Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX Review > Infectious Disease II - Bacterial Infections > Flashcards

Infectious Disease II - Bacterial Infections Flashcards

1
Q

Name common pathogens in bone and joint infections.

A

s. aureus, s. epi, strep, n. gono

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

Name common pathogens in UTIs.

A

E. coli, kleb, proteus, strep, enterococci, s. saprophyticus

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

Name common lower respiratory pathogens (community and hospital).

A

community: atypicals, strep pneumo, h. flu, possibly enteric GNRs
hospital: pseudomonas, enteric GNR, s. aureus, strep pneumo

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

Name common meningitis pathogens.

A

Listeria (in very young and elderly), neisseria, GBS (young), E. coli (young), s. pneumo, h. flu

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

Name common upper respiratory pathogens.

A

s. pneumo/pyo, h. flu, moraxella

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

Name common endocarditis pathogens.

A

s. aureus, s. epi, strep, enterococci

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

Name common intra-abdominal pathogens.

A

enteric GNR, enterococci, strep, bacteroides

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

Name common SSTI pathogens.

A

staph, strep, GNR (diabetics)

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

How long before surgery should preop abx be hung?

A

Most antibiotics should be hung 1 hour before surgery, except FQs and vanc, which should be 2 hours before.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which types of operations require additional coverage outside of skin flora? What additional bugs should be considered?

A

colorectal procedures and hysterectomies require anaerobic and GNR coverage

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

Which antibiotics are most frequently used in preop ppxs?

A

For routine procedures that don’t warrant additional pathogen coverage, cefazolin, cefuroxime, and vanc are the most common choices. For anaerobic/GNR coverage, cefotetan, metronidazole, amp/sulb, cefoxitin, ertapenem, and ceftriaxone are options.

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

What are the drugs and doses used for meningitis empirically in most patients (2-50 years old)?

A

To cover neisseria and strep pneumo, high doses of vanc and ceftriaxone are used.

30-45 mg/kg/day vanc and 2g q12h ceftriaxone

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

Which medication is used to cover for Listeria?

A

ampicillin

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

What is the empiric meningitis regimen for adults aged >50 years?

A

ceftriaxone, vanc, and ampicillin covering strep, neisseria, listeria, and GNB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the empiric meningitis regimen for neonates?

A

ampicillin with cefotaxime or gent

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

What are the preferred drugs and doses for acute otitis media treatment? How long should you treat?

A

amoxicillin 90 mg/kg/day or augmentin 90 mg/kg/day

use the lowest amount of clavulanate possible to avoid diarrhea SE

Tx duration is usually 5-7 days for mild/moderate infections, and 10 days for severe.

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

When would it be a good idea to use augmentin over amoxicillin in a child presenting with AOM?

A

if the child has had amoxicillin in the last 30 days

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

What are the criteria for anti-infectives in suspected pharyngitis? sinusitis?

A

pharyngitis - positive rapid antigen test

sinusitis - either 10 days of symptoms or 3 days of severe symptoms

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

What are first-line treatments for pharyngitis and sinusitis in patients that meet anti-infective criteria?

A

pharyngitis - penicillin or 1/2 gen ceph

sinusitis - augmentin, if tx failure or severe pen allergy cna use clinda, resp FQ, or doxy

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

How long should you treat pharyngitis? sinusitis?

A

pharyngitis is treated for 10 days unless using azith (5d)

sinusitis initial tx is 5-7 days, may require 7-10 if treatment failure

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

How is acute bronchitis not related to a COPD exacerbation treated?

A

NOT with antibiotics, as the cause is often not bacterial. ONLY consider antibiotics in severe cases. Supportive care (hydration, antipyretics, antitussives) recommended.

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

When are antibiotics warranted in acute bronchitis?

A

1) when related to COPD exacerbation and meets specific criteria (another question)
2) when pneumonia is suspected
3) when whooping cough (Bordatella) is confirmed

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

What are the criteria for antibiotic use in acute bacterial exacerbations of chronic bronchitis?

A

increased sputum purulence plus either increased sputum production or increased dyspnea

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

In a health patient with no recent antibiotic use, name two drugs most commonly used to treat outpatient CAP.

A

1) azithromycin

2) doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What characteristics should you look for in a patient history that would suggest combination or broader spectrum monotherapy would be necessary for outpatient CAP?
1) comorbidities like CHF, DM, liver/renal disease, malignancy, asplenia 2) recent antibiotic use (last 90 days) 3) immunocompromised
26
What agents should be used in patients the require more extensive treatment for outpatient CAP?
1) beta-lactam and macrolide 2) resp FQ monotherapy 3) beta-lactam and doxy
27
What are the preferred beta-lactams in outpatient CAP?
high dose amoxicillin (1g TID), cefpodoxime, augmentin, cefdinir
28
What are the preferred beta-lactams for inpatient CAP?
ceftriaxone, cefotaxime
29
When should a resp FQ be used in inpatient CAP?
Due to safety concerns, FQs should be reserved for patients with severe penicillin allergies.
30
What are some risk factors for MDR pathogens and MRSA in patients with HAP/VAP?
1) IV abx use within the last 90 days 2) high prevalence of MRSA in hospital unit 3) hospitalization of at least 5 days prior to ventilation 4) septic shock at the time of VAP onset 5) acute RRT at time of VAP onset
31
When is double coverage of pseudomonas warranted?
Use two drugs that cover pseudomonas when the patient has a high risk of mortality, has had IV abx in the last 90 days, or has MDR risk factors for HAP/VAP.
32
Which drugs will cover pseudomonas and MSSA in patients without risk factors for MDR or MRSA?
cefepime, levo, pip/tazo, meropenem
33
This class of drugs will only be used for pseudomonas as combination therapy - they are not options for single coverage of pseudomonas.
aminoglycosides
34
If a patient has risk factors for MRSA, they will have one of these two drugs on board:
vanc or linezolid
35
What are the 6 pseudomonas monotherapy options?
cefepime, ceftazidime, aztreonam, levofloxacin, pip/tazo, meropenem
36
What is the general duration of treatment for HAP/VAP?
7 days, longer or shorter based on radiologic/lab/clinical findings
37
two most important rifampin pearls/counseling points
1) take on an empty stomach - food decreases absorption | 2) will cause bodily secretions to be stained orange, which can stain contact lenses, clothes, etc.
38
Which drug may be substituted for rifampin in patients that must avoid drug interactions?
rifabutin (dosed at half rifampin dose - 5 mg/kg/day)
39
Which drugs are part of the induction regimen for TB?
rifampin 10 mg/kg daily, isoniazid, 5 mg/kg daily, pyrazinamide 25 mg/kg daily, and ethambutol 20 mg/kg daily
40
Describe the treatment approach for TB.
Induction and continuation phases. induction is usually 2 months, and continuation is usually 4 but may be prolonged. the most common reason to prolong the continuation phase to 7 months is a positive sputum culture at the end of the induction phase. higher doses of continuation drugs may be given less frequently (2-3x/week) and directly observed if adherence is an issue.
41
two most important pearls/counseling points for isoniazid
1) take on empty stomach | 2) warning for peripheral neuropathy - supplementation with pyrodoxine 25 mg daily can help prevent
42
What is a side effect common to all TB drugs that must be monitored for?
liver wreckage
43
adverse effects of isoniazid
1) hyperglycemia 2) GI upset 3) hemolytic anemia 4) drug induced lupus erythematosus
44
adverse effects of pyrazinamide
1) hyperuricemia 2) GI upset 3) rash 4) arthralgia/myalgia
45
adverse effects of ethambutol
1) optic neuritis - contraindicated if previously existing | 2) confusion/hallucinations
46
Which two TB drugs must be given with a longer dosing interval in renal impairment?
pyrazinamide (CrCl < 30) and ethambutol (CrCl < 50)
47
most common causative organisms in endocarditis
staph, strep, enterococci, viridans strep
48
What patient anatomical characteristics guide endocarditis treatment?
