deck_6776960

Question 1

what do the beta-lactams do?

Answer 1

inhibit cell wall synthesis

Question 2

what are the sub-classes of beta-lactams?

Answer 2

penicillins

cephalosporins

carbapenems

monobactams

Question 3

which classes of antibiotics inhibit bacterial protein synthesis?

Answer 3

macrolides (50s)

aminoglycosides (30s)

tetracyclines (30s)

Question 4

what class of antibiotics inbhitis DNA gyrase?

Answer 4

quinolones

Question 5

what are the major members of the Penicillin family?

Answer 5

penicillin, oxacillin, nafcillin, dicloxacillin

Question 6

what is the coverage for penicillin?

Answer 6

gram positives

some anaerobes

NO STAPH COVERAGE

Question 7

what can oxacillin/nafcillin/dicloxacillin cover that penicillin can not?

Answer 7

MSSA (staph aureus)

Question 8

what is unasyn?

Answer 8

ampicillin/sulbactam

Question 9

what are the similarities in coverage for augmentin and unasyn?

Answer 9

both cover gram positive, gram negtive and some anaerobes

***Neither covers pseudomonas

Question 10

How is unasyn administered?

Answer 10

IV

Question 11

what can you use from the penicillin family to cover pseudomonas?

Answer 11

piperacillin

pip/tazo (zosyn)

Ticar/clav (timentin)

Question 12

what are the 1st gen cephalosporins and what do they cover?

Answer 12

cefazolin (Ancef)

cephalexin (Keflex)

cover gram positive

Question 13

what are the second generation cephalosporins and what do they cover?

Answer 13

cefuroxime, cefoxitin

gream neg, and some gram positive

Question 14

what are the 3rd generation cephaolsporins and what do they cover?

Answer 14

ceftriaxone (Rocephin)

ceftadzidime

gram positive and gram negative and ceftazadime has pseudomonas coverage

Question 15

what are the 4th generation cephalosporins and what do they cover?

Answer 15

Cefepime, covers gram positive and gram negative, plus MSSA and pseudomonas

Question 16

what are the 5th generation cephalosporins and what do they cover?

Answer 16

ceftaroline (MRSA but NOT pseudomonas)

Question 17

which of the carbapenems cover anerobes, including pseudomonas and other resistant organisms?

Answer 17

meropenem

imipenem

(both are IV only)

Question 18

what are the common macrolides?

Answer 18

erythromycin

clarithromycin

azithromycin

Question 19

what do the macrolides cover?

Answer 19

gram positive

gram negative diplococci and coccobacilli

atypicals

Question 20

what do the quinolones cover?

Answer 20

gram positive (levo more than cipro)

gram negative (good coverage)

atypicals

pseudomonas (levo and cipro ONLY)

Question 21

what do the aminoglycosides typically cover?

Answer 21

gram negatives including pseudomonas

Question 22

which tetracycline is good for resistant gram negatives?

Answer 22

tigecycline

Question 23

which tetracycline is used for tick borne disease?

Answer 23

doxycycline

Question 24

many of the tetracyclines are good coverage for what organisms?

Answer 24

atypicals

MSSA

P. acnes (doxy esp.)

Question 25

which abx give good anerobic coverage?

Answer 25

clindamycin metronidazole augmentin unasyn zosyn carbapenems

Question 26

what is the first line drug choice for treating MRSA?

Answer 26

Vancomycin Linezolid tidezolid daptomycin

Question 27

what can be used to treat vancomycin resistant enterococci (VRE)?

Answer 27

linezoid, tidezolid daptomycin (but not in the lungs!)

Question 28

What can you treat PCP or toxoplasmosis with?

Answer 28

Bactrim (TMP/SMX)

Question 29

A 6 y/o presents with sore throat with a strawberry appearance and fever, no cough, headache and with a rapid strep test. How would you like to treat this patient?

Answer 29

penicillin x 10 days amoxacillin (kids) clindamycin, azithromycin (PCN allergy)

Question 30

what are the complications of Group A strep infections?

