Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

cobbled-together pre-mcc review > id quick > Flashcards

id quick Flashcards

(98 cards)

Start Studying
1
Q

If you see gram positive cocci in clusters, think…

A

Staphylococcus (MSSA, MRSA)

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

If you see gram positive cocci in pairs and short chains, think…

A

Streptococci, enterococci

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

If you see gram positive bacilli, think…

A

Listeria, Corynebacterium, Clostridium

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

If you see gram negative bacilli, think…

A

Enterobacteriacea (E. coli, Klebsiella, Enterobacter)

Pseudomonas, Stenotrophomonas

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

If you see gram negative coccobacilli, think…

A

H. influenzae, Pasturella, Brucella

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

If you see gram negative diplococci, think…

A

Neisseria, Moraxella, Acinetobacter

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

What flora are normally found on human skin?

A 
Staphylococcus aureus (MSSA, MRSA)
Streptococcus pyogenes (Group A streptococcus)
Staphylococcus epidermidis (CNST)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What flora are normally found in human nasopharynx?

A

Streptococcus pneumoniae
Hemophilus influenzae
Moraxella catarrhalis
Streptococcus pyogenes

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

What flora are normally found in human oropharynx?

A 
Peptococcus
Peptostreptococcus
Streptococci (viridans)
Fusobacterium
Eikenella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What flora are normally found in distal human GI tract?

A 
Escherichia coli
Several species in each of these classes:
• Klebsiella
• Proteus
• Enterococcus
• Bacterioides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What flora are normally found in human urinary tract?

A

Escherichia coli
Klebsiella
Enterococcus species

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

What species are commonly resistant to penicillin based on their production of beta-lactamases?

A

E. coli, Klebsiella spp, H. influenzae & M. cattarhalis

Note: if just beta lactamase, carbapenems still work

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

What does spp mean wrt Abx?

A

several species

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

Which organisms most commonly produce carbapenemases?

A

Pseudomonas, E.coli, Klebsiella, and Acinetobacter spp.

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

What are the members of the beta lactam family?

A

Penicillins, cephalosporins, and carbapenems

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

How do beta lactam Abx work? (MOA, properties)

A

Cell wall-active agents
Bactericidal
Time-dependent killing

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

Name some penicillins

A
  • penicillin V & penicillin G
  • ampicillin (IV) & amoxicillin
  • amoxicillin – clavulanic acid
  • cloxacillin
  • piperacillin - tazobactam

So note: piptazo and amoxclav are still penicillins, they just have an add-on beta-lactamase-inhibitor, which counteracts the main mechanism of bacterial resistance

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

What is Pen G/V useful against?

A

Narrow spectrum agent; mostly aerobic gram positive cocci

Beta-hemolytic strep (group A, B, C, G)
Tremponema pallidum (Syphillis)

Also: n. meningitidis, though some resistance
oral anaerobes
enterococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Pen G/V NOT useful against?

A

most gram negative organisms

beta-lactamase producing organisms (S. aureus - ~90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are amoxicillin/ampicillin useful against?

A

narrow spectrum agent; mostly Gram positive aerobes, some Gram
negative aerobes

Everything Penicillin does plus: HiPEEL:

  • H. influenzae (~25% resistance)
  • Proteus mirabilis
  • E. coli (~30% resistance)
  • enterococcus (E.faecalis vs. penicillin)
  • Listeria monocytogenes (HiPEEL)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Amox-Clav useful for?

A

Amoxicillin + ß-lactamase inhibitor
– broad-spectrum agent
– extends spectrum of amoxicillin to cover more gram negatives (E.coli, H. influenzae, Salmonella, Shigella) + gut anaerobes (B. fragilis)

Note: does NOT cover pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Pip-Tazo useful for?

A

Most broad-spectrum penicillin; aerobic Gram positives (including MSSA, E. faecalis), difficult aerobic Gram negatives (including Enterobacter, Klebsiella, Serratia, Pseudomonas, Acinetobacter), anaerobes (including B. fragilis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is cloxacillin useful for?

A

Drug of choice for MSSA; otherwise pretty narrow spectrum, not widely used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is important to know about the cephalosporins re MOA and gram +/- activity?

