Infectious Diseases - Kaplan

Question 1

Linezolid:

Answer 1

MC –> Thrombocytopenia.

–> It is a MAO inhibitor (avoid tyramine-containing foods).

Question 2

Daptomycin:

Answer 2

CPK + LFT elevations.

Question 3

Tigecycline:

Answer 3

Hepatotoxic + Causes nausea/diarrhea.

Question 4

Colistin/Polymyxin:

Answer 4

Very toxic to the kidney and to the nerves.

–> Topical applications of the skin, eye, and ear.

Question 5

Mefloquine:

Answer 5

Neuropsychiatric abnormalities:
1. Psychosis.
2. Hallucinations.
3. Seizures.
Cardiac rhythm effects:
1. Bradycardia.
2. QT prolongation.

Question 6

Doxycycline:

Answer 6

Photosensitivity rash.

Question 7

Zanamivir:

Answer 7

May cause some wheezing, because it is administered by inhalation.

Question 8

Ganciclovir:

Answer 8

Neutropenia.

Question 9

Foscarnet:

Answer 9

1. Nephrotoxicity.
2. Urethral ulcers.
3. Hypocalcemia.
4. Hypomagnesemia.

Question 10

Cidofovir:

Answer 10

Nephrotoxicity.

Question 11

Valganciclovir:

Answer 11

1. Seizures.

2. Neutropenia.

Question 12

Drotrecogin:

Answer 12

MC –> Bleeding (activated ProteinC analog).

Question 13

Influenza vaccine:

Answer 13

1. Can induce a mild fever and mild muscle soreness.
2. Contra when the patient is allergic to eggs.
3. Live attenuated should NOT be given to pregnant or immunocompromised patients.

Question 14

Pneumococcal vaccine:

Answer 14

Extremely safe - Local muscle soreness is the only significant side effect.
–> NO CONTRAINDICATIONS.

Question 15

Clindamycin:

Answer 15

Often leads to diarrhea from C.difficile.

Question 16

Metronidazole:

Answer 16

1. Metallic taste.
2. Disulfiram reaction (severe nausea + vomiting) with alcohol.
3. Rarely –> Seizures + Neurological disorders.

Question 17

Amphotericin:

Answer 17

1. Raise the creatinine level.

2. Distal renal tubular acidosis with hypokalemia.

Question 18

Voriconazole:

Answer 18

1. Can be hepatotoxic - Like ALL azoles.
2. It can prolong the QT on an EKG.
3. MOST UNIQUE EFFECT is a transient visual disturbance.

Question 19

Echinocandins (caspofungin, micafungin, anidulafungin):

Answer 19

Very few side effects.
Minor histamine release:
1. Flushing.
2. Headache.
3. Urticaria.
4. Pruritus.

Question 20

Posaconazole:

Answer 20

Very few:

1. Hepatotoxicity.
2. QT prolongation.
   (rarely) .

Question 21

Isoniazid:

Answer 21

Hepatotoxicity –> Routine monitoring of liver function is NOT necessary, unless underlying liver disease or alcoholism is present.

Question 22

Isoniazid, rifampin, pyrizinamide, ethambutol:

Answer 22

All can cause hepatotoxicity –> They are stopped at 2 times the upper limit of normal LFTs. Specific side effects:
INH –> Peripheral neuropathy.
Rifampin –> Red-orange discoloration of body fluids.
Pyrizinamide –> Hyperuricemia. Do NOT treat.
Ethambutol –> Optic neuritis + color vision abnormalities.

Question 23

Acyclovir, Valacyclovir, Famciclovir:

Answer 23

MC is nephrotoxicity - Precipitation of medication in the kidney tubule.
Rarely –> Confusion, tremors, hallucincations.

Question 24

TMP/SMX:

Answer 24

MC –> Rash.

Bone marrow suppression + Renal insufficiency can also occur.

Question 25

PIs:

Answer 25

All protease inhibitors cause: 1. Hyperlipidemia. 2. Hyperglycemia. + Hepatotoxicity.

Question 26

Indinavir:

Answer 26

Unique --> Nephrolithiasis.

Question 27

Dapsone:

Answer 27

1. MC --> Rash. 2. Hemolysis in G6PD-def. 3. Methemoglobinemia. 4. Aplastic anemia can happen with all folic acid inhibitors.

Question 28

Vancomycin:

Answer 28

Red man syndrome --> From rapid infusion - Flushing from histamine release provoked by the vancomycin.

Question 29

Terbinafine:

Answer 29

1. Hepatotoxicity. | 2. Taste disturbance.

Question 30

Side effect in the treatment of syphilis:

Answer 30

The Jarisch-Herxheimer reaction: Fever, rash, myalgias, headache. - -> Release of lipopolysaccharide from dying spirochetes. - -> Treated with aspirin.

Question 31

Efavirenz:

Answer 31

Specifically contraindicated in pregnancy because of the risk of neural tube defects.

Question 32

All NRTIs can cause:

Answer 32

Lactic acidosis.

Question 33

Zidovudine can cause:

Answer 33

Anemia.

Question 34

Didanosine and stavudine can cause:

Answer 34

Pancreatitis + Neuropathy.

Question 35

Tenofovir can cause:

Answer 35

Renal insufficiency + Fanconi syndrome.

Question 36

Aminoglycosides:

Answer 36

Nephro/Ototoxicity. | Rarely --> Neuromuscular blockade + Myasthenia-like weakness.

Question 37

Carbapenems:

Answer 37

Can cause neurotoxicity.

Question 38

Quinolones:

Answer 38

1. Rarely --> CNS toxicity. | 2. Inhibition of chondroblasts can lead to Achilles tendon rupture --> Contra in pregnancy/children.

Question 39

Gatifloxacin:

Answer 39

Hyperglycemia. | Occasionally --> Prolongs QT interval.

Question 40

Podophyllin:

Answer 40

Teratogenic.