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Flashcards in Case Studies (Buxton/Habal) Deck (34)
1

What organism causes strep throat?

Staph pyogenes (GAS)

2

Which antibiotics are used for the treatment of Strep throat?

amoxicilliin

penicillin (give upset stomach)

3

What is the mechanism of action for amoxicillin?

inhibit transpeptidase which inhibits cell wall synthesis

4

What symptoms might be present with strep throat?

fever
exudative pharyngitis
headache

5

Which organisms cause otitis media?

H. flu
Moraxella
resistant Strep pneumo

6

Why are H. flu and Moraxella resistant to amoxicillin?

they produce b lactamase

7

Why would Clavulanate be paired with amoxicillin?

it is a b-lactamase inhibitor

8

Which organism would cause a post-surgical skin infection?

Staph
Strep

9

Which antibiotics are often used to treat Staph and Strep?

Nafcillin (anti Staph)
1st/2nd generation cephalosporin
1st- Cefazolin - IV
2nd - Cefuroxime - IV

10

What is the mechanism of action of Nafcillin and cephalosporins?

Cell wall inhibitors that act by binding to D-ala-D-ala bonds to prevent cross linking

11

Is there antibiotic resistance with Nafcillin and cephalosporin? mechanism:

Yes, altered PBPs

12

Diagnsosis of acute uncomplicated cystitis. What is the most likely cause?

E coli

13

Which drugs could be used to treat UTIs?

1st/2nd gen cephalosporin:
cephalexin (oral)
cefuroxime (oral)
TMP/SMX
Cipro (Fluoroquinolone)
ampicillin

14

What is mechanism of action for cephalosporins TMP/SMX, Cipro or ampicillin?

cell wall synthesis inhibitors

inhibits DNA gyrase (?)

15

If pregnant, which drugs would you not give for UTI?

TMP/SMX
Fluoroquinolones

16

Which organisms cause native valve endocarditis?

Staph Aureus
Staph Epidermidis
Strep Viridans

17

What are some empiric therapies for Staph Aureus, Staph Epiderminid, or Strep Viridans

ceftriaxone
(vancomycin ??)

18

What is the most likely definitive treatment for a viridans group streptococci that is susceptible to all tested antibiotics?

Penicillin G + Gentamycin (for anaerobic gram negative)

ceftriaxone (3rd?)

19

Developed community acquired bacterial pneumonia. What are the top 6 causes?

Strep pneumo
H. influenza
Legionella pneumophilia
Chlamydia pneumo
Moraxella
mycoplasma pneuomoni

20

What are some likely empiric regimens for CA bacterial pneumonia?

ceftriaxone + azithromycin (or another macrolide...clarithromycin, erythromycin )
fluoroquinalone

21

How does ceftriaxone and azithromycin work?

Ceftriaxone - inhibits cell wall synthesis
Macrolides - inhibit protein synthesis

22

How is antibiotic resistance determined in the lab?

AGAR disc diffusion

23

Student develops sepsis from ruptured appendix. Which organism could be involved?

Enterococcus
E. coli
Klebsiella
bacteroids

24

Which antibiotics are commonly used when you need a broad spectrum antibiotic against gram positive and gram negative aerobes and anaerobic bacteria?

piperacillin
ticarcillin
carbenicillin

+ tazobactam

25

Woman develops PID. What are the most common organisms causing PID?

N. gonorrhea
Chlamydia
trachomatic
bacteroides

26

Which antibiotics are most likely used to treat PID?

3rd gen cephalosporin
- ceftriaxone (for N gonorrhea or bacteroides

Tetracycline/doxycycline (for C. trachomatis)

27

Man acquired HA pneumonia. MRSA was isolated from aspirated sputum. Which drug could be used to treat this patient?

vancomycin

28

What is the mechanism of antibiotic resistance for MRSA?

mutated/altered PBP

29

Man developed sepsis after hospitalization for prostate cancer surgery. Cultures grew Pseudomonas aeruginosa. Is this CA or HA acquired infection?

HA Pseudomonas aeruginosa

30

What are the drugs that could be used for a HA Pseudomonas aeruginosa?

Carbapenums, or piperacillin + tazobactum

3rd/4th gen cephalosporin
Ceftriaxone
Cefepime

31

What drug should not be used if the patient has kidney disease?

fluoroquinolones (inhibit DNA gyrase)
cipro

32

What drug would be used if he was allergic to penicillin?

macrolides??

33

Inmate developed fever, weakness chills, weight loss and cough productive bloody sputum. What is the most likely etiology?

Mycobacterium tuberculosis (TB)

34

What is the antibiotic regimen for TB?

RIPE