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Step 2CK > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What are the 4 most common MRSA antibiotics?

A
  1. Vancomycin
  2. Daptomycin
  3. Linezolid
  4. Ceftaroline
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2
Q

What are 4 drugs that treat minor MRSA infections of the skin?

A
  1. TMP-SMX
  2. Doxycycline
  3. Clindamycin
  4. Linezolid
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3
Q

What are 2 common drugs that cover E. coli and other gram negatives?

A
  1. Amoxicillin

2. Penicillin

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4
Q

What’s the best initial antibiotic for otitis media?

A

Amoxicillin

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5
Q

What’s the best initial antibiotic for dental infection and endocarditis prophylaxis?

A

Amoxicillin

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6
Q

What’s the best initial antibiotic for limited Lyme disease?

A

Amoxicillin

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7
Q

What’s the best initial antibiotic for UTI in pregnant women?

A

Amoxicillin

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8
Q

What’s the best initial antibiotic for Listeria?

A

Amoxicillin

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9
Q

What’s the best initial antibiotic for enterococcal infections?

A

Amoxicillin

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10
Q

Which is the main drug that is penicillinase-resistant?

A

Dicloxacillin

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11
Q

What’s the toxicity of Methicillin?

A

Allergic interstitial nephritis

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12
Q

What’s second-line to penicillin if the patient develops a rash?

A

Cephalosporins

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13
Q

What’s second-line to penicillin if the patient gets anaphylaxis?

A

Non B-lactams

aka no cephalosporins, carbapenems, or monobactams

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14
Q

What’s the only cephalosporin that will cover MRSA?

A

Ceftaroline

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15
Q

What’s the best initial antibiotic therapy for PID (2 drugs together)?

A
  1. Cefotetan or cefoxitan

2. Doxycycline

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16
Q

Why should you avoid ceftriaxone in neonates?

A

Impaired biliary metabolism

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17
Q

What’s the first-line antibiotic for meningitis?

A

Ceftriaxone

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18
Q

What’s the first-line antibiotic for CAP (2 drugs together)?

A
  1. Ceftriaxone

2. Macrolide (Azithromycin)

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19
Q

What’s the first-line antibiotic for neutropenia and fever?

A

Cefepime

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20
Q

What’s the first-line antibiotic for VAP?

A

Cefepime

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21
Q

What’s the potential toxicity of cephalosporins?

A

Deplete prothrombin and thereby increase risk of bleeding

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22
Q

What’s a good fluoroquinolone for cystitis and pyelonephritis?

A

Ciprofloxacin

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23
Q

What’s the first-line antibiotic for diverticulitis?

A

Moxifloxacin

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24
Q

What are 2 adverse side effects of fluoroquinolones?

A
  1. Bone growth abnormalities in children and pregnant women

2. Tendonitis/Achilles rupture

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25
Q

What’s the only indication for Nitrofurantoin?

A

Cystitis, especially in pregnant women

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26
Q

Which antibiotic can cause bone marrow suppression and also cause hemolysis with G6PD deficiency?

A

TMP-SMX (because it’s a folate antagonist)

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27
Q

What’s the first-line antibiotic for Lyme disease?

A

Doxycycline

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28
Q

Which antibiotic can cause tooth discoloration, Fanconi syndrome, and photosensitivity?

A

Doxycycline

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29
Q

What’s a first-line antibiotic for

A

Pip-Tazo

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30
Q

What are the 5 most common organisms causing meningitis?

A
  1. Strep pneumo
  2. GBS
  3. H. influenzae
  4. Neisseria meningiditis
  5. Listeria
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31
Q

What’s the most likely dx: AIDS with <100 CD4?

A

Cryptococcus

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32
Q

What’s the most likely dx: camper/hiker, target rash, tick, joint pain?

A

Lyme disease

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33
Q

What’s the most likely dx: camper/hiker, rash moves from arms/legs to trunk, tick?

A

RMSF

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34
Q

What’s the most likely dx: pulmonary TB in 85%?

A

Tb

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35
Q

What’s the most likely dx: adolescent, petechial rash?

A

Neisseria

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36
Q

Is CSF elevated in viral meningitis?

A

No

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37
Q

Are there high neutrophils in bacterial meningitis CSF?

A

Yes

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38
Q

What 4 warning signs tell you that head CT is necessary instead of LP?

A
  1. Papilledema
  2. Seizures
  3. Focal neuro abnormalities
  4. Confusion
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39
Q

Do you treat empirically for meningitis if there is a contraindication to immediate LP?

A

Yes

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40
Q

Which test test for cryptococcus?

A

India Ink

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41
Q

What 3 medications are first-line for treating bacterial meningitis?

A
  1. Ceftriaxone
  2. Vancomycin
  3. Steroids
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42
Q

What’s the most common neurological deficit of untreated bacterial meningitis?

A

8th CN deficit/deafness

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43
Q

Which 3 drugs are used for meningitis prophylaxis for close contacts?

A
  1. Rifampin
  2. Ciprofloxacin (only adults)
  3. Ceftriaxone
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44
Q

What dx might present with acute onset of fever and confusion?

A

Encephalitis

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45
Q

What’s the best initial treatment for herpes encephalitis?

A

Acyclovir

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46
Q

What drug should be used for acyclovir-resistant herpes?

A

Foscarnet

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47
Q

What’s the time interval in which you can swab to check for the flu?

A

48 hours since onset of sx

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48
Q

If less than 48 hours of sx, what 2 meds can you use to shorten the duration of sx?

A
  1. Oseltamivir

2. Zanamivir

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49
Q 
What do the following organisms present with in stool?
Salmonella
Campy
Shigella
E. coli
Vibrio
Yersinia
C. diff
A

Blood and WBCs

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50
Q 
What do the following present with in stool?
Viruses
Cryptosporidius
Bacillus cereus
Staph
A

No blood or WBCs in stool

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51
Q

What antibiotic treats giardia?

A

Metronidazole

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52
Q

What medication treats cryptosporidiosis?

A

Nitazoxanide

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53
Q

What does the following Hep B serologic pattern mean?:

All positive except surface antibody?

A

Acute or chronic infex

54
Q

What does the following Hep B serologic pattern mean?:
Positive core antibody
Positive surface antibody
Negative others

A

Resolved, old past infex

55
Q

What does the following Hep B serologic pattern mean?:

Only positive surface antibody

A

Vaccination

56
Q

What does the following Hep B serologic pattern mean?:

Only positive core antibody (IgG or IgM)

A

Window period

57
Q

Which serologic marker in Hep B correlates with viral replication?

A

E-antigen (DNA polymerase)

58
Q

Do Hep A and E resolve themselves?

59
Q

What defines chronic Hep B?

A

Surface antigen present for >6 months

60
Q

Which hepatitis is transmitted oral-fecally?

A

Hep E

“fEcal”

61
Q

What are the treatment options for chronic Hep B?

A

Entecavir
Adefovir
Lamivudine
Tenofovir

62
Q

Hep __ is the only form of acute hepatitis to be treated?

63
Q

What are 2 meds for acute hepatitis C?

A
  1. Ledipasvir

2. Sofosbuvir

64
Q

Which drug is not first-line in hepatitis because of its side effects of arthralgia, myalgia, anemia, and depression?

A

Interferon

65
Q

Both cystitis and urethritis give dyruria with urinary frequency and burning, but _____ does not give urethral discharge?

66
Q

What antibiotics do you use for PID and urethritis?

A

Ceftriaxone IM plus doxycycline +/- metronidazole

67
Q

What’s the next step when you suspect PID in a female?

A

Exclude pregnancy first

68
Q

What’s the tx for cervicitis?

A

Ceftriaxone and azithromycin in a single dose

69
Q

What presents with a strawberry cervix?

A

Cervicitis

70
Q

What presents with scrotal pain superior and lateral to the testicle that develops over a few days and very severe point tenderness of the testicle?

A

Epididymitis

71
Q

How do you treat younger men <35 for epididymitis?

A

Ceftriaxone and doxycycline

72
Q

How do you treat older men for epididymitis?

73
Q

How do you test for varicocele?

A

Abdominal CT

74
Q

T/F: all ulcerative genital disease can have inguinal adenopathy?

75
Q

What’s the most likely genital dx for: painless ulcer?

76
Q

What’s the most likely genital dx for: painful ulcer?

A

Chancroid (H. ducreyi)

77
Q

What’s the most likely genital dx for: lymph nodes tender and suppurating?

A

Lymphogranuloma venereum

78
Q

What’s the most likely genital dx for: vesicles prior to ulcer and painful?

A

Herpes simplex

79
Q

How do you treat syphilis?

A

Single dose of IM penicillin

80
Q

How do you treat chancroid?

A

Azithromycin

81
Q

How do you treat lymphogranuloma venereum?

A

Doxycycline

82
Q

How do you test for lymphogranuloma venereum?

A

Complement fixation titers in blood

83
Q

How do you test for chancroid?

A

Culture on specialized media

84
Q

How do you test for syphilis?

A

Dark-field microscopy

85
Q

What dx presents with painless genital ulcer with indurated edges and painless adenopathy?

A

Primary syphilis

86
Q

What dx presents with rash on palms and soles, alopecia areata, mucous patches, and condylomata lata?

