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Step 2 CK > Infectious Diseases (Antibiotics) > Flashcards

Infectious Diseases (Antibiotics) Flashcards

1
Q

What is the most accurate diagnostic test for infectious diseases?

A

Culture

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2
Q

What bacteria are covered by amoxicillin?

A

HELPS: H. Influenzae, E. Coli, Listeria, Proteus, and Salmonella

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3
Q

For which illnesses are penicillins the “best initial therapy”

A

Otitis media
Dental infection and endocarditis prophylaxis
Lyme disease limited to rash, joint, or CNVII involvement
UTI in pregnant women
Listeria Monocytogenes
Enterococcal infections

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4
Q

What are the penicillinase-resistant penicillins

A

Oxacillin
Cloxacillin
Dicloxacillin
Nafcillin

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5
Q

What are the penicillinase-resistant penicillins used to treat?

A 
Skin infections (cellulitis, impetigo, erysipelas)
Endocarditis, meningitis, and staphylococcal bacteremia
Osteomyelitis and septic arthritis when organism is sensitive
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6
Q

Which penicillins cover gram negative bacilli?

A

Piperacillin, ticarcillin, azlocillin, mezlocillin

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7
Q

Piperacillin, ticarcillin, azlocillin, mezlocillin are the best initial therapies for…

A 
Cholecystitis and ascending cholangitis
Pyelonephritis
Bacteremia
Hospital-acquired/ventilator-associated pneumonia
Neutropenia and fever
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8
Q

The only cephalosporin that will cover MRSA is…

A

Ceftaroline

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9
Q

______, ______, and ______ are resistant to all forms of cephalosporins

A

Listeria, MRSA, Enterococcus

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10
Q

What are the first generation cephalosporins?

A

Cefazolin, Cephalexin, Cephadrine, Cefadroxyl

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11
Q

What are first generation cephalosporins used to treat?

A

Staphylococci (methicillin sensitive)
Streptococci (except enterococcus)
E. Coli (but not Pseudomonas)
Osteomyelitis, septic arthritis, endocarditis, cellulitis

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12
Q

What are the second generation cephalosporins?

A

Cefotetan, Cefoxitin, Cefaclor, Cefprozil, Cefuroxime, Loracarbef

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13
Q

Second generation cephalosporins cover all the same organisms as 1st generation cephalosporins and add coverage for…

A

anaerobes and more gram-negative bacilli

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14
Q

Which are the only cephalosporins that cover anaerobes?

A

Cefoxitin and Cefotetan

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15
Q

What is the best initial therapy for pelvic inflammatory disease when combined with doxycycline?

A

Cefoxitin or Cefotetan

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16
Q

What are the risks of Cefotetan and Cefoxitin?

A

Increase risk of bleeding (deplete prothrombin) and give a disulfiram like reaction with alcohol

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17
Q

What are the third generation cephalosporins?

A

Ceftriaxone, Cefotaxime, Ceftazidime

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18
Q

Ceftriaxone is first line for…

A

Pneumococcus, Meningitis, CAP (in combination with macrolides), Gonorrhea, Lyme disease involving brain or heart

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19
Q

Why should you avoid ceftriaxone in neonates? What should you use instead?

A

Because of impaired biliary metabolism; Cefotaxime

20
Q

Which third generation cephalosporin has pseudomonal coverage?

A

Ceftazidime

21
Q

What is the fourth gen cephalosporin? What is its advantage over the 3rd generation?

A

Cefepime; has better staphylococcal coverage compared with the 3rd gen cephalosporins

22
Q

What is the 5th gen cephalosporin? What does it treat?

A

Ceftaroline; Treats gram-negative bacilli and MRSA

23
Q

What are the Carbapenems? What are they used to treat?

A

Imipenem, Meropenem, Ertapenem, Doripenem; Used to treat neutropenia and fever

24
Q

What is the only monobactam drug?

A

Aztreonam

25
Q

Aztreonam is exclusively for…

A

Gram-negative bacilli (including pseudomonas)

26
Q

What is the best therapy for community acquired pneumonia (CAP)?

A

Fluoroquinolones

27
Q

What fluoroquinolone is used for cystitis and pyelonephritis?

A

Ciprofloxacin

28
Q

What is covered by fluorquinolones?

A

Gram negative bacilli including most psuedomonads

29
Q

Which Fluoroquinolone is the only one that can be used as a single agent for diverticulitis

A

Moxifloxacin (all others require metronidazole)

30
Q

Risks of quinolones?

A

Bone growth abnormalities in children and pregnant women

Tendonitis and achilles tendon rupture

31
Q

What are the aminoglycosides?

A

Gentamicin, Tobramicin, Amikacin

32
Q

What do aminoglycosides cover?

A

Gram negative bacilli

33
Q

Why do aminoglycosides have NO EFFECT against anaerobes?

A

They need oxygen to work

34
Q

Aminoglycosides have what types of toxicity?

A

Nephrotoxicity and ototoxicity

35
Q

What can Doxycycline be used to treat?

A

Chlamydia
Lyme disease (limited to rash, joint of CNVII palsy)
Rickettsia
MRSA of skin and soft tissue
Primary and secondary syphilis (if allergic to penicillin)
Borrelia, Ehrlichia, and Mycoplasma

36
Q

What are the adverse effects of doxycycline?

A

Tooth discoloration, Fanconi syndrome (type II RTA proximal), Photosensitivity, Esophagitis/ulcer

37
Q

What is TMP/SMX used to treat?

A

Cystitis
Pneumocystitis pneumonia (tx and prophylaxis)
MRSA of skin and soft tissue (cellulitis)

38
Q

What are some adverse effects of TMP/SMX?

A

Rash, Hemolysis with G6PD deficiency, bone marrow suppression (folate antagonist)

39
Q

What are the beta lactam/beta lactamase combinations?

A

Amoxicillin/Clavulanate
Ticarcillin/Clavulanate
Ampicillin/Sulbactam
Piperacillin/Tazobactam

40
Q

Beta lactam/beta lactamase combinations are the first choice for…

A

Mouth and GI abscess

41
Q

Gram positive cocci (Staph and Strep) are best treated with…(4)

A

Penicillins: Oxacillin, Cloxacillin, Dicloxacillin, Nafcillin
1st Gen Cephalosporins
Fluorquinolones
Macrolides (3rd line agents)

42
Q

MRSA is best treated with… (6)

A 
Vancomycin
Linezolid
Daptomycin
Tigecycline
Ceftaroline
Telvancin
43
Q

All the beta lactam/beta lactamase combinations cover _____ with equal efficacy to metronidazole

A

Anaerobes

44
Q

How are anaerobes treated when…
Above the diaphragm (oral):
Abdominal/GI:

A

Above the diaphragm (oral): Penicillin; Clindamycin

Abdominal/GI: Metronidazole or beta lactam/beta lactamase combination

45
Q

What are the gram negative bacilli?

A

E. Coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Citrobacter

46
Q

Which antibiotics cover gram negative bacilli? (6)

A 
Quinolones
Aminoglycosides
Carbapenems
Piperacillin, ticarcillin
Aztreonam
Cephalosporins
47
Q

What is the one indication for Nitrofurantoin?

A

Cystitis

Step 2 CK (4 decks)

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