Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pre reg Thammis cards > infections > Flashcards

infections Flashcards

1
Q

What organisms do aminoglycoside cover

A

gram positive (pseudomonas auriginosa) and gram negative (mycobacterium TB)

inactive/ poor activity against anaerobes and streptococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when should OD dosing be avoided with aminoglycoside?

A

CrCl <20
Gram positive endocarditis
HACEK endocarditis
burns covering more than 20% of body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the monitoring serum concentrations (peak and trough) and what do you do if they are too high

A

peak: 5-10mg/l or 3-5mg/l for endocarditis
reduce dose if too high

trough: <2mg/l or <1mg/l for endocarditis
increase interval if too high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

contraindications for aminoglcyosides

A

myasthenia gravis
pregnancy unless benefit outweighs risk
perforated ear drums

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

interactions for aminoglycosides

A

drugs that cause ototoxicity: loop diuretics, vancomycin

drugs that cause nephrotoxicity: vancomycin, ciclosporin, tacrolimus, platinum chemotherapy, cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MHRA warning for aminoglycosides

A

histamine related adverse reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the coverage of glycopeptides (vancomycin and tecioplanin)

A

gram positive and with oral use anaerobic cover (C.DIFF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

monitoring and serum concentrations of glycopeptides

A

renal function, ototoxicity, blood count
check serum levels after 3-4 doses or after dose change
trough level: 10-20mg/l but 15-20 recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

side effects of glycopeptides

A 
ototoxicity
nephrotoxicity
red man syndrome
thrombophlebitis (pain at infusion site)
blood dyscrasias
skin disorders: steven johnson syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

name the different generation of cephalosporins

A

ORALLY ACTIVE - useful for UTI’s, RTI, otitis media, skin & soft tissue infections
1st gen: cefalexin, cefadroxil, cefadrine
2nd gen: cefuroxime, cefaclor (good activity against H. influenzae) give with food to increase absorption

PARENTERALLY ACTIVE
3rd gen: cefixime, ceftriaxone, cefotaxime, ceftazidime
5th gen: ceftaroline (CAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what coverage is cephalosporins

A

broad spectrum (differs between generations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

indications of cephalosporins

A

UTI, meningitis, septicaemia, pneumonia, peritonitis,

cefataxime and ceftriaxone can be used to treat meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

side effects of cephalosporins

A

hypersensitivity reactions
antibiotic associated colitis
C.difficile risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

interactions with cephalosporins

A 
warfarin = increased anticoagulant effects
aminoglycosides = increased risk of nephrotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

coverage and indications of chloramphenicol

A

broad spectrum

indications: mainly eye infections, can be used for serious, life threatening infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

use of chloramphenicol in pregnancy and licensing OTC

A

pregnancy: avoid due to risk of grey baby syndrome (3rd trimester)
OTC: licensed for over 2 years of age
max duration: 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

coverage of clindamycin

A

gram positive including MRSA, anaerobe,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

counselling and side effects of clindamycin

A

stop if diarrhoea develops- risk of C.difficile

Abx associated colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

interactions of clindmycin

A

erythromycin

CYP3A4 inducer/ inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

linezolid coverage and indications

A

gram positive and anaerobes

indications: pneumonia, soft tissue infections, cellulitis…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

counselling and safety information of linezolid

A

ocular neuropathy: report visual disturbance
avoid tyramine rich food as linezolid is a reversible MAOI
risk of blood disorders
risk of hypertensive crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

interactions of linezolid

A

Drugs inducing risk of serotonin syndrome: SSRI’s, TCA’s, dopaminergics…
tyramine rich foods
MAOI inhibitors within 2 weeks: phenelzine, selegeline, moclebemide
rifampicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

coverage of macrolides and indications

A

broad spectrum

indications: H.pylori, skin and soft tissue infections, RTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

caution and side effectsof macrolides

A 
prolongs QT interval 
myasthenia gravis 
hepatotoxicity
ototoxicity
GI disturbance (take with food)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

can macrolides be used in pregnancy

A

erythromycin preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

interactions of macrolides

A 
STATINS: increases risk of mypathy
WARFARIN: increases bleed risk 
MHRA: erythromycin + rivaroxaban = increased bleeding risk 
drugs thats cause hypokalaemia
drugs that prolong QT interval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

