Micro

Question 1

C.difficile class of bacteria?

Answer 1

GPR

Question 2

H. pylori tx

Answer 2

Bismuth quadruple tx: PPI, bismuth, tetracycline, flagyl

Triple tx: PPI, clarithro, amox/flagyl

Question 3

Treatment of invasive aspergillosis

Answer 3

Voriconazole

Question 4

Component of Klebsiella responsible for septic shock

Answer 4

Lipid A

Gram neg bacteria have 3 layer cell wall (vs 2 layer cell wall of gram pos bacteria). This 3rd layer is outer membrane that has the LPS complex which consists of Lipid A which is endotoxin and cause cause septic shock

Question 5

Cutaneous mucormycosis tx

Answer 5

systemic or liposomal Amphotericin B

Also tx for aspergillosis, blastomycosis, candida, coccidiomycosis, cryptococcosis

Question 6

Mucormycosis

Answer 6

assoc w/ immunosuppression, burns, trauma, near-drowning, uncontrolled DM

Question 7

Oropharyngeal & esophageal candidiasis tx

Answer 7

Fluconazole

SEs: liver toxicity, GI upset, rash

Question 8

Invasive candidiasis tx

Answer 8

Echinocandins (micafungin, caspofungin, anidulafungin)

SEs: rash & infusion reaction (caspfungin), thrombocytopenia (micafungin)

Question 9

Aspergillosis tx

Answer 9

Voriconazole

SEs: visual changes, vivid dreams, psychosis, hepatotoxicity phototoxicity

Question 10

MC viral sexually transmitted infection in US

Answer 10

anorectal condylomata acuminate by HPV

Question 11

MC bacterial sexually transmitted infection in US

Answer 11

Chlamydia trachomatis

Question 12

Part if GN bacterial cell wall that causes severe immune response

Answer 12

Lipid A

Question 13

Pseudomonas

Answer 13

GPR

tx: aminoglycosides (-mycins), Zosyn, 3rd-gen CPs, most fluoroquinolones (-floxacins; except moxifloxacin), and carbapenems

Question 14

Aminoglycosides

Answer 14

Gentamycin, tobramycin, etc.

bactericidal

inhibit 30S ribosome unit assoc with protein synthesis
resistance is with decrease in active transport

SEs: nephrotoxic, ototoxic

Question 15

RFs for invasive fungal infection

Answer 15

Solid organ transplant
Prolonged antibiotics
TPN
GI perforation
Hemodialysis
ICU stay for >7 days

Question 16

BK viral infection post-kidney transplant

Answer 16

BK virus = polyomavirus
Remains latent in renal tubular epithelial cells
RFs:
- High immunosuppression (T-cell depletion, tacrolimus, mycophenolate mofetil)
- Pulse dose steroids (to treat rejection)
- Ischemia-reperfusion injury
- Significant donor/recipient HLA mismatch
- Presence of very high BK viral load

Cause interstitial nephritis, hematuria, formation of blood clots in bladder, obstruction of ureter (stenosis)

Tx: decrease immunosuppression, continuous bladder irrigation, cystoscopy

Question 17

Pts at high risk for developing infective endocarditis

Answer 17

Prosthetic material in place for heart valve repair or replacement
Prior history of infective endocarditis
Unrepaired cyanotic congenital heart disease
Repaired cyanotic congenital heart disease with residual shunts or valvular abnormalities

need abx ppx for procedures

Question 18

High risk procedure causing infective endocarditis

Answer 18

Dental work
Invasive respiratory tract procedures
GI or GU procedures for ongoing infection
Procedures on infected skin or musculoskeletal tissue
Cardiac or vascular procedures with planned placement of prosthetic material

Question 19

Gentamycin

Answer 19

bactericidal
normal peak: 6-10 mcg/mL
normal trough: <1mcg/mL

If peak levels are too high, decrease dose amount
If trough levels are too high, decrease frequency of dose