A

beta lactams

generally, earlier gen better gram + worse gram - and later gen worse gram + better gram -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Name 1st gen cephalosporins
cefazolin cephalexin cefadroxil
26
What are 1st gen cephalosporins useful for?
Narrow spectrum: – aerobic gram positives (MSSA, ß-hemolytic Streptococcus) – Some aerobic gram negatives (PEcK: Proteus, E.coli, Klebsiella) – oral anaerobes NOT for enterococci, gut anaerobes
27
Name 2nd gen cephalosporins
cefuroxime, cefaclor, cefprozil, cefoxitin
28
What are 2nd gen cephalosporins useful for?
Oral stepdown therapy for CAP! “Middle of the road” coverage • Covers [almost] everything that 1st generations cover*: – Gram positives: MSSA, Streptoccocus (↓activity vs. 1st generation) – Gram negatives: PEcK + H. influenzae & Moraxella – oral anaerobes, NOT gut anaerobes* *exception: cefoxitin – poor Gram positive coverage; covers B. fragilis (but resistance ~20%)
29
Name 3rd gen cephalosporins
ceftriaxone, cefotaxime, ceftazidime
30
What are 3rd gen cephalosporins useful for?
ceftriaxone and cefotaxime: Broad-spectrum • Gram positive coverage: MSSA (reasonable coverage), Streptococcus (excellent coverage) • Gram negatives: difficult to kill Gram negatives (Serratia, Enterobacter, Citrobacter), N.menigitidis, N.gonnorhea (ceftriaxone) • oral anaerobes NOT: enterococcus, pseudomonas, gut anaerobes
31
What is ceftazidime useful for?
Pseudomonas! | documented Pseudomonal infections and empiric Gram negative coverage where Pseudomonal coverage is desired
32
What is ceftriaxone useful for?
N. menigitidis, N. gonorrhea
33
Name 4th gen cephalosporins
cefepime (trick Q, there's only 1 of them!)
34
What are 4th gen cephalosporins useful for?
treatment of documented Pseudomonal infections, empiric Gram negative coverage where Pseudomonal coverage is desired broad-spectrum • Like ceftriaxone, but: – Gram positives: better activity vs. MSSA – Gram negatives: Pseudomonas Remember, it's JUST cefepime
35
What are the carbapenems?
* Ertapenem * Meropenem * Imipenem-cilastin * Doripenem
36
Generally, what are carbapenems useful for?
``` “Tanks” of the ß-lactams • Extremely broad-spectrum: - most aerobic Gram positives - most aerobic Gram negatives- including ESBLs!!! - most anaerobes - Drugs of choice for ESBLs ``` Reserve for serious infections with resistant organisms!
37
What are ESBLs?
Extended Spectrum Beta Lactamase bacteria produce an enzyme that can break down commonly used antibiotics
38
Name the fluroquinolones
– ciprofloxacin – levofloxacin – moxifloxacin
39
How do the fluoroquinolones work?
MOA: inhibit DNA gyrase – inhibit DNA replication Bactericidal Concentration-dependent killing
40
What is ciprofloxacin useful for?
aerobic gram negatives (Pseudomonas if susceptible; increasing resistance) NOT useful for: gram positive or anaerobic infections
41
What are levofloxacin and moxifloxacin useful for?
aerobic gram positives/Gram negatives, atypicals Classic indication: CAP eg atypicals: Chlamydia, Mycoplasma, Legionella NOT useful for: MRSA, enterococcus Note: some differences, eg pseudomonas levo is better, gut anaerobes moxi is better
42
Name the aminoglycosides
– tobramycin – gentamicin – amikacin
43
How do aminoglycosides work?
``` Antimicrobial Properties – bactericidal – concentration-dependent killing Mechanism of Action: – inhibit 30S ribosomal unit – inhibit protein synthesis ```
44
What are aminoglycosides useful for?
* Narrow spectrum; aerobic gram negatives only (including ESBLs) * Can be used for synergy with a ß-lactam against Gram positives (streptococci, enterococci) Useful for: aerobic gram negatives, ESBLs, Pseudomonas (tobramycin) Not useful for: gram positives (except synergy with ß-lactams) • Differences between agents: – Klebsiella, Serratia: G > T > A – Pseudomonas: T > G >A – Amikacin has lowest resistance; but 4X higher MICs
45
Name the macrolides
– erythromycin – azithromycin – clarithromycin
46
How do macrolides work?
``` Antimicrobial Properties – bacteriostatic – time-dependent killing Mechanism of Action: – inhibit 50S ribosomal unit – inhibit protein synthesis ```
47
What are macrolides good for?
Relatively broad-spectrum – Gram positives: Streptococci (note increasing resistance with S. pneumoniae ~20%) – some Gram negatives (A & C only): H. influenzae, M. cattarhalis – atypicals – NO anaerobic coverage Useful for: Niche: RTIs, Legionella Not useful for: MRSA, enterococcus
48
What is the PEcK mnemonic for?
First gen cephalosporins PEcK = Proteus, Escherichia coli, Klebsiella
49
What is the most common pathogen in acute rhinitis?
Viral (rhinovirus, coronavirus, influenza, RSV, parainfluenza, adenovirus)
50
What is the Abx for acute rhinitis?
None -- viral
51
What is the most common pathogen in pharyngitis?
Viral (rhinovirus, coronavirus, influenza, parainfluenza, adenovirus, coxsackievirus)
52
What is the most common pathogen for strep pharyngitis?
Group A beta-hemolytic streptococcus
53
What is first-line for treating strep pharyngitis?
Children and adults: penicillin | Erythromycin 2nd line for both
54
What are the most common pathogens for sinusitis?
S. pneumoniae H. influenzae M. catarrhalis S. aureus
55
What is first-line for treating sinusitis?
Children and adults: amox | 2nd line for both: amox-clav
56
What organisms cause Acute Otitis Media?
``` S. pneumoniae H. influenzae M. catarrhalis Group A Strep S. aureus ```
57
Rx for acute OM
if treating: | amox, then amox-clav (both adult and ped)
58
Otitis externa: organisms
P. aeruginosa Coliforms S. aureus
59
Otitis externa: Rx
Cortisporin® otic solution 4 drops tid or qid (3 drops tid or qid for children) TM defect: Ciprodex® otic suspension 4 drops bid x 5 d Necrotizing (i.e. bone involvement): ciprofloxacin 750 mg PO bid x 4-8 wk
60
Bronchitis: organisms
viral
61
Bronchitis: Tx
None -- viral
62
Pneumonia: CAP, no comorbidity: organisms
S. pneumoniae M. pneumoniae C. pneumoniae
63
Pneumonia: CAP, no comorbidity: Rx
``` First line: Amoxicillin erythromycin clarithromycin azithromycin ```
64
Pneumonia: CAP, with comorbidity: organisms
S. pneumoniae M. pneumoniae C. pneumoniae H. influenzae
65
Pneumonia: CAP, no comorbidity: Rx
amox, amox/clav, cefuroxime, cefprozil PLUS clarithromycin, azithromycin, doxycycline OR levofloxacin, moxifloxacin [unclear if these are solo or adjunct to line 1]
66
Dental infections: Rx
penicillin or clindamycin
67
Diarrhea: organisms?
Enterotoxigenic E. coli (ETEC) Campylobacter Salmonella Shigella Viruses Protozoa
68
Diarrhea: Rx?
symptomatic if mild If mod-severe: fluoroquinolones (olfloxacin, norfloxacin, ciprofloxacin, levofloxacin) If kids: Azithromycin -- safe, tolerable, easily administered If coming from south/southeast Asia, may have quinolon-resisitant campylobacter: use azithromycin
69
Diarrhea post-Abx: organisms?
C difficile
70
Diarrhea post-Abx: Rx?
mild-moderate: metronidazole | Severe (WBC≥15, Cr ≥1.5x baselin): vancomycin
71
Peptic ulcer disease (non-NSAID): organism?
H pylori
72
Peptic ulcer disease (non-NSAID): Rx?
First line: PPI + amox + clarithromycin Or PPI + metronidazole + clarithromycin
73
Vulvovaginal candidiasis: Rx?
fluconazole orally miconazole intravaginal Other -azole tx available OTC
74
Bacterial vaginosis: organisms?
Overgrowth of: G. vaginalis M. hominis Anaerobes
75
Bacterial vaginosis: Rx?
first line: metronizadole PO; metronidazole or clindamycin intravaginally
76
In which patients would you treat asymptomatic BV?
high-risk pregnancy, prior IUD insertion, gynecologic surgery, induced abortion, or upper tract instrumentation
77
HSV: Rx?
First and recurrent episodes: acyclovir, famiciclovir, valacyclovir Can do prophylaxis in pregnancy starting at 36w
78
Gonorrhea/Chlamydia: Rx?
ceftriaxone 250 mg IM x 1 dose + azithromycin 1 g PO single dose or doxycycline 100 mg PO bid x 7 d
79
Mastitis: organisms?
S. aureus | S. pyogenes
80
Mastitis: Rx?
cloxacillin | cephalexin
81
Tinea Cruris/Pedis (jock itch/athlete’s foot): organism?
clotrimazole | ketoconazole
82
Cellulitis (uncomplicated): organisms?
S. aureus | Group A Streptococcus
83
Cellulitis (uncomplicated): Rx?
1st line: cephalexin 2nd line: cloxacillin or clindamycin Note: Tx for 10-14d
84
If ?penicillin allergy: can you use cephalosporins?
If rash: cephalosporins OK | If anaphylaxis do NOT use cephalosporins
85
MRSA
Vancomycin, Linezolid, Daptomycin
86
Pseudomonas
Pip-Tazo, Carbapenems, Cefepime
87
Outpt Pneumonia
Doxycycline, Azithromycin, Moxifloxacin
88
Inpt Pneumonia
CAP: 3rd gen cephalosporin + Azithromycin HAP: Vancomycin + Pip-Tazo
89
Neutropenic fever
Cefepime (4th gen cephalosporin) | Carbapenems
90
UTI
Trimethoprim-sulfamethoxazole, Nitrofurantoin
91
Meningits
Vancomycin, Ceftriaxone, +/- steroids, +/- Ampicillin
92
Cellulitis
Cefazolin, Trimethoprim-sulfamethoxazole, clindamycin | IV Vancomycin
93
Anaerobe: what's your strategy?
Gut or vagina: metronidazole | Everywhere else: clindamycin
94
Staph: what's your strategy?
Methicillin (eg cloxacillin) MRSA: Vancomycin Vancomycin-resistant: Linezolid
95
Gram negatives: what's your strategy?
start with Amoxicillin (with or without clav); don't cover pseudomonas If Pseudomonas coverage needed, bump up to Piperacillin-Tazosin
96
Brand names: ancef is ...
cefazolin
97
Brand names: flagyl is ...
metronidazole
98
Brand names: Bactrim, Septra is ...
sulfamethoxazole-trimethoprim

cobbled-together pre-mcc review (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions