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Flashcards in Infectious Disease Deck (48):
1

MSSA IV and oral treatment

IV: oxacillin/nafcillin; cefazolin
Oral: dicloxacillin; cephalexin

2

Severe MRSA treatment

Vancomycin, daptomycin, ceftaroline, tigecycline, linezolid, telavancin

3

SE of linezolid

Thrombocytopenia

4

SE of daptomycin

Myopathy and elevated CPK

5

Minor MRSA treatment

TMP/SMX, clindamycin, doxycyline

6

If a patient presents with infection best treated with penicillin but allergy includes rash is it safe to use cephalosporins?

Yes

7

In patients with anaphylactic penicillin allergies what are appropriate options for treatment?

Macrolides (azithromycin, clarithromycin)
Clindamycin

8

MOA of TMP/SMX

Folate antagonist

9

What are three specific medications used to treat Streptococcus but not Staphylococcus? (Hint: all from same family)

Penicillin, Amoxicillin, Ampicillin

10

What class of antibiotics are great at treating pneumococcus?

Fluoroquinolones

11

SE of imipneme

Seizures

12

What cephalosporins offer good gram negative rod coverage?

Cefepime
Ceftazidime

13

What is the best antibx for abdominal anaerobes?

Metronidazole

14

What are the only cephalosporins which cover anaerobes?

Cefoxitin
Cefotetan

15

What antibx is the best for respiratory anaerobes?

Clindamycin

16

Best therapy for CMV retinitis

Valganciclovir

17

SE of foscarnet

Renal toxicity

18

SE of valganciclovir and ganciclovir

Neutropenia and BM suppression

19

What are simeprevir, boceprevir, sofosbuvir, and ledipasvir used for?

Chronic hepatitis C

20

What medication is used in combination with IFN to treat HCV?

Ribavirin

21

SE of ribavirin

Anemia

22

What are lamivudine, IFN, adefovir, tenofovir, entecavir, and telbivudine used to treat?

Chronic hepatitis B

23

What can be used to Candidiasis, Cryptococcus, and as an alternative to oral and vaginal candidiasis?

Fluconazole

24

What medication is best for coverage against Aspergillus?

Voriconazole

25

SE of voriconazole

Visual disturbance

26

What class of medication (and list examples) are great for neutropenic fever patients?

Echinocandins (inhibit 1,3 glucan synthesis step of fungi)
E.g. caspofungin, micafungin, and anidulafungin

27

How do -azole antifungals work?

Inhibit step turning lanosterol to ergosterol which leads to more permeable fungal cell membrane

28

Amphotericin is effective against a wide variety of fungi but due to significant toxicity it has only two main uses currently, what are they?

Cryptococcus
Mucomycosis

29

SE of amphotericin

Renal toxicity (directly toxic to distal tubules leading to distal RTA causing K and Mg loss which leads to H+ retention)
Hypokalemia
Metabolic acidosis
Fever/shakes/chills

30

Best initial test for osteomyelitis
Most accurate test

Initial: X-ray (2nd is MRI)
Accurate: bone bx and culture

31

What is the earliest finding of osteomyelitis on X-ray?

Periosteal elevation

32

Patient with osteomyelitis come in and you decide to culture the visible sinus tract and ulcer. Good idea?

No! You should never culture the ulcer or sinus tract

33

What should you be trending as you treat osteomyelitis to know response to therapy?

ESR; if still elevated then continue treating since majority of patients won't be febrile or have elevated WBC

34

Otitis externa is best treated how?
What adjunctive medications can assist?

Topical antibx (ofloxacin, ciprofloxacin, or polymyxin/neomycin)

Topical hydrocortisone: reduces swelling and itching
Acetic acid and water solution reacidifies ear to eliminate infection

35

How is malignant otitis externa different than simple otitis externa?

Very different. Malignant is basicallt osteomyelitis of skull often occurring in diabetics and caused by Pseudomonas

36

Tx of malignant otitis externa

Surgical debridement and antibix against Pseudomonas

37

Best initial test for sinusitis

Xray

38

Most accurate test for sinusitis

Sinus aspirate for culture

39

Tx of Strep pharyngitis

Penicillin or amoxicillin
(If allergic then azithromycin or clarithromycin)

40

If dx of influenza is unclear what test can you do?

Viral rapid antigen detection

41

Which influenza treatment works for both strains A and B?

Oseltamivir and Zanamivir (if symptoms started with last 48 hrs)

42

When is the inactivated influenza vaccine indicated?

>50 years old and with illness

43

Tx impetigo

Topical mupirocin or retapamulin

Severe disease: oral dicloxacillin or cephalexin

44

What presents with skin infection where the skin becomes red and hot and often occurs on the face?
Tx?

Erysipelas
Oral dicloxacillin or cephalexin

45

What are sequela of erysipelas or pharyngitis caused by Strep?

Erysipelas: Strep glomerulonephritis

Pharyngitis: Strep glomerulonephritis and/or Rheumatic fever

46

When considering LE cellulitis what else should you order?

Dopplers to rule out DVT

47

How is cellulitis treated?

Minor: dicloxacillin or cephalexin orally
Severe: oxacillin, nafcillin, or cefazolin

48

How are folliculitis, furuncles, carbuncles, and boils treated?

Same as cellulitis but possibly drainage if gets too large