antibiotics that prolong QT interval

A

macrolides

quinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

indications for metronidazole

A

protoazoal: vaginosis

anaerobic infections: C.diff, H. pylori, gastro, dental infections…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

cover for metronidazole

A

narrow spectrum- anaerobic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

contraindications for metronidazole

A

liver impairment- reduce dose by 1/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

counselling and side effects of metronidazole

A 
avoid alcohol until 48 hours after (due to disufuram reactions)
take with food 
may discolour urine to brown colour
metallic taste/ dry mouth
GI disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

interactions of metronidazole

A

warfarin = bleed risk
CYP inducers: rifampicin, phenytoin
lithium = increases lithium toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

indication and coverage of nitrofurantoin

A

coverage: broad spectrum, MRSA
indications: UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Contraindications of nitrofurantoin

A

eGFR <45ml/min
pregnancy at term/ breastfeeding
less than 3 months old
G6PD deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

duration of treatment for men, women, pregnant and catheter

A

men/ pregnant/ catheter: 7 days

women: 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

counselling and side effects

A

brown/ yellow urine
take with food/ milk
se: nausea
report signs of hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

4 types of penicillin and give example

A

broad spectrum: amoxicillin, ampicillin
narrow spectrum: penicillin G (benzylpenicillin for meningitis), penicillin V (phenoxymethylpenicillin for RTI)
antipseudomonas: piperacillin tazobactam (serious infections, psuedomonas, septicaemia, HAP)
penicillinase resistant: fluclocxacillin

38
Q

caution and SE of penicillins

A

rash, anaphylaxis, diarrhoea (broad spectrum),
do not give intrathecally = risk of encephalopathy = fatal
take ampicillin before food
take flucloxacillin on empty stomach
rare side effect of flucloxacillin = cholestatic jaundice

39
Q

coverage of quinolones and indications

A

broad spectrum
indications: RTI, UTI, avoid in MRSA
Ciprofloxacin uniquely covers pseudomonas

40
Q

4 MHRA ALERTS of quinolones

A
  1. tendon damage
  2. disabling SE of MSK/ CNS
  3. aortic aneurysm: report any chest/ back pain
  4. arthropathy
41
Q

caution and interactions of quinolones

A

avoid NSAIDS = increased risk of seizure threshold
caution in diabetics, epilepsy, children,
avoid milk/ indigestion remedies 2 hours prior
avoid dairy
avoid other drugs that increase QT interval/ corticosteroids
C. difficile risk
anticoagulants = increased bleed risk
theophylline = risk of toxicity
myasthenia gravis
reduce sunlight exposure
may impair driving ability- enhanced by alcohol

42
Q

tetracyclines indication and coverage

A

coverage: broad spectrum, atypical, MRSA, haemophillus influenzae
indication: acne, rosacea, LRTI, malaria, chlamydia

43
Q

contraindications of tetracyclines

A

under 12 years, pregnancy/ breast feeding,
deposit onto growing bone and teeth - discolouration
renal impairment (except doxycycline and minocycline)

44
Q

cautions of tetracyclines

A

myasthenia gravis

hepatic impairment- tetracyclines are hepatotoxic- avoid other hepatotoxic drugs

45
Q

counselling and side effects of tetracyclines

A

intracranial hypertension- report/ stop visual disturbance/ headache
photosensitivity- avoid exposure to sunlight
dysphagia/ oesophageal reactions- swallow whole, stand upright,
avoid milk (except DLM: doxy, limocycline, minocycline)
avoid indigestion remedies 2 hours before and after
Lupus-erythematosus-like syndrome and irreversible pigmentation

46
Q

trimethoprim coverage and indications

A

coverage: gram positive and negative, E.coli, pneumocystis jirovecci, staph
indications: UTI, prostatitis, pylenephritis, diverticulitis, RTI

47
Q

contraindications and cautions of trimethoprim

A

pregnancy- teratogenic in 1st trimester (antifolate)
blood dyscrasias
caution: acute porphyrias