Answer 30

scarlet fever rheumatic fever (why we treat) glomerulonephritis

Question 31

31 y/o female patient at 25 weeks gesttation presents to ob/gyn with dysuria and urinary frequency, afebrile. UA clean catch dips positive. Now what?

Answer 31

Don't gram stain - waste of time Nitrofurantoin is the drug of choice here

Question 32

what's the problem with prescribing Bactrim to a pregnant woman with a UTI?

Answer 32

it interferes with folate metabolism

Question 33

what can you prescribe in any patient with a UTI? What additional options are available for a nonpregnant patient?

Answer 33

oral cephalosporin nitrofurantoin? Amox/Clav (augmentin) Nonpregnant: Bactrim, Doxy, Quinolones

Question 34

what are the most common bacteria in acute otitis media?

Answer 34

Strep pneumo H. influenza M. catarrhalis

Question 35

what is the first line drug in acute otitis media?

Answer 35

Amoxicillin (assuming no penicillin allergy)

Question 36

what if you see AOM in a child who just had finished antibitoics?

Answer 36

augmention oral cephalosporins

Question 37

what antibiotic would be your first choice in community-acquired pneumonia with diffuse infiltrates (atypical pneumonia)?

Answer 37

azithromycin (macrolides) (could also do doxy, quinolones that are anti-pneumococcus like levoflox, augmentin + macrolide)

Question 38

what is a good treatment for bacterial meningitis a person 1mo -50 years old with unknown organism?

Answer 38

ceftriaxone + vancomycin (covers positive and negative including resistant strep. pneumo) consider whether to add dexamethasone add ampicillin for listeria in \>50 or immunocompromised

Question 39

what are the typical organisms that cause bacterial meningitis in neonates?

Answer 39

Group B strep E. Coli Listeria

Question 40

what are the antibiotics used in baterial meningitis in neonates?

Answer 40

ampicillin plus ceftaxime plus gentamicin

Question 41

what are the common pathogens of post-op wound infections?

Answer 41

Staph aureus Group A, B, C, G streps Enterococcus (add gram negatives if near the abdomen)

Question 42

what is a good first-choice antibiotic for a surgical site infection?

Answer 42

Augmentin 1st gen cephalosporin dicloxacillin clindamycin (good if pen/ceph. allergic)

Question 43

what's the treatment for chlamydia again?

Answer 43

azithromycin 1 gram OR Doxycycline (according to her)

Question 44

what is good for treating bacterial vaginosis or trichomonas?

Answer 44

metronidazole

Question 45

If you have a positive RPR, what do you use to treat for syphilis?

Answer 45

Penicillin G IM

Question 46

what do you use to treat LGV (lynphogranuloma venereum) or granculoma inguinale (Donovanosis)?

Answer 46

doxycycline or azithroymcin

Question 47

what are the most common causative organisms in hospital acquired pneumonia?

Answer 47

staph aureus gram negative rods (pseudomonas/coliforms) anerobes strep pneumo enterococci

Question 48

what is a good choice of antibiotic to cover empiric treatment for hospital acquired pneumonia?

Answer 48

pip/tazo +/- vanc or +/- aminoglycoside or quinolone or cefepime impipenem or meropenem

Question 49

what can you use to treat C. diff?

Answer 49

metronidazole or oral vancomycin

Question 50

patient with signs of early sepsis from a decubitus ulcer (extended hospitalization) shows up at the ER. What do you give him

Answer 50

IVF + meropenem + vancomycin

Question 51

how do you want to treat acute bacterial sinusitis?

Answer 51

augmentin + saline irrigation and decongestants quinolones are an option or doxy (for PCN allergy)

Question 52

when should you treat for acute bacterial sinusitis?

Answer 52

symptoms \> or equal to 10 days severe symptoms (fever, facial pain) \> 3-4 days symptoms after URI

Question 53

how do you diagnose bronchitis?

Answer 53

clinical - history and PE (bilateral rhonchi)

Question 54

what is the therapy for bronchitis?

Answer 54

antitussive, NSAIDS and inhaled bronchodilator if it fails to respond, then investigate bacterial