board review micro treatment

Question 1

tx for chancroid (spirochete)

presents as painful ulcer and painful lymphadenopathy w/ purulent drainage caused by H ducreyi

Answer 1

azithromycin

Question 2

TX: lymphogranuloma venereum (chylamydia trachomatis serovars L1-L3)

painless genital ulcers (heal spontaenously) spread to inguinal LN –> buboes that suppurate and become painful –> draining sinuses, procitis and rectal strictures

Answer 2

doxycycine

Question 3

Q on boards

tx for neurosyphilis if pt has PCN allergy?

Answer 3

desensitize and treat w/ PCN

Question 4

treatment for staph epi

Answer 4

remove foreign body (central linie)

vancomycin

Question 5

tx for impetigo (pyoderma)

caused by strept pyogenes or staph

Answer 5

mupirocin ointment

inhibits bacterial protein synthesise

Question 6

prophylaxis to pregnant women test positive for Grp B strept

Answer 6

ampicillin.

Question 7

Q

enterococci (Grp D strept)

are resistance to?

to how do you treat?

Answer 7

resistant to cephalosporin

TX: ampicillin/penicilin or vancomycin are only inhibitory- add aminoglycoside for synergy (bactericidal activity)

Question 8

enterococcal resistance

is mediated by?

Answer 8

forming aminoglycoside-modifying enzymes that transfer chemical grps (actyl,, adenyl) to aminoglycoside molecule –> impairment of antibiotics binding to ribosomal subunits.

Question 9

know this

(like enterococcus) is resistant to all ?

Answer 9

cephalosporins

Question 10

tx for clostridium?

C diff

Answer 10

1st line metronidazole.

in recurrent cases, use metronidazole again. to treat the activated spores.\

if relapse (fidaxomicin)

resistant oral* vancomycin.

Question 11

C perfrigens treatment

food poisoning?

necrotizing fasciitis - (lecithinase and hyaluronidase) tx?

Answer 11

PCN

NF: surgical consult + vancomycin, PCN , clindaycin

Question 12

boards

child and adults with S. pnemonia meningitis

Answer 12

ceftriaxone and vancomycin

Question 13

boards meningitis tx.

meningococcal meningitis

Answer 13

N. meningococcal meningitis: high doses of penicillin and

contacts receive rifampin prophylaxis

Question 14

boards

cryptococcus neoformans meningitis tx

Answer 14

IV amphotericin B

Question 15

exacerbation of COPD and a common cause of sinusitis

diagnosis is moraxella catarrhalis

tx?

Answer 15

amoxacillin clavulanic acid.

Question 16

for

klebsiellla pneumonia

Answer 16

3rd gen cephalosporin

Question 17

how do bacteria such as ecoli develop resistance to ampicillin, amoxicillin , or aminopenicllins

Answer 17

penicillinase in bacteria (a type of* B-lactamase)

cleaves B lactam ring

Question 18

what antibacterial agents inhibit

bacterial CELL WALL synthesis inhibiton

Answer 18

penicillins

cephalosporins

aztreonam

vancomycin

impipnem meropenem

Question 19

which antibacterial drus

inhibit bacterial protein synthesis inhibition

Answer 19

aminoglycosides

chloramphenicol

tetracyclines

macrolides

linezolid

Question 20

which antimicrobial agents

inhbit DNA replication

Answer 20

fluoroquinolones

rifampin

Question 21

which antibacterial agents

inhibit nucleic acid synthesis

Answer 21

trimethoprim

flucytosine

Question 22

which antibacterial agent inhibit folic acid

Answer 22

sulfonamides

trimethoprim

pyrimethamine

Question 23

fungi have a complex carbohydrate cell walls

formed mainly by chitin, glucans and mannans

what antifungal site of action is

glucan

Answer 23

caspofungin (echinocandins)

Question 24

Q on boards

pt presents with atypical pneumonia

works in a pet shop/ veterinarian

diagnosis: psittacosis (chylamydia psittaci)

tx?

Answer 24

doxycyline

Question 25

Q how would you treat **para - coccidioidomycosis** if antigfungals arent an option

Answer 25

**sulfaonamides** **(sulfadiazine)**

Question 26

on boards treatment for Malassezia furfur **tenia versicolor**

Answer 26

topical **selenium sulflide** if infection keeps coming back treat with **ketoconazole**

Question 27

**question on boards** how do you treat **aspergilloma**

Answer 27

**surgical removal** of the aspergilomma nots antifungals

Question 28

Q on boards how do you treat allergic bronchopulmonary aspergillosis (ABPA) : hyperswensitivity response associated w/ asthma and cystic fibrosis; may cause bronchiecasis and **eosinophilia** wheezing, ,fever, migratory pulmonary infiltrates (inc IgE)

Answer 28

**steriods\*\*\***

Question 29

question on boards you have a pt that has been on chemo for a long term he is stable with neutropenia all of the sudden he develops **fever, cough,** take chest xray and see **patchy infiltrate** diagnosis \*\*how you treat?

Answer 29

**invasive pulmonary aspergillosis** **(**necrotizing bronchopenumonia in immunocompromised) **VORICONAZOLE**

Question 30

Q on boards given pt on amphotericin B and devleops QT prolongation --\> torsades de pointe --\> arythmia seen on ecg and loses consciousness. what it the cause\>

Answer 30

**hypokalemia** and **hypomagenesmia** uworld explaination renal toxicity from amp B --\> renal vasoconstriction, dec GFR, direct toxic effect on renal epithelial cells --\> aTN, renal tubular acidosiis **severe hypokal, hypo mag** (reflecting inc distal tubular membrane permeability)

Question 31

if **ciprofloxacin and doxycyline** arent avaiable to treat anthrax what can you give?