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Infectious Diseases USMLE Step 3 > Section 1: Antimicrobials > Flashcards

Section 1: Antimicrobials Flashcards

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USMLE® Step 1 flashcards
1
Q

List the I.V. Rx for Sensitive staph (MSSA)

A
  • Oxacillin
  • Nafcillin
  • Cefazolin (first-generation cephalosporin)
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2
Q

List the oral Rx for Sensitive staph (MSSA)

A
  • Dicloxacillin
  • Cephalexin (first-generation cephalosporin)
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3
Q

Rx for severe infection with resistant staph (MRSA)

A
  • Vancomycin
  • Linezolid
  • Daptomycin
  • Ceftaroline
  • Tigecycline
  • Telavancin
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4
Q

Rx for minor infection with resistant staph (MRSA)

A
  • Trimethoprim/sulfamethoxazole (TMP/ SMX)
  • Clindamycin
  • Doxycycline
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5
Q

Side effects of:

  1. Linezolid
  2. Daptomycin
  3. Imipenem
A
  1. Thrombocytopenia
  2. Myopathy and a rising CPK
  3. Seizures
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6
Q

Rx of staph infection in the presence of penicillin allergy in the form of RASH

A

Cephalosporins are a safe choice

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7
Q

Rx of staph infection in the presence of penicillin allergy in the form of anaphylaxis

A
  • Macrolides (azithromycin, clarithromycin)
  • Clindamycin
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8
Q

Rx of severe staph infection in the presence of penicillin allergy

A
  • Vancomycin
  • Linezolid
  • Daptomycin
  • Telavancin
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9
Q

Rx of minor staph infection in the presence of penicillin allergy

A
  • Macrolides (azithromycin, clarithromycin),
  • Clindamycin
  • TMP/ SMX
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10
Q

List medications that will cover for both Staphylococcus aureus and Streptococcus

A
  • Oxacillin
  • Nafcillin
  • Cefazolin
  • Dicloxacillin
  • Cephalexin
  • Vancomycin
  • Linezolid
  • Daptomycin
  • Ceftaroline
  • Tigecycline
  • Telavancin
  • Trimethoprim/ sulfamethoxazole (TMP/ SMX)
  • Clindamycin
  • Doxycycline
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11
Q

List 3 medications specific for Streptococcus

A
  • Penicillin
  • Ampicillin
  • Amoxicillin
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12
Q

List six gram-negative bacilli (rods)

A
  • Escherichia coli
  • Enterobacter
  • Citrobacter
  • Morganella
  • Pseudomonas
  • Serratia
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13
Q

List the class of drugs used in the Rx of gram negative bacilli (rods)

A
  • Cephalosporins
  • Penicillins
  • Monobactam
  • Quinolones
  • Aminoglycosides
  • Carbapenems
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14
Q

List the cephalosporins used in the Rx of gram negative bacilli (rods)

A
  • Cefepime (4th generation)
  • Ceftazidime (3rd generation)
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15
Q

List the penicillins used in the Rx of gram negative bacilli (rods)

A
  • Piperacillin
  • Ticarcillin
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16
Q

List the monobactam used in the Rx of gram negative bacilli (rods)

A

Aztreonam

17
Q

List the quinolones used in the Rx of gram negative bacilli (rods)

A
  • Ciprofloxacin
  • Levofloxacin
  • Moxifloxacin
  • Gemifloxacin
18
Q

List the aminoglycosides used in the Rx of gram negative bacilli (rods)

A
  • Gentamicin
  • Tobramycin
  • Amikacin
19
Q

List the carbapenems used in the Rx of gram negative bacilli (rods)

A
  • Imipenem
  • Meropenem
  • Ertapenem
  • Doripenem
20
Q

Which carbapenem does not cover Pseudomonas

A

Ertapenem

21
Q

True or False

  1. Piperacillin and ticarcillin also cover streptococci and anaerobes
  2. Levofloxacin, gemifloxacin, and moxifloxacin are excellent pneumococcal drugs
  3. Aminoglycosides work synergistically with other agents to treat staph and strep
  4. Carbapenems are excellent antianaerobic medications. They cover streptococci and all sensitive staphylococcus (MSSA)
  5. Tigecycline covers MRSA and is broadly active against gram-negative bacilli.

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 316-353). Kaplan Publishing. Kindle Edition.

A
  1. True
  2. True
  3. True
  4. True
  5. True
22
Q

Gastrointestinal anaerobes

  1. Another for gastrointestinal anaerobes
  2. Best medication for abdominal anaerobes
  3. List 3 medications with equal efficacy for abdominal anaerobes compared to metronidazole
  4. List the two cephalosporins with anaerobic coverage. What subclass do they belong to?
A
  1. Bacteroides
  2. Metronidazole
  3. Carbapenems, piperacillin, and ticarcillin
  4. Cefoxitin and cefotetan. in the cephamycin class
23
Q

Respiratory anaerobes

  1. Another name for respiratory anaerobes
  2. Best drug for (1)
A
  1. Anaerobic streptococcus
  2. Clindamycin
24
Q

List the medications with no anaerobic coverage

A
  • Aminoglycosides
  • Aztreonam
  • Fluoroquinolones
  • Oxacillin/ nafcillin
  • All the cephalosporins except cefoxitin and cefotetan
25
Q

A man is admitted for endocarditis. His blood cultures grow S. aureus, and vancomycin is started while awaiting sensitivity testing. He develops red skin, particularly on the neck. What should you do?

A

Slow the rate of the infusion. Vancomycin is associated with “red man syndrome,” which is red, flushed skin from histamine release. This happens from rapid infusion of vancomycin. There is no specific therapy, and you do not need to switch the medication. If the rate of infusion is slowed, the reaction will not occur.

26
Q

Antiviral agents for the Rx of herpes simplex, varicella zoster

A
  • Acyclovir
  • Valcyclovir
  • Famciclovir

All 3 agents are equal in efficacy

27
Q

Antiviral agents for the Rx of cytomegalovirus (CMV)

A
  • Ganciclovir
  • Valganciclovir
  • Foscarnet

These are essentially equal in efficacy. They _also cover herpes simplex and varicella_

28
Q

Best long term therapy for CMV retinitis

A

Valganciclovir

29
Q

Side effects of:

  1. Valganciclovir and ganciclovir
  2. Foscarnet
A
  1. Neutropenia and bone marrow suppression
  2. Renal toxicity
30
Q
  1. Antiviral agents for the Rx of Influenza A and B
  2. What class of drugs are these agents?
A
  1. Oseltamivir and zanamivir
  2. Neuraminidase inhibitors
31
Q

Ribavirin is used for the Rx of what conditions?

A
  • Hepatitis C (in combination with interferon)
  • Respiratory syncytial virus (RSV)
32
Q

Medications for the Rx of chronic hepatitis B

A
  • Lamivudine
  • Interferon
  • Adefovir
  • Tenofovir
  • Entecavir, and
  • Telbivudine
33
Q

Indications for fluconazole

A
  • Candida
  • Cryptococcus
34
Q

List the candida infections not treated with fluconazole

A
  • Candida krusei
  • Candida glabrata
35
Q
  1. What is the best antifungal agent against Aspergillus?
  2. Side effect of (1)
  3. What other fungi does it cover?
A
  1. Voriconazole
  2. Visual disturbance
  3. Covers all candida
36
Q
  1. List three examples of echinocandins
  2. Main indication if (1)
  3. Name one fungi (1) does not cover
  4. List adverse effect(s) of (1)
  5. Why is echinocandins preferred to amphotericin B for (2) above?
A
  1. Caspofungin, micafungin, anidulafungin
  2. Rx of fungal infection in neutropenic fever patients
  3. Cryptococcus
  4. None. Echinocandins have no significant human toxicity because they affect/inhibit the 1,3 glucan synthesis step, which does not exist in humans
  5. Echinocandins is associated with less mortality
37
Q

Indications for amphotericin B

A
  • All candida
  • Cryptococcus
  • Aspergillus
38
Q
  • Voriconazole
  • Amphotericin
  • Caspofungin
  • Fluconazole

From the above choices, what is the drug of choice for

  1. Aspergillus
  2. Neutropenic fever
  3. Candida
A
  1. Voriconazole
  2. Caspofungin
  3. Fluconazole
39
Q

List the side effects of amphotericin

A
  • Renal toxicity (increased creatinine)
  • Hypokalemia
  • Metabolic acidosis
  • Fever, shakes, chills

Infectious Diseases USMLE Step 3 (8 decks)

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