A

Secondary syphilis

87
Q

What dx presents with stroke, loss of position and vibratory sense, incontinence, pupil that reacts to accommodation but not light, skin and bone lesions, and memory changes?

A

Tertiary syphilis

88
Q

What tests neurosyphilis?

89
Q

What dx presents with fever and worse sx after penicillin treatment for syphilis?

A

Jarisch-Herxheimer rxn

90
Q

How do you treat Jarisch-Herxheimer rxn??

A

Aspirin and antipyretics; it will pass

91
Q

How do you treat Condylomata Acuminata?

A

Podophyllin or trichloroacetic acid, or imiquimod to slough off the lesion

92
Q

How do you treat pediculosis (crabs)?

A

Permethrin

93
Q

How do you treat scabies?

A

Permethrin

94
Q

In a UTI, do not do a urine culture unless there are ___’s?

95
Q

How long do you treat an uncomplicated cystitis in a female?

A

Nitrofurantoin for 3 days or TMP-SMX

96
Q

When do you suspect a perinephric abscess?

A

Pyelonephritis that does not resolve with appropriate therapy

97
Q

What dx presents with perineal pain and tender prostate on exam?

A

Prostatitis

98
Q

How do you treat a perinephric abscess?

99
Q

How do you treat prostatitis?

A

Cipro or TMP-SMX

100
Q

What dx presents with fever, new murmur, flat lesions and raised and painful lesions, spots in eyes, conjunctival petechiae, splenomegaly?

A

Endocarditis

101
Q

What’s the best test for endocarditis?

A

Blood culture

102
Q

Can there be culture-negative endocarditis?

103
Q

What’s the first-line tx for endocarditis?

A

Vancomycin

104
Q

When do you need surgery for endocarditis?

A

If a valve ruptures

105
Q

What type of tick transmits Lyme disease?

A

Ixodes scapularis (deer tick)

106
Q

How many days after a tick bite does the Lyme rash appear?

A

5-14 days after

107
Q

What is erythema migrans?

A

The Lyme rash

108
Q

What’s the most common long-term manifestation of Lyme?

A

Joint pain

109
Q

What’s the most common neurological manifestation of Lyme disease?

A

7th nerve palsy

110
Q

What’s the risk of vaginal transmission of HIV (insertive and receptive)?

A

1: 3000-1:10,000 for insertive
1: 1000 for receptive

111
Q

What’s the risk of oral sex transmission of HIV (receptive)?

112
Q

What’s the risk of needle stick transmission of HIV?

113
Q

What’s the risk of anal sex transmission of HIV (receptive)?

114
Q

What’s the risk of mother to child transmission of HIV?

A

25-30% without medication

115
Q

What infex are at increased frequency with HIV but a CD4 count still above 200 (6)?

A
  1. VZV
  2. HSV
  3. TB
  4. Candidiasis
  5. Bacterial pneumonia
  6. Kaposi sarcoma
116
Q

What’s the best initial test for HIV?

A

HIV 1/2 P24

117
Q

What’s a good way to measure treatment efficacy in HIV?

A

Viral load testing (PCR-RNA)

118
Q

What’s the best initial treatment of HIV?

A

2 nucleoside reverse-transcriptase inhibitors
+
1 integrase inhibitor

119
Q 
What's the category of the following drugs:?
Bictegravir
Dolutegravir
Elvitegravir
Raltegravir
A

Integrase inhibitors

120
Q

What’s the suffix of the category of drugs which are the best initial treatment for HIV (combined with 1 integrase inhibitor)?

A

Gravir

“We need to integrate so that the HIV doesn’t get gravir”

121
Q

What are some of the preferred NRTIs for combo with the integrase inhibitors?

A

Tenofovir, alafenamide, and emtricitabine

Abacavir and lamivudine

122
Q

What must you test for before starting abacavir?

123
Q

All significant needle stick injuries and sexual exposures are given __ weeks of PEP?

124
Q

What meds are PEP?

A

Same as initial meds (2 NRTI’s and 1 integrase inhibitor)

125
Q

T/F: treat HIV positive pregnant patients immediately, without waiting for genotyping?

126
Q

Babies born to an HIV+ mother should receive _______ during delivery and for 6 weeks after?

A

Zidovudine

127
Q

If an HIV+ mother’s viral load is above ______ at time of delivery, C-section is performed?

128
Q

T/F: fully controlled HIV (viral load <1% gives less than 1% mother-fetus transmission)?

129
Q

What PreP drug combo should be taken before the exposure and 1 month after?

A

Emtricitabine-tenofovir

130
Q

Intermittent use of PreP can reactivate hepatitis __?

A

Hepatitis B

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