Infectious Diseases Flashcards
1
Q
What are the 4 most common MRSA antibiotics?
A
- Vancomycin
- Daptomycin
- Linezolid
- Ceftaroline
2
Q
What are 4 drugs that treat minor MRSA infections of the skin?
A
- TMP-SMX
- Doxycycline
- Clindamycin
- Linezolid
3
Q
What are 2 common drugs that cover E. coli and other gram negatives?
A
- Amoxicillin
2. Penicillin
4
Q
What’s the best initial antibiotic for otitis media?
A
Amoxicillin
5
Q
What’s the best initial antibiotic for dental infection and endocarditis prophylaxis?
A
Amoxicillin
6
Q
What’s the best initial antibiotic for limited Lyme disease?
A
Amoxicillin
7
Q
What’s the best initial antibiotic for UTI in pregnant women?
A
Amoxicillin
8
Q
What’s the best initial antibiotic for Listeria?
A
Amoxicillin
9
Q
What’s the best initial antibiotic for enterococcal infections?
A
Amoxicillin
10
Q
Which is the main drug that is penicillinase-resistant?
A
Dicloxacillin
11
Q
What’s the toxicity of Methicillin?
A
Allergic interstitial nephritis
12
Q
What’s second-line to penicillin if the patient develops a rash?
A
Cephalosporins
13
Q
What’s second-line to penicillin if the patient gets anaphylaxis?
A
Non B-lactams
aka no cephalosporins, carbapenems, or monobactams
14
Q
What’s the only cephalosporin that will cover MRSA?
A
Ceftaroline
15
Q
What’s the best initial antibiotic therapy for PID (2 drugs together)?
A
- Cefotetan or cefoxitan
2. Doxycycline
16
Q
Why should you avoid ceftriaxone in neonates?
A
Impaired biliary metabolism
17
Q
What’s the first-line antibiotic for meningitis?
A
Ceftriaxone
18
Q
What’s the first-line antibiotic for CAP (2 drugs together)?
A
- Ceftriaxone
2. Macrolide (Azithromycin)
19
Q
What’s the first-line antibiotic for neutropenia and fever?
A
Cefepime
20
Q
What’s the first-line antibiotic for VAP?
A
Cefepime
21
Q
What’s the potential toxicity of cephalosporins?
A
Deplete prothrombin and thereby increase risk of bleeding
22
Q
What’s a good fluoroquinolone for cystitis and pyelonephritis?
A
Ciprofloxacin
23
Q
What’s the first-line antibiotic for diverticulitis?
A
Moxifloxacin
24
Q
What are 2 adverse side effects of fluoroquinolones?
A
- Bone growth abnormalities in children and pregnant women
2. Tendonitis/Achilles rupture
25
What's the only indication for Nitrofurantoin?
Cystitis, especially in pregnant women
26
Which antibiotic can cause bone marrow suppression and also cause hemolysis with G6PD deficiency?
TMP-SMX (because it's a folate antagonist)
27
What's the first-line antibiotic for Lyme disease?
Doxycycline
28
Which antibiotic can cause tooth discoloration, Fanconi syndrome, and photosensitivity?
Doxycycline
29
What's a first-line antibiotic for
Pip-Tazo
30
What are the 5 most common organisms causing meningitis?
1. Strep pneumo
2. GBS
3. H. influenzae
4. Neisseria meningiditis
5. Listeria
31
What's the most likely dx: AIDS with <100 CD4?
Cryptococcus
32
What's the most likely dx: camper/hiker, target rash, tick, joint pain?
Lyme disease
33
What's the most likely dx: camper/hiker, rash moves from arms/legs to trunk, tick?
RMSF
34
What's the most likely dx: pulmonary TB in 85%?
Tb
35
What's the most likely dx: adolescent, petechial rash?
Neisseria
36
Is CSF elevated in viral meningitis?
No
37
Are there high neutrophils in bacterial meningitis CSF?
Yes
38
What 4 warning signs tell you that head CT is necessary instead of LP?
1. Papilledema
2. Seizures
3. Focal neuro abnormalities
4. Confusion
39
Do you treat empirically for meningitis if there is a contraindication to immediate LP?
