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Step 2 > Infectious Dz > Flashcards

Infectious Dz Flashcards

1
Q

Coverage of Penicillin (G, V, benzathine)

A

Viridans strep

Strep pyo

Oral anaerobes

Syphillis

leptospira

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2
Q

Coverage of ampicillin and amoxicillin

A

Same as penicillin +

E. coli

Lyme

Some G (-) coverage

HELPS

H. influenszae

E. coli

Leptospira

Proteus

Salmonella

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3
Q

Penicillins are the best initial therapy for

A

Otits media

Dental infection and endocarditis prophylaxis

Lyme disease

UTI in prego

Listeria

Enterococcal

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4
Q

What are the penicillinase resistant penicillins?

What are they used to Tx?

A

Skin infections (impitigo, cellulitis, erysipelas)

Endocarditis, meningitis, bacteremia from staph

Osteomyelitis and septic arthritis is bug sensititive

Oxacillin, cloxacillin, dicloxacillin, nafacillin

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5
Q

Best initial therapy for:

Cholecystitis, ascending cholangitis

Pyelonephritis

Bacteremia

VAP

Neutropenia with fever

A

Pipercillin

ticarcillin

azlocillin

mezlocillin

(cover G- bacilli as well as pseudomonas)

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6
Q

Reason we do not use methacillin

A

Causes renal failure from allergic interstitial nephritis

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7
Q

Best initial therapy for PID

A

Cefotan or cefoxitin (2nd gen)

+

Doxycycline

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8
Q

Ceftriaxone is this generation and covers…

A

3rd gen

CAP- pneumococcus with a macrolide

Meningitis

Gonorrhea

Lyme involving heart or brain

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9
Q

Which cefalosporin not to give noenates

A

Ceftriaxone

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10
Q

4th gen cephalosporin

A

Cefepime

Covers more staph– VAP

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11
Q

Adverse effect of cefoxitin and cefotan

A

deplete prothrombin and increase bleeding risk

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12
Q

Carbapenems cover…

A

Gram - bacilli

anaerobes

Step

Staph

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13
Q

Only monobactam abx

Good for…

A

Aztreonam

Exclusively for gram negative bacilli and pseudomonas

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14
Q

Best therapy for CAP

A

Levofloxacin and other Fluoroquinolones

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15
Q

Best treatment for cystitis and pyelonephritis

A

Ciprofloxacin

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16
Q

Only single agent treatment for diverticulitis

A

Moxifloxacin

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17
Q

Cautions with fluroquinolones

A

Bone growth abnormalities

Tendonitis and achillies tendon rupture

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18
Q

Side effects of aminoglycosides (gentamycin and tobramycine)

A

Ototoxic and nephrotoxic

god for gram negative bacilli in the bowel urine and bacteremia

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19
Q

Doxycycline works well for…

A

Chlamydia

Lyme disease (limited to joint, rash, bell palsy)

Rikettsia

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20
Q

Adverse effects of doxy

A

tooth discoloation

fanconi syndrome (Type II RTA proximal)

Photosensitivity

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21
Q

TMP-SMX works well for

A

cystitis

PCP pna tx and prophylaxis

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22
Q

Adverse effects of TMP-SMX

A

Rash

Hemolysis in G6PD deficiency

Bone marrow suppression (folate antag)

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23
Q

Best initial therapy for gram-positive organisms (staph and strep)

A

Oxacillin

Cloxacillin

Dicloxacillin

Nafcillin

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24
Q

Best initital treatments for MRSA

A

Vanc

Linezolid

Daptomycin- elevated CPK

Tigecycline

Ceftaroline

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25
Q

Best tharapies for gram-negative bacilli

(peritonitis, diverticulitis, pyelo, cholangitis, cholecystitis)

A

Quinolones

aminoglycosides

carbapenems

piparcillin

aztreonam

cephalosporins

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26
Q

Coverage for oral anaerobes

A

Penicillin (G, VK, ampicillin, amxicillin)

Clindamycin

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27
Q

Coverage for abdominal/GI anaerobes

A

Metronidazole

beta-lactamase/lactamase combo

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28
Q

When to answer head CT first when suspecting infection…

A

If there is the possibility of a space occupying lesion

  • papilledema
  • seizures
  • focal neurological abnormalities
  • Confusion
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29
Q

Best initial treatment for bacterial meningitis

A

Ceftriaxone

Vancomycin

steroids

30
Q

If a patient presents with meningitis and has risk factors for listeria, what medication should be added/started…

A

Ampicillin

Risk factors:

Elderly, neonate, steroids, AIDS/HIV, pregnant, alcoholics

31
Q

Close contacts to patients with Neisseria meningitidis should recieve…

A

Rifampin

Cipro

or Ceftriaxone

32
Q

Most common neurological deficit of untreated bacterial meningitis

A

CN VIII deafness

33
Q

Most common cause of encephalitis (acute onset confusion and fever)

A

Herpes simplex

34
Q

Best initial therapy for herpes encephalitis

A

Acyclovir

35
Q

Adverse effect of acyclovir…what is the treatment

A

Nephrotoxicity

decrease dose and add hydration

36
Q

Treatment of choice for herpes encephalitis if acyclovir resistant

A

Foscarnet

37
Q

A patient has recurrent otitis media that is reisitant to ABX, what is the best step in management

A

Typanocetesis

38
Q

What is the most accurate diagnostic test for otitis media

A

tympanocentesis

39
Q

Best initial therapy for otitis media

A

amoxicillin

amox-clavulinate if resistant

40
Q

Patient with clearly described sinusitis..what is the next step OR action OR management

A

Amoxcillin/clavulinic acid and a decongestant

Dx clear so treat it

41
Q

Tx for strep pharyngitis

A

Amoxicillin or penecillin

42
Q

Tx for strep pharygitis if patient allergic to penicillion

A

Cephalexin if reaction is rash

clinda or macrolid is rxn is anaphylactic

43
Q

Wheezing, flushing, rash following ingestion of fish

A

Scombroid– tx with antihistamines

44
Q

Treatment for giardia

A

metronidazole or tinidazole

45
Q

e-antigen in hepatitis is synonomys with

A

DNA polymerase

46
Q

Tx of Hep C PCR-RNA is elevated

A

Interferon

+

Ribavirin and wither bocepavir or teleprevir

47
Q

Treatment for gonorrhea and chlamydia

A

cefixime/ceftriaxone

and

Azithromycin or doxycycline

48
Q

Most accurate test for PID

A

Laproscopy

49
Q

Treatment for pyelonephritis

A

Ceftriaxone or ertipenem

Amp an gent until cultures are known

Cipro outpatient

50
Q

Treatment for prostatitis

A

TMP/SMX for 6-8 weeks

51
Q

Best initial empiric therapy for endocarditis

A

Vancomycin and gentamicin

52
Q

Tx for Viridans endocarditis

A

ceftriaxone 4 weeks

53
Q

Treatment for sensitive staph aureus

A

Nafacillin, oxacillin, or cefazolin

54
Q

Enterococcus endocarditis

A

ampicillin and gentamicin

55
Q

Add this drug for prosthetic valve endocarditis

A

rifampin

56
Q

Most common cause of culture negative endocarditis….tx?

A

Coxiella

(HACEK organism)

Ceftriaxone

57
Q

Treatment of lyme with cardiac manifestation

A

IV ceftriaxone

58
Q

Best initial drug regimen for HIV

A

Emtricitrabine

Tenofovir

Efavirenz

59
Q

Drug side effect associated with:

Zidovudine

Didanosine

Abacavir (HLA B5701)

Protease inhibitors

A

Zidovudine- anemia

Didanosine- pancratitis

Abacavir- SJS

Protease inhibs- Metabolic syndrome (HLD and hyperglycemia)

60
Q

Indication for c-section in HIV+ mother

A

Viral load >1000/uL

61
Q

Most common cause of CAP

A

S. pneumoniae

62
Q

Most common causes of HCAP

A

GNR (E. coli, pseudomonas)

S. aureus

63
Q

PNA in the upper lobe a nursing home pt…think of this bug

A

Pseudomonas

64
Q

Uncomplicated CAP give this abx

A

Azithromycin or clarithromycin

65
Q

CAP with comorbidities give this abx

A

fluoroquinolone

66
Q

HCAP tx is taylored towards G(-) so give this abx

A

Ceftazidime or cefipime

Imipenem

Pipercillin/tazoctam (zosyn)

67
Q

Toxicity common to all TB drugs

A

Hepatotoxicity

68
Q

What is the common empiric treatment algorhythm for suspected bacterial meningitis in all age groups

A
  1. Cefotaxime (kids), or Ceftriaxone (adults), or Ceftazidime (immunocomp)
  2. Vancomycin
  3. Ampicillin

(add aminoglycoside in neonates)

69
Q

A patient with head, fever mailaise, myalgias, changes in alertness and behavior. MRI shows increased signals in frontotemporal area

A

HSV encephalitis

70
Q

Tx for uncomplicated pyelonephritis

A

TMP/SMX or a fluoroquinolone for G(-) Rods

Amoxicillin for G(+) Cocci

71
Q

Prophylactic agents for MAC pna in AIDS cd4 <100

A

Clarithromycin and azithromycin

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