moderate: metronidazole

Severe (WBC≥15, Cr ≥1.5x baselin): vancomycin

Question 20

Peptic ulcer disease (non-NSAID): organism?

Answer 20

H pylori

Question 21

Peptic ulcer disease (non-NSAID): Rx?

Answer 21

First line:
PPI + amox + clarithromycin
Or
PPI + metronidazole + clarithromycin

Question 22

Vulvovaginal candidiasis: Rx?

Answer 22

fluconazole orally
miconazole intravaginal
Other -azole tx available OTC

Question 23

Bacterial vaginosis: organisms?

Answer 23

Overgrowth of:
G. vaginalis
M. hominis
Anaerobes

Question 24

Bacterial vaginosis: Rx?

Answer 24

first line: metronizadole PO; metronidazole or clindamycin intravaginally

Question 25

In which patients would you treat asymptomatic BV?

Answer 25

high-risk pregnancy, prior IUD insertion, gynecologic surgery, induced abortion, or upper tract instrumentation

Question 26

HSV: Rx?

Answer 26

First and recurrent episodes: acyclovir, famiciclovir, valacyclovir
Can do prophylaxis in pregnancy starting at 36w

Question 27

Gonorrhea/Chlamydia: Rx?

Answer 27

ceftriaxone 250 mg IM x 1 dose + azithromycin 1 g PO single dose
or
doxycycline 100 mg PO bid x 7 d

Question 28

Mastitis: organisms?

Answer 28

S. aureus

S. pyogenes

Question 29

Mastitis: Rx?

Answer 29

cloxacillin

cephalexin

Question 30

Tinea Cruris/Pedis (jock itch/athlete’s foot): organism?

Answer 30

clotrimazole

ketoconazole

Question 31

Cellulitis (uncomplicated): organisms?

Answer 31

S. aureus

Group A Streptococcus

Question 32

Cellulitis (uncomplicated): Rx?

Answer 32

1st line: cephalexin
2nd line: cloxacillin or clindamycin
Note: Tx for 10-14d

Question 33

If ?penicillin allergy: can you use cephalosporins?

Answer 33

If rash: cephalosporins OK

If anaphylaxis do NOT use cephalosporins

Question 34

MRSA

Answer 34

Vancomycin, Linezolid, Daptomycin

Question 35

Pseudomonas

Answer 35

Pip-Tazo, Carbapenems, Cefepime

Question 36

Outpt Pneumonia

Answer 36

Doxycycline, Azithromycin, Moxifloxacin

Question 37

Inpt Pneumonia

Answer 37

CAP: 3rd gen cephalosporin + Azithromycin
HAP: Vancomycin + Pip-Tazo

Question 38

Neutropenic fever

Answer 38

Cefepime (4th gen cephalosporin)

Carbapenems

Question 39

UTI

Answer 39

Trimethoprim-sulfamethoxazole, Nitrofurantoin

Question 40

Meningits

Answer 40

Vancomycin, Ceftriaxone, +/- steroids, +/- Ampicillin

Question 41

Cellulitis

Answer 41

Cefazolin, Trimethoprim-sulfamethoxazole, clindamycin

IV Vancomycin

Question 42

Anaerobe: what’s your strategy?

Answer 42

Gut or vagina: metronidazole

Everywhere else: clindamycin

Question 43

Staph: what’s your strategy?

Answer 43

Methicillin (eg cloxacillin)
MRSA: Vancomycin
Vancomycin-resistant: Linezolid

Question 44

Gram negatives: what’s your strategy?

Answer 44

start with Amoxicillin (with or without clav); don’t cover pseudomonas
If Pseudomonas coverage needed, bump up to Piperacillin-Tazosin

Question 45

Brand names: ancef is …

Answer 45

cefazolin

Question 46

Brand names: flagyl is …

Answer 46

metronidazole

Question 47

Brand names: Bactrim, Septra is …

Answer 47

sulfamethoxazole-trimethoprim