Yes
40
Which test test for cryptococcus?
India Ink
41
What 3 medications are first-line for treating bacterial meningitis?
1. Ceftriaxone
2. Vancomycin
3. Steroids
42
What's the most common neurological deficit of untreated bacterial meningitis?
8th CN deficit/deafness
43
Which 3 drugs are used for meningitis prophylaxis for close contacts?
1. Rifampin
2. Ciprofloxacin (only adults)
3. Ceftriaxone
44
What dx might present with acute onset of fever and confusion?
Encephalitis
45
What's the best initial treatment for herpes encephalitis?
Acyclovir
46
What drug should be used for acyclovir-resistant herpes?
Foscarnet
47
What's the time interval in which you can swab to check for the flu?
48 hours since onset of sx
48
If less than 48 hours of sx, what 2 meds can you use to shorten the duration of sx?
1. Oseltamivir
| 2. Zanamivir
49
```
What do the following organisms present with in stool?
Salmonella
Campy
Shigella
E. coli
Vibrio
Yersinia
C. diff
```
Blood and WBCs
50
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What do the following present with in stool?
Viruses
Cryptosporidius
Bacillus cereus
Staph
```
No blood or WBCs in stool
51
What antibiotic treats giardia?
Metronidazole
52
What medication treats cryptosporidiosis?
Nitazoxanide
53
What does the following Hep B serologic pattern mean?:
| All positive except surface antibody?
Acute or chronic infex
54
What does the following Hep B serologic pattern mean?:
Positive core antibody
Positive surface antibody
Negative others
Resolved, old past infex
55
What does the following Hep B serologic pattern mean?:
| Only positive surface antibody
Vaccination
56
What does the following Hep B serologic pattern mean?:
| Only positive core antibody (IgG or IgM)
Window period
57
Which serologic marker in Hep B correlates with viral replication?
E-antigen (DNA polymerase)
58
Do Hep A and E resolve themselves?
Yes
59
What defines chronic Hep B?
Surface antigen present for >6 months
60
Which hepatitis is transmitted oral-fecally?
Hep E
| "fEcal"
61
What are the treatment options for chronic Hep B?
Entecavir
Adefovir
Lamivudine
Tenofovir
62
Hep __ is the only form of acute hepatitis to be treated?
Hep C
63
What are 2 meds for acute hepatitis C?
1. Ledipasvir
| 2. Sofosbuvir
64
Which drug is not first-line in hepatitis because of its side effects of arthralgia, myalgia, anemia, and depression?
Interferon
65
Both cystitis and urethritis give dyruria with urinary frequency and burning, but _____ does not give urethral discharge?
Cystitis
66
What antibiotics do you use for PID and urethritis?
Ceftriaxone IM plus doxycycline +/- metronidazole
67
What's the next step when you suspect PID in a female?
Exclude pregnancy first
68
What's the tx for cervicitis?
Ceftriaxone and azithromycin in a single dose
69
What presents with a strawberry cervix?
Cervicitis
70
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?
Epididymitis
71
How do you treat younger men <35 for epididymitis?
Ceftriaxone and doxycycline
72
How do you treat older men for epididymitis?
TMP-SMX
73
How do you test for varicocele?
Abdominal CT
74
T/F: all ulcerative genital disease can have inguinal adenopathy?
True
75
What's the most likely genital dx for: painless ulcer?
Syphilis
76
What's the most likely genital dx for: painful ulcer?
Chancroid (H. ducreyi)
77
What's the most likely genital dx for: lymph nodes tender and suppurating?
Lymphogranuloma venereum
78
What's the most likely genital dx for: vesicles prior to ulcer and painful?
Herpes simplex
79
How do you treat syphilis?
Single dose of IM penicillin
80
How do you treat chancroid?
Azithromycin
81
How do you treat lymphogranuloma venereum?
Doxycycline
82
How do you test for lymphogranuloma venereum?
Complement fixation titers in blood
83
How do you test for chancroid?
Culture on specialized media
84
How do you test for syphilis?
Dark-field microscopy
85
What dx presents with painless genital ulcer with indurated edges and painless adenopathy?
Primary syphilis
86
What dx presents with rash on palms and soles, alopecia areata, mucous patches, and condylomata lata?
Secondary syphilis
87
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?
Tertiary syphilis
88
What tests neurosyphilis?
FTA
89
What dx presents with fever and worse sx after penicillin treatment for syphilis?
Jarisch-Herxheimer rxn
90
How do you treat Jarisch-Herxheimer rxn??
Aspirin and antipyretics; it will pass
91
How do you treat Condylomata Acuminata?
Podophyllin or trichloroacetic acid, or imiquimod to slough off the lesion
92
How do you treat pediculosis (crabs)?
Permethrin
93
How do you treat scabies?
Permethrin
94
In a UTI, do not do a urine culture unless there are ___'s?
WBC's
95
How long do you treat an uncomplicated cystitis in a female?
Nitrofurantoin for 3 days or TMP-SMX
96
When do you suspect a perinephric abscess?
Pyelonephritis that does not resolve with appropriate therapy
97
What dx presents with perineal pain and tender prostate on exam?
Prostatitis
98
How do you treat a perinephric abscess?
Drainage
99
How do you treat prostatitis?
Cipro or TMP-SMX
100
What dx presents with fever, new murmur, flat lesions and raised and painful lesions, spots in eyes, conjunctival petechiae, splenomegaly?
Endocarditis
101
What's the best test for endocarditis?
Blood culture
102
Can there be culture-negative endocarditis?
Yes
103
What's the first-line tx for endocarditis?
Vancomycin
104
When do you need surgery for endocarditis?
If a valve ruptures
105
What type of tick transmits Lyme disease?
Ixodes scapularis (deer tick)
106
How many days after a tick bite does the Lyme rash appear?
5-14 days after
107
What is erythema migrans?
The Lyme rash
108
What's the most common long-term manifestation of Lyme?
Joint pain
109
What's the most common neurological manifestation of Lyme disease?
7th nerve palsy
110
What's the risk of vaginal transmission of HIV (insertive and receptive)?
1: 3000-1:10,000 for insertive
1: 1000 for receptive
111
What's the risk of oral sex transmission of HIV (receptive)?
1:1000
112
What's the risk of needle stick transmission of HIV?
1:300
113
What's the risk of anal sex transmission of HIV (receptive)?
1:100
114
What's the risk of mother to child transmission of HIV?
25-30% without medication
115
What infex are at increased frequency with HIV but a CD4 count still above 200 (6)?
1. VZV
2. HSV
3. TB
4. Candidiasis
5. Bacterial pneumonia
6. Kaposi sarcoma
116
What's the best initial test for HIV?
HIV 1/2 P24
117
What's a good way to measure treatment efficacy in HIV?
Viral load testing (PCR-RNA)
118
What's the best initial treatment of HIV?
2 nucleoside reverse-transcriptase inhibitors
+
1 integrase inhibitor
119
```
What's the category of the following drugs:?
Bictegravir
Dolutegravir
Elvitegravir
Raltegravir
```
Integrase inhibitors
120
What's the suffix of the category of drugs which are the best initial treatment for HIV (combined with 1 integrase inhibitor)?
Gravir
"We need to integrate so that the HIV doesn't get gravir"
121
What are some of the preferred NRTIs for combo with the integrase inhibitors?
Tenofovir, alafenamide, and emtricitabine
Abacavir and lamivudine
122
What must you test for before starting abacavir?
HLA B5701
123
All significant needle stick injuries and sexual exposures are given __ weeks of PEP?
4 weeks
124
What meds are PEP?
Same as initial meds (2 NRTI's and 1 integrase inhibitor)
125
T/F: treat HIV positive pregnant patients immediately, without waiting for genotyping?
True
126
Babies born to an HIV+ mother should receive _______ during delivery and for 6 weeks after?
Zidovudine
127
If an HIV+ mother's viral load is above ______ at time of delivery, C-section is performed?
1,000
128
T/F: fully controlled HIV (viral load <1% gives less than 1% mother-fetus transmission)?
True
129
What PreP drug combo should be taken before the exposure and 1 month after?
Emtricitabine-tenofovir
130
Intermittent use of PreP can reactivate hepatitis __?
Hepatitis B