The duration is mainly driven by the level of resistance of the organism and the valve type (tissue vs. prosthetic). Antibiotic choice is determined by organism and susceptibility.
49
What is the recommended duration of therapy for aminoglycosides when used for synergy?
2 weeks
50
Give the most common endocarditis prophylaxis regimen for all patients and options for penicillin allergic patients.
amoxicillin 2g one hour before procedure clindamycin 600 mg or azithromycin 500 mg for penicillin allergy
51
Describe the difference between primary and secondary peritonitis.
Primary peritonitis is most frequently caused by liver disease. Secondary peritonitis usually follows abdominal trauma (ulceration, ischemia, surgery).
52
What are the most common causative organisms in intra-abdominal infections?
anaerobes, strep, and enteric gram negs note: anaerobes much less common in primary than secondary peritonitis
53
What is the usual treatment duration for intra-abdominal infections?
4-7 days, longer if more severe or abscesses are present
54
What additional organisms should you cover for in critically ill patients with intra-abdominal infections?
pseudomonas, CAPES
55
What are the most common agents used for typical, non critically ill patients with intra-abdominal infections?
cefoxitin (not enterococci), moxi (moderate activity for enterococci), ertapenem, cephalosporin/FQ + metronidazole
56
What are the 3 most common SSTIs and the treatments of choice for each?
1) impetigo (staph and strep) - treated with topical mupirocin or systemic Keflex if numerous widespread lesions 2) folliculitis and related (staph including MRSA) - Keflex for MSSA, Bactrim or doxy if suspect CA-MRSA 3) cellulitis (staph, strep) - Keflex or penicillin if mild, bactrim or doxy of suspect CA-MRSA
57
For how long should you treat a diabetic foot infection?
usually 7-14 days, weeks if deeper infection present such as osteo
58
Which patients would meet criteria for an uncomplicated UTI?
nonpregnant premenopausal female patients with no urologic abnormalities
59
Which patients would be classified as a complicated UTI?
all males with UTI, pregnant females, catheter-related UTIs
60
two most common treatments for uncomplicated UTIs
1) macrobid 100 BID WITH FOOD | 2) Bactrim DS BID if CrCl 30-60
61
most common pathogens for UTI
E. Coli, E. Coli, E. Coli, Klebsiella, Proteus, enterococci
62
Which drug class is preferred for pyelonephritis or complicated UTIs?
FQs (except moxi) If quinolone resistance is more than 10%, give a single dose of ceftriaxone or extended interval AG followed by quinolone. can also use bactrim or a beta-lactam for 14 days
63
In which group of patients will asymptomatic bacteruria always be treated? What is the UA cutoff of bacteria/mL?
Bacteruria is defined as at least 10^5 bacteria/mL on a UA. Treat all cases in pregnant women, as lack of treatment can be harmful to the fetus.
64
preferred tx for asymptomatic bacteruria in pregnant women
augmentin or oral cephalosporin
65
What are the ACOG recommendations for pregnant patients with penicillin allergies that get a UTI?
nitrofurantoin and bactrim have recommendations per ACOG, but have limited use. Both should be avoided in the 1st and 3rd trimesters.
66
How long should asymptomatic bacteruria be treated in pregnant women?
3-7 days
67
What are the two recommended treatment options for C. diff initial episode?
vanc 125mg PO QID or fidaxomycin 200 mg BID both are 10 days duration
68
In recurrent C. diff, what are the treatment options if vancomycin was used initially? fidaxomycin? metronidazole?
vanc - fidaxomycin 200 mg BID or vanc tapered/pulsed regimen fidax - vanc tapered/pulsed regimen metro - vanc 125 mg QID
69
What regimens are available for patients that present with fulminant or complicated C. diff infections?
vanc 500 mg QID or metronidazole 500 mg IV TID
70
State the preferred treatments for each stage of syphilis (primary/early, secondary, tertiary/late).
primary and secondary have very similar recommendations - IM benzathine penicillin 2.4 million U x1 dose for primary and weekly x3 doses for secondary

NAPLEX Review (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions