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IM Internal Med > last minute ID > Flashcards

last minute ID Flashcards

1
Q

Name the four classes of cell wall inhibitors

A

penicillins
cephalosporins
cabrpenems
glycopeptices

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2
Q

What drugs are in the penicillin class? What is the MOA

A 
Benzyl penicillins (penicillin G, penicillin V)
Aminopenicillin (ampicillin, amoxicillin)
Isoxazyolyl penicillin (cloxacillin, methicillin, nafcillin, oxacillin)

All of the above are beta-lactams

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3
Q

What is the MOA of penicillins?

A

Bactericidal

Beta lactam inhibits cell wall synthesis

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4
Q

What is special about amox-clav and pip-tazo?

A

They pair a beta lactam (amoxicillin, piperacillin)

with a beta-lactamase inhibitor (clavulanate, tazobactam)

Some bacteria produce beta-lactamase: this counters that.

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5
Q

What is the mechanism of action of cephalosporins?

A

Bactericidal
Beta lactam inhibits cell wall synthesis
Less susceptible to penicillinases

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6
Q

What are the subgroups of cephalosporins?

A

Generations

1: cephalexin (Keflex), cefazolin (Ancef)
2: cefuroxime, cefprozil
3: cefixime, ceftriaxone
4: cefepime

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7
Q

What is the MOA of carbapenems?

A

Beta lactam inhibits cell wall synthesis

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8
Q

What drugs are in the carbapenem class?

A

imipenem, meropenem, ertapenem

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9
Q

What is the MOA of glycopeptides?

A

glycopeptid sterically inhibits cell wall synthesis

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10
Q

What drugs are in the glycopeptide class?

A

Vancomycin only

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11
Q

What Abx classes are protein synthesis inhibitors?

A

50S ribosome:

  • Macrolides
  • Lincosamides

30S ribosome:

  • Aminoglycosides
  • Tetracyclines
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12
Q

Which drugs are macrolides?

A

erythromycin
clarithromycin
azithromycin

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13
Q

Which drugs are lincosamides?

A

clindamycin
chloramphenicol
linezolid

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14
Q

Which drugs are aminoglycosides?

A

gentamycin
tobramycin
amikacin

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15
Q

Which drugs are tetracyclines?

A

tetracycline
minocucline
doxycycline
tigecycline

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16
Q

Which drugs are topoisomerase (DNA) inhibitors?

A

fluoroquinolones:

ciprofloxacin
norfloxacin
ofloxacin

Respiratory:
Levofloxicin
moxifloxacin

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17
Q

Which drugs are anti-metabolites?

A

trimethoprim-sulfamethazole (Septra, Bactrim)

nitrofurantoin

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18
Q

Which drugs are anti-mycobacterials?

A

isoniazid
rifampin
ethambutol
pyrazinamide

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19
Q

Name the classes of antifungals

A 
polyenes
- amphociterin B, nystatin
imidazoles
- clotrimazole, miconazole, ketoconazole
triazoles
- fluconazole, itraconazole, voriconazole, posaconazole
allylamines
- terbinafine
echinocandins 
- caspofungin, micafungin, anidulafungin
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20
Q

What are the most common causes of acute rhinitis? What antimicrobial should be used?

A

rhinovirus, coronavirus, influenza, RSV, parainfluenza, adenovirus

None

21
Q

What are the most common causes of pharyngitis? What antimicrobial should be used?

A

rhinovirus, adenovirus, influenza, parainfluenza, coxsackievirus, coronavirus

None

22
Q

What are the most common causes of strep pharyngitis?

What antimicrobial should be used?

A

Group A beta-hemolytic streptococcus

Penicillin, then macrolide (eg erythromycin), then cephalosporin (eg cephalexin)

23
Q

What are the most common causes of sinusitis?

What antimicrobial should be used?

A

S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus

Penicillin, Penicillin/beta-lactamase inhibitor, cephalosporin in kids fluoroquinolone in adults

24
Q

What are the most common causes of bronchitis?

What antimicrobial should be used?

A

H. influenzae, parainfluenza, coronavirus, rhinovirus, RSV

None

25
Q

What are the most common causes of CAP (outpt w/o comorbidity)?
What antimicrobial should be used?

A

S. pneumoniae, M. pneumoniae, C. pneumoniae

Penicillin, or one of the macrolides (-romycin); 2nd line is doxycycline

26
Q

What are the most common causes of CAP (outpt w/ comorbidity)?
What antimicrobial should be used?

A

S. pneumoniae, M. pneumoniae, C. pneumoniae, H. influenzae

Beta lactam, plus macrolide or doxy, or -floxacine

27
Q

What are the most common causes of diarrhea?

What antimicrobial should be used?

A

Enterotoxogenic e. coli, ampylobacter, salmonella, shigella, viruses, protozoa

If >3BM/d, fever, blood:
fluoroquinolone (-floxacin), or if SE asia azithryomycin

28
Q

What are the most common causes of diarrhea after Abx?

What antimicrobial should be used?

A

c. diff!

mild-mod: metronidazole
Severe (WBC>15, Cr >1.5x baseline): vancomycin

29
Q

What are the most common causes of PUD?

What antimicrobial should be used?

A

H pylori (after NSAIDs)

Penicillin + macrolide (clarithromycin), + PPI.

30
Q

What is the treatment for gonorrhea/chlamydia?

A

ceftriaxone 250mgIM + azithromycin 1g PO

or, doxycycline

31
Q

What are the common skin flora?

A

Coagulase-negative staphylococci, corynebacterium, C. acnes, Bacillus, S. aureus

32
Q

What are the common oropharyngeal flora?

A

viridans group steptococci, haemophilus, neisseria, anarobes (peptostreptococcus, bacteroides, veillonella, fusobacterium, actinomyces, prevotella)

33
Q

What are the common small bowel flora?

A

e. coli, anaerobes (low numbers)

34
Q

What are the common colon flora?

A

E. coli, Klabsiella, enterobacter, enterococcus, anaerobes (Bacteroides, peptostreptococcus, clostridium)

35
Q

What are the common vaginal flora?

A

lactobacillus acidophilus, viridans group streptococci, coagulase-negative streptococci, facultative Gram-negative bacilli, anaerobes

36
Q

What are the common gram-positive anaerobic cocci?

A

peptostreptococcus, C. acnes

37
Q

What are the common gram-positive anaerobic bacilli?

A

Clostridium

  • c. difficile
  • c. tetani
  • c botulinum
  • c. perfringens
38
Q

What are the common gram-negative anaerobes?

A

Only Bacilli

bacteroides: B. fragilis

39
Q

What are the common gram-positive aerobic cocci?

A

Staph (eg aureus)
Strep (pneumoniae, pyogenes = GAS, agalactiae = GBS)
Enterococcus: e. faecalis

40
Q

What are the common gram-positive aerobic bacilli?

A

Bacillus:

  • b. anthracis
  • listeria
  • nocardia
41
Q

What are the common gram-negative aerobic bacilli?

A 
Enterobacteriaceae
- e. coli, salmonella, shigella, campylobacter, yersinia
Klebsiella
Legionella
Pseudomonas
Haemophilus (H influenzae)
42
Q

What are the common gram-negative aerobic diplococci?

A

Neisseria (meningiditis, gonorrheae)

Moraxella (catarrhalis)

43
Q

What are the common non-gram stain bacteria?

A

Acid fast:

Mycobacteria (tuberculosis, leprae, avium complex)

44
Q

What common bacteria are obligate intracellular?

A

Rickettsiae
Chlamydia (trachomatis)
Chlamydophila (pneumonia)

45
Q

Which bacteria have no cell wall?

A

Mycoplasma

46
Q

Which bacteria are spirochetes?

A

trepnema pallidum

47
Q

Cocci in clusters: what is it?

A

Staphylococcus

48
Q

Cocci in lines: what is it?

A

Streptococcus

IM Internal Med (11 decks)

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