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NAPLEX review 2024 RXPrep Book > Infectious Diseases II: Bacterial Infections > Flashcards

Infectious Diseases II: Bacterial Infections Flashcards

(62 cards)

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1
Q

Preferred ABX for surgery prophylaxis

A

Cefazolin - start 1hr before incision, used to prevent MSSA and strep infections

Clindamycin/Vanc used if beta-lactam allergy

Vanc preferred if MRSA colonization or risk present

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2
Q

ABX prophylaxis for GI surgery

A

gram - + anaerobe coverage

Cefazolin + metro/cefoteta/cefoxitin or amp/sulbactam

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3
Q

Classic meningitis symptoms

A

Stiff neck
Fever/Headache
altered mental status

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4
Q

How to Dx meningitis?

A

Lumbar puncture for CSF sample

high CSF pressure could also be a sign of infection

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5
Q

common bacterial causes of meningitis

A

Neisseria meningitides
streptococcus pneumoniae
Haemophilus influenzae

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6
Q

Risk of meningitis due to L.monocytogenes is higher in…

A

neonates
> 50 yrs old
immunocompromised patients

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7
Q

Meningitis treatments

A

abx course depends on bug, ranging from 7-21 days

dexamethasone given empirically before d/c or keep of s.penumo

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8
Q

Empiric Meningitis txm

A

< 1 month = Ampicillin + Cefotaxime/Gent
1 month - 50 yrs old = Ceftriaxone/Cefotaxime + Vanc
> 50 yrs old = Ampicillin + Ceftriaxone/Cefotaxime + Vanc

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9
Q

Acute otitis Media info

A

most infections are viral
observe for 48-72 hrs before starting abx

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10
Q

AOM 1st line TXM

A

High dose Amoxicillin or Amox/Clav

use formulation with least amount of Clav to decrease diarrhea risk (14:1 ratio)

Duration 10 days for < 2 yrs old, 7 days 2-5, 5-7 days 6yrs <

** 2nd/3rd gen ceps if non severe allergy to pen **

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11
Q

Pertussis treatment…

A

highly contagious

should use macrolides

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12
Q

COPD exacerbation defined as….

A

increase in symptoms that worsen in < 14 days

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13
Q

3 cardinal symptoms of COPD exacerbation

A

increased dyspnea
increased sputum volume
increased sputum purulence

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14
Q

who meets criteria for abx for COPD exacerbation

A

abx for 5-7 days if….

  1. meets all 3 symptoms
  2. inc sputum purulence + 1 additional symptoms
  3. mechanically ventilated

preferred abx: amox/clav, azith, doxy, resp quinolone

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15
Q

CAP gold standard for diagnosis

A

Chest x-ray

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16
Q

Usual duration for CAP treatment?

A

5-7 days of abx

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17
Q

CAP txm for healthy, no comorbidities

A

amox 1g TID
Doxy
Macrolide (azith/clarith)

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18
Q

CAP txm for high risk, comorbidities (DM, AUD, cancer, heart/lung/liver/renal disease)

A

amox/clav or cephalosporin + macrolide/ doxy

moxi/levo monotherapy

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19
Q

inpatient CAP txm

A

non-severe = Blactam (ceftriaxone/unasyn) + macrolide or doxy, resp quinolone therapy

severe = blactam + macrolide or resp quinolone

MRSA risk = add vanc/linezolid
Pseudomonas = Pip/tazo/cefepime/meropenem

if hospitalized last 90 days or used IV abx, treat as MRSA & pseudomonas risk

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20
Q

Hospital acquired pneumonias starts with….

A

> 48hrs after hospital admission

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21
Q

Ventilator associated pneumonias starts with….

A

> 48yrs after start of mechanical ventilation

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22
Q

HAP/VAP regimen

A

All req MSSA/Pseudomonas ABX = Cefepime, Zosyn, levo

Add Vanco/Linezolid if MRSA risk

Use two anti-pseudomonas if MDR risk, dont use 2 Blactam (Zosyn, Cefepime, meropenem) levo/cipro, aztreonam, AminoGlyc (usually tobra)

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23
Q

Who can get a false positive with TST test?

A

those who got Calmette-Guerin (BCG) vaccine

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24
Q

Latent TB treatment regimens

A
  1. Isoniazid + refapentine QW for 12 week = not used in preg
  2. INH + rifampin QD for 3 months
  3. Rifampin 600mg QD for 4 months
  4. INH 300mg QD for 6-9 months = pref HIV pt due to reduce DI
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25
Active TB treatment 2 phases
intensive = RIPE (rifampin, isoniazid,pyrazinamide,ethambutol) 2 months continuation = rifampin + isoniazid = 4 months, extend if needed
26
Rifampin SE
inc LFTs, hemolytic anemia, orange colored secretions (can stain skin-contact stuff), many drug-drug interactions, can replace with rifabutin if needed
27
Isoniazid Boxed warning
Severe and fetal hepatitis
28
Isoniazid CI
active liver disease, previous severe adverse reaction to isoniazid
29
Isoniazid warnings & SE
warning: peripheral neuropathy, vit B6 supplementation recommended SE: inc LFTs, DILE, hemolytic anemia
30
Pyrazinamide CI & SE
CI: acute gout, severe hepatic damage SE: increased LFTs, gout, GI upset
31
Ethambutol CI & SE
CI: optic neuritis, dont use young patients, anyone who cant discern and report visual changes SE: inc LFTs, dose related optic neuritis, confusion, hallucinations
32
Common Rifampin DI
warfarin, dec INR by a lot so inc dose oral contraceptives, dec efficacy dont use with apixaban/rivaroxaban/edoxaban/dabigatran
33
Infective Endocarditis info
Empiric txm = vanc + ceftriaxone, Gentamicin added for synergy generally 4-6 wk txm IV abx
34
IE prophylaxis dental regimen
1 dose 30-60min before procedure Amox 2g Doxy 100mg or Azith/Clarith 500mg if cant do amox
35
Spontaneous Bacterial peritonitis (SBP) info
often occurs in patients with cirrhosis and ascites fluid > 250 cells PMNs
36
SBP empiric treatment
Ceftriaxone 5-7 days SMX/TMP or quinolone for secondary prophylaxis after getting SBP
37
Intra-abdominal infections txm duration....
4-5 days after source control
38
Txm for Intra-abdominal infection, community acquired (low risk)
Ertapenem Moxiflox Cipro/Levo + metro Cephalosporin + metro
39
Txm for intra-abdominal infection, risk for resistant or nosocomial pathogens
Carbapenem (no ertapenem) pip/tazo Cefepime/ceftazidime + metro
40
Impetigo info & txm
honey-colored crusts around nose/mouth/hands/arms use mupirocin topical or cephalexin/dicloxacillin QID
41
folliculitis txm
SMX/TMP DS 1-2 tabs BID or Doxy 100 BID
42
Cellulitis txm
Cephalexin 500mg QID, Dicloxacillin 500mg QID, Clinda 300mg QID if allergic to B-lactam txm duration = 5 days, longer if needed
43
Abscess, purulent infection txm
SMX/TMP 1-2 BID Doxy 100mg BID Minocycline 200mg X 1, 100mg BID Clinda 300mg QID ** Cephalexin if MSSA**
44
Severe purulent SSTI txm
7-14 day txm duration Vanco Daptomycin Linezolid PO abx once stable
45
Necrotizing fasciitis txm
vanc or daptomycin + zosyn/meropenem + clinda
46
When is urinalysis considered positive?
WBC> 10 (pyuria) bacteria positive leukocyte esterase nitrates
47
Pyelonephritis (Upper UTI) vs cystitis (Lower UTI)
Pyelo = flank pain, fever/chills/nausea, ab pain cystitis = burn/pain when peeing, inc in frequency, blood in urine
48
Acute uncomplicated cystitis txm
Macrobid 100mg BID X 5 days (dont use CrCl < 60) SMX/TMP DS 1 tab BID X 3 days Fosfomycin 3g X 1 dose
49
Options for pregnant women uncomplicated cystitis
Amox Cephalexin tx for 7 days
50
acute pyelonephritis txm
Cipro 500mg BID X 5-7 days Levo 750mg QD X 5-7 days very ill hospitalized pt = IV ceftriaxone/cirpo/levo or carbapenem if think ESBL
51
Urinary analgesic
phenazopyridine can make urine red/orange 200mg TID for 2 days max
52
Bacteriuria and pregnancy info
should be treated, even if asymptomatic amox/clav or oral ceph preferred avoid quinolones Nitro or SMX/TMP can be used
53
C.diff symptoms
3 or more watery stools in 1 day abdominal cramps fever elevated WBC
54
C.diff treatment
vancomycin or fidaxomicin preferred bezlotoxumab reduces incidence of recurrence but doesn't treat, has to be given with abx txm
55
Syphillis txm
primary, secondary or early latent: Pen G 2.4mil unit X 1, Doxy 100mg BID X 14 days if allergy late latent or tertiary: Pen G 2.4mil unit QW X 3 W, Doxy 100mg BID X 28 days if allergy
56
Neurosyphillis txm
Pen G 3-4mil unit IV Q4H X 10-14 days, if allergy, then desensitization prior
57
Gonorrhea txm
Ceftriaxone: < 150kg = 500mg X 1 > 150kg = 1g X 1 add doxy if chlamydia not excluded Cefixime 800mg if ceftriaxone no avail
58
Chlamydia txm
nonpreg = doxy 100mg BID X 7 days Preg = azith 1g X 1 dose Erythromycin 500mg QID X 7 days, Levo 500mg QD X 7 days if allergy preg + allergy = amox 500mg TID X 7 days
59
Bacterial vaginosis treatment
Metronidazole 500mg BID X 7 days or metro gel X 5 days or Glinda 2% cream X 7 days ** Dont douche **
60
Trichomoniasis txm
metronidazole, females 500mg BID X 7 days, males 2g X 1 dose can still use in preg for trich
61
Geneital wort txm
imiquimod cream, apply 3X per week until cleared or 16 weeks
62
Go to drug for tick borne diseases?
Doxy 100mg BID from 5-14 day depending on what it is

NAPLEX review 2024 RXPrep Book (78 decks)

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