48
Q

side effects of trimethoprim

A

blood dyscrasias- report mouth ulcers, fever, sore throat, rash, bleed…
hyperkalaemia

49
Q

interactions of trimethoprim

A

antifolates: methotrexate, phenytoin

50
Q

dosing of trimethoprim in normal and renal impairment

A

males: 200mg BD 7 days, females: 3 days
eGFR 15-30: reduce dose by half after 3 days
if eGFR <15: reduce dose by half

51
Q

Dosing regimen for TB

A 
initial treatment: 2 months
- rifampicin 
- isoniazid
- pyrazinamide
- ethambutol 
continuous phase: 4 months
- rifampicin
- isoniazid

pyridoxine (vitamin b6) given to prevent peripheral neuropathy

52
Q

dosing regimen for latent TB

A

rifampicin + isoniazid for 3 months OR

Isoniazid for 6 months

53
Q

counselling points and cautions for TB drugs

A

all hepatotoxic except ethambutol
rifampicin- CYP450 inducer, discolours contacts and bodily fluids red-orange
isoniazid - enzyme inhibitor
ethambutol- may cause ocular toxicity- report visual disturbance
do not use contraceptive pill with rifampicin- use IUD/ barrier

54
Q

drug treatment for animal bites (1st line and 2nd line)

A

1st line: co-amoxiclav
2nd line: doxycycline + metronidazole

prophylaxis (no signs of infection): 3 days
treatment: 5 days

55
Q

drug treatment for animal scratches

A

flucloxacillin

prophylaxis: 3 days
treatment: 5 days

56
Q

drug treatment for lyme disease/ tick bites)

A

1st line: doxycycline 100mg BD
2nd line: amoxicillin 1g TDS

treatment: 21 days

57
Q

treatment of mild and moderate/ severe diabetic foot

A

mild:
1st line: flucloxacillin
2nd line: macrolide (clarithromycin/ erythromycin - pregnancy)/ tetracycline (doxycycline)

moderate/ severe/ osteomyelitis:
1st line: flucloxacillin OR co-amoxiclav +/- gentamicin and /or metronidazole
2nd line: co-trimoxazole +/- gentamicin and / or metronidazole

58
Q

treatment for cellulitis

A

1st line: flucloxacillin
2nd line: macrolide (erythromycin for pregnancy)/ doxycycline/ co-amoxiclav

if infection is near eyes or nose:
1st line: co-amoxiclav
2nd line: clarithromycin + metronidazole

59
Q

treatment for CAP (mild, moderate and severe)

A

MILD:
1st line- amoxicillin
2nd line- doxycycline/ erythromycin/ clarithromycin

MODERATE:
1st line: amoxicillin + clarithromycin/ erythromycin
2nd line: doxycycline/ erythromycin/ clarithromycin

SEVERE:
1st line: co-amoxiclav + clarithromycin/ erythromycin
2nd line: levofloxacin

60
Q

treatment for HAP

A

1st line: co-amoxiclav

2nd line:

adults: doxycycline/ co-trimoxazole/ cefalexin/ levofloxacin
children: clarithromycin

61
Q

treatment for C.diff / diarhheoa

A

1st line: oral vancomycin
2nd line: fidoxamicin

life threatening: vancomycin + IV metronidazole

62
Q

treatment and prophylaxis for travellers diarrhoea

A

treatment/ prophylaxis: bismuth salicylate

standby treatment when abroad: azithromycin

63
Q

treatment and prophylaxis for travellers diarrhoea

A

treatment/ prophylaxis: bismuth salicylate

standby treatment when abroad: azithromycin

64
Q

treatment for otitis externa

A

1st line: acetic acid
2nd line: neomycin + corticosteroid
if systemic treatment needed: flucloxacillin

65
Q

treatment for otitis media

A 
1st line: amoxicillin
2nd line (if persists after 2-3 days of treatment): co-amoxiclav

penicillin allergy: clarithromycin or erythrmocyin (pregnancy)

66
Q

treatment and diagnosis for h.pylori

A

PPI + 2Abx (at least amoxicillin unless allergy)
omeprazole + amoxicillin 1g BD/ metronidazole 400mg BD/ Clarithromycin 500mg BD

urea 13C breath test
- do not do within 2 weeks of PPI or 4 weeks of antibiotic therapy

67
Q

treatment for impetigo

A

non-severe (non-bullous)
1st line: hydrogen peroxide
2nd line: fusidic acid (or mupirocin if resistance)

widespread non-bullous
1st line: fusidic acid (or mupirocin if resistance)

systemic/ bullous
1st line: flucloxacillin
2nd line: clarithromycin or erythromycin (pregnancy)

68
Q

treatment for scarlett fever/ strep throat

A

caused by streptococcus, symptoms: flu like symptoms, swollen lymph nodes, red rash, feels like sandpaper

1st line: phenoxymethylpenicillin
2nd line: clarithromycin or erythromycin in pregnancy

69
Q

treatment for lower urinary tract infection

A

1st line: nitrofurantoin or trimethoprim (not in pregnancy) (male/ pregnant 7 days, female 3 days)
2nd line: fosfomycin or pivmecillinam
2nd line pregnancy: cefalexin or amoxicillin

70
Q

treatment for chlamydia

A

doxycycline

71
Q

treatment for bacterial vaginosis and trichomoniasis

A

metronidazole

72
Q

treatment for dental abscess

A

amoxicillin or metronidazole

73
Q

treatment for meningitis

A

benzylpenicillin

74
Q

treatment for gonorrhoea

A

ceftriaxone or ciprofloxacin

75
Q

treatment for scabies

A

permethrin

76
Q

treatment for sinusitis

A

phenoxymethylpenicillin (doxycycline if penicillin allergy)

77
Q

treatment for threadworm

A

mebendazole

78
Q

treatment of aspergillosis

A

voriconazole

79
Q

treatment of crytococcosis

A

amphotericin B

80
Q

treatment for thrush

A

vaginal: clotrimazole/ fluconazole
oral: nystatin/ miconazole/ fluconazole

resistant oral/ vaginal -> itraconazole

81
Q

what is used to treat ringworm (tinea)

A

topical antifungals
if difficult to treat area (such as scalp and nails) or multiple areas can use oral imidazole / triazole antifungal such as itraconazole or terbinafine
for nail: amolorfine or terbinafine can be used
for tinea: micronazole, clotrimazole or terbinafine can be used

82
Q

what are the side effects of antifungals

A

QT prolongation and hepatotoxic
itraconazole: heart failure and hepatotoxicity
oral ketoconazole: MHRA risk of hepatotoxicity outweighs benefits- do not use orally
voriconazole: hepatoxicity and phototoxicity
amphotericin B: caution in renal failure and risk of anaphylaxis with IV- test dose needed with 30 min observation first. maintain on same brand

83
Q

treatment of varicella zoster, shingles, chicken pox, herpes

A

aciclovir

valaciclovir (pro-drug)

84
Q

treatment of chicken pox

A

patients over 14 should take antivirals

do not use NSAIDs - increases risk of skin infection

85
Q

symptoms of shingles/ herpes

A

herpes: tingling sensation, fluid filled blisters
shingles: looks like a belt around half the body, follows pattern on individual nerves on one side of body

86
Q

malaria bite prevention methods

A

mosquito nets impregnated with permethrin
apply DEET 20-50% after suncream - suitable for above 2months and pregnancy and breast feeding
long sleeve and trousers

87
Q

name the different malaria chemoprophylaxis

A 
malarone (atorvaquone + proguanil)
chloroquine
proguanil
mefloquine 
doxycycline
88
Q

what is the regimen for malarone (atorvaquone + proguanil)

A

start taking 1-2 days before travel
take 1 daily
take for 1 week after travel
can use for a maximum of 1 year

89
Q

what is the regimen for chloroquine

A

take 1 week before travel
1 weekly
take for 4 weeks after travel
maximum long term use

90
Q

what is the regimen for proguanil

A

take 1 week before
1 daily
take for 4 weeks after travel
maximum use long term

91
Q

regimen for mefloquine

A

take 2-3 weeks before travel
1 weekly
take for 4 weeks after travel
maximum 1 year use

pre reg Thammis cards (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions