Vignettes And Commonly Confused Topics Flashcards

1
Q

A patient comes into the clinic with mild and painful erythema on her leg. It is non-purulent. Given your suspected causative pathogen, what would treat it with?

A

Beta hemolytic group A strep
PO beta lactams: dicloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A patient comes into the clinic with a mild red, purulent abscess, what is your first treatment modality?
How would that change if it was moderate?

A

Mild: I&D only

Moderate:
I&D, culture then PO abx
Doxycycline (BID)
TMP/SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A young boy presents to the clinic with honey crusted lesions around his mouth, what is your first line treatment?

A

Impetigo
Topical mupirocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A vet comes to the clinic, she has been bitten by a cat, she tells you that she washed it ASAP but is concerned because the bite penetrated quite deeply and the cat was a stray. What treatment would you prescribe and for how long?

A

amoxicillin-clavulanate
PO
5 days

OR
Ampicillin-sulbactam IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

During a clinic visit, you inspect your patient’s feet because she is diabetic. You notice a moderate ulcer on the sole of her right foot. Given what you know about the likely causative pathogen(s), you prescribe….

A

Most likely to be polymicrobial and include gram negatives as well as anaerobes

Moderate:
—amox-clav (Augmentin)
—or, amp-sulbactam
—or, ceftriaxone + metro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

You HIV patient comes to the clinic complaining of fever, cough and chest pain, you suspect a fungal infection in his lungs. Knowing the causative pathogen, which anti-fungal is recommended for this patient?

A

Aspergillus
Voriconazole PO

if invasive, voriconazole + amphotericin B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A patient has been diagnosed with invasive aspergillosis and you are considering the best treatment options. His medical record shows a history of QTc prolongation, which medication would you avoid? Which would you select?

A

Avoid: voriconazole
Select: Isavuconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which fibrate do you NOT give w/ statins d/t risk of myopathy

A

Gemfibrozil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which non-statin lipid lowering medication do you have to discontinue w/ tendon rupture?

A

Bempedoic acid
(think about the acid tearing through the tendon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which non-statin lipid lowering medication CANNOT be taken with simvastatin >20mg or Pravastatin >40mg

A

Bempedoic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient has TGs >500, which non statin lipid lowering medication can you NOT give?

A

Bile acid sequestrant (meds beginning with Chole/cole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

All azoles prolong QTc except?

A

Isavuconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

You can’t give a patient with gout………. ?!?! You idiot!!

A

Loop and thiazide diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which TB med should you supplement with B6

A

Isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which HIV med has an ADR of a rash?

A

Abacavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which antifungal has a BBW to exercise extreme caution in pts w/ impaired renal function?

A

FluCYtosine (5-FU)

Think renal, close to bladder > CY part of Flucytosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which antifungal do you always use in combination with another antifungal?

A

Flucytosine (5-FU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Don’t eat/drink grapefruit juice and red yeast rice with?

A

STATINS (esp. Simvastin)

19
Q

ALL ~azoles have these 3 main ADRs

A

—QTc prolongation (except isavoruconazole)
—hepatotoxicity
CYP INHIBITORS

20
Q

For the treatment of CMV retinitis, which would be the better ORAL medication?

A

VALganciclovir

ganciclovir is available parenterally

21
Q

Most common NNRTI is efavirenz but what do the others end in so you can recognise them?

A

~ine

I.e nevirapine, delaviridine, etraviridine etc

22
Q

Patient with asthma, you’re going to put them on a BB, which do you NOT choose?

A

Propanalol (B1 & B2)

B2 vasoconstricts bronchioles

23
Q

Which is the only DOAC you can give for DVT prophy in medical patients?

A

Rivaroxaban

24
Q

Which DOAC must be given with food?

A

Rivaroxaban

25
Q

Which DOACs are major CYP34A substrates?

A

Rivaroxaba (Xarelto)
Apixaban (Eliquis)

26
Q

All DOACs can be used post hip/knee surgery except?

A

Edoxaban
(think E = except)

27
Q

Mainstay treatment for stroke prevention a/w afib or cardiac valve replacement

A

Warfarin (Coumadin)

28
Q

For VTE treatment, which DOACs do you need to give LMWH for 7d first? 2

A

Edoxaban
Dabigatran

29
Q

What are the two K-sparing diuretics that inhibit renal epithelial Na+ channels?

A

Triamterene
Amiloride

30
Q

Patient has a sub segmental PE without proximal DVT of the legs. She is high risk. What is the best management?

A

Anticoagulate and then observe

31
Q

Patient has an acute PE, what is the best course of action?

A

Administer a fibrinolytic

32
Q

A patient as a superficial DVT but you are concerned it could travel and progress to a deep DVT or a proximal DVT, what course of action do you take? Which 2 medications could you administer?

A

Low dose fondaparinux
Rivaroxaban

33
Q

An 86 year old lady is going into hospital for a knee replacement surgery, does she need prophylaxis for VTE? Why, why not?

A

Yes! Because a) she is being hospitalised and b) she is having a knee replacement surgery (also valid for hip surgery)

34
Q

You prescribe amphotericin B w/ Flucytosine for a patient with cryptococcus meningitis. The patient starts to deteriorate, what could be going wrong? 3

A

Rigors and phlebitis
Nephrotoxicity
Electrolyte imbalances

35
Q

You have a patient w/ primary / homozygous familial HLD, what are your mono therapy options? 3

A

Ezetimibe
PCSK9 inhibitors
Bile acid sequestrant

36
Q

Diabetic patient comes in complaining of sudden irregular sweating.
History of DM
Recently started anti-HTN med, which class could it be?

A

Beta blockers

37
Q

IE culture comes back w/ viridans strep
How do you treat?

A

Penicillin G
or
Ceftriazone
+/- gentamicin

38
Q

IE culture comes back w/ enterococcus
Treat with?

A

Penicillin G
or
Ampicillin
+/- gentamicin

39
Q

IE culture comes back w/ staph aureus MSSA, treat w? 3

A

Nafcillin
Oxacillin
Cephazolin IV

40
Q

IE culture comes back w/ MRSA, treat with?

A

Vanco
Or dapto if VRE

41
Q

IE culture comes back w/ coag neg staph, treat with?

A

Vanco
+/- gentamicin
+/- rifampin if prosthetic valve

42
Q

IE culture comes back w/ HACEK, treat with?

A

Ceftriaxone
+/- surgery

43
Q

IE culture comes back w/ funghi, treat with?

A

Nystatin if candida
Voriconazole if aspergillosis