Infectious Dz Flashcards by Ben Dover

Coverage of Penicillin (G, V, benzathine)

Viridans strep

Strep pyo

Oral anaerobes

Syphillis

leptospira

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Coverage of ampicillin and amoxicillin

Same as penicillin +

E. coli

Lyme

Some G (-) coverage

HELPS

H. influenszae

E. coli

Leptospira

Proteus

Salmonella

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Penicillins are the best initial therapy for

Otits media

Dental infection and endocarditis prophylaxis

Lyme disease

UTI in prego

Listeria

Enterococcal

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What are the penicillinase resistant penicillins?

What are they used to Tx?

Skin infections (impitigo, cellulitis, erysipelas)

Endocarditis, meningitis, bacteremia from staph

Osteomyelitis and septic arthritis is bug sensititive

Oxacillin, cloxacillin, dicloxacillin, nafacillin

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Best initial therapy for:

Cholecystitis, ascending cholangitis

Pyelonephritis

Bacteremia

VAP

Neutropenia with fever

Pipercillin

ticarcillin

azlocillin

mezlocillin

(cover G- bacilli as well as pseudomonas)

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Reason we do not use methacillin

Causes renal failure from allergic interstitial nephritis

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Best initial therapy for PID

Cefotan or cefoxitin (2nd gen)

Doxycycline

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Ceftriaxone is this generation and covers…

3rd gen

CAP- pneumococcus with a macrolide

Meningitis

Gonorrhea

Lyme involving heart or brain

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Which cefalosporin not to give noenates

Ceftriaxone

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4th gen cephalosporin

Cefepime

Covers more staph– VAP

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Adverse effect of cefoxitin and cefotan

deplete prothrombin and increase bleeding risk

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Carbapenems cover…

Gram - bacilli

anaerobes

Step

Staph

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Only monobactam abx

Good for…

Aztreonam

Exclusively for gram negative bacilli and pseudomonas

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Best therapy for CAP

Levofloxacin and other Fluoroquinolones

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Best treatment for cystitis and pyelonephritis

Ciprofloxacin

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Only single agent treatment for diverticulitis

Moxifloxacin

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Cautions with fluroquinolones

Bone growth abnormalities

Tendonitis and achillies tendon rupture

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Side effects of aminoglycosides (gentamycin and tobramycine)

Ototoxic and nephrotoxic

god for gram negative bacilli in the bowel urine and bacteremia

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Doxycycline works well for…

Chlamydia

Lyme disease (limited to joint, rash, bell palsy)

Rikettsia

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Adverse effects of doxy

tooth discoloation

fanconi syndrome (Type II RTA proximal)

Photosensitivity

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TMP-SMX works well for

cystitis

PCP pna tx and prophylaxis

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Adverse effects of TMP-SMX

Rash

Hemolysis in G6PD deficiency

Bone marrow suppression (folate antag)

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Best initial therapy for gram-positive organisms (staph and strep)

Oxacillin

Cloxacillin

Dicloxacillin

Nafcillin

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Best initital treatments for MRSA

Vanc

Linezolid

Daptomycin- elevated CPK

Tigecycline

Ceftaroline

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Best tharapies for gram-negative bacilli (peritonitis, diverticulitis, pyelo, cholangitis, cholecystitis)

Quinolones aminoglycosides carbapenems piparcillin aztreonam cephalosporins

Coverage for oral anaerobes

Penicillin (G, VK, ampicillin, amxicillin) Clindamycin

Coverage for abdominal/GI anaerobes

Metronidazole beta-lactamase/lactamase combo

When to answer head CT first when suspecting infection...

If there is the possibility of a space occupying lesion - papilledema - seizures - focal neurological abnormalities - Confusion

Best initial treatment for bacterial meningitis

Ceftriaxone Vancomycin steroids

If a patient presents with meningitis and has risk factors for listeria, what medication should be added/started...

Ampicillin Risk factors: Elderly, neonate, steroids, AIDS/HIV, pregnant, alcoholics

Close contacts to patients with Neisseria meningitidis should recieve...

Rifampin Cipro or Ceftriaxone

Most common neurological deficit of untreated bacterial meningitis

CN VIII deafness

Most common cause of encephalitis (acute onset confusion and fever)

Herpes simplex

Best initial therapy for herpes encephalitis

Acyclovir

Adverse effect of acyclovir...what is the treatment

Nephrotoxicity decrease dose and add hydration

Treatment of choice for herpes encephalitis if acyclovir resistant

Foscarnet

A patient has recurrent otitis media that is reisitant to ABX, what is the best step in management

Typanocetesis

What is the most accurate diagnostic test for otitis media

tympanocentesis

Best initial therapy for otitis media

amoxicillin amox-clavulinate if resistant

Patient with clearly described sinusitis..what is the next step OR action OR management

Amoxcillin/clavulinic acid and a decongestant Dx clear so treat it

Tx for strep pharyngitis

Amoxicillin or penecillin

Tx for strep pharygitis if patient allergic to penicillion

Cephalexin if reaction is rash clinda or macrolid is rxn is anaphylactic

Wheezing, flushing, rash following ingestion of fish

Scombroid-- tx with antihistamines

Treatment for giardia

metronidazole or tinidazole

e-antigen in hepatitis is synonomys with

DNA polymerase

Tx of Hep C PCR-RNA is elevated

Interferon + Ribavirin and wither bocepavir or teleprevir

Treatment for gonorrhea and chlamydia

cefixime/ceftriaxone and Azithromycin or doxycycline

Most accurate test for PID

Laproscopy

Treatment for pyelonephritis

Ceftriaxone or ertipenem Amp an gent until cultures are known Cipro outpatient

Treatment for prostatitis

TMP/SMX for 6-8 weeks

Best initial empiric therapy for endocarditis

Vancomycin and gentamicin

Tx for Viridans endocarditis

ceftriaxone 4 weeks

Treatment for sensitive staph aureus

Nafacillin, oxacillin, or cefazolin

Enterococcus endocarditis

ampicillin and gentamicin

Add this drug for prosthetic valve endocarditis

rifampin

Most common cause of culture negative endocarditis....tx?

Coxiella (HACEK organism) **Ceftriaxone**

Treatment of lyme with cardiac manifestation

**IV ceftriaxone**

Best initial drug regimen for HIV

Emtricitrabine Tenofovir Efavirenz

Drug side effect associated with: Zidovudine Didanosine Abacavir (HLA B5701) Protease inhibitors

Zidovudine- anemia Didanosine- pancratitis Abacavir- SJS Protease inhibs- Metabolic syndrome (HLD and hyperglycemia)

Indication for c-section in HIV+ mother

Viral load \>1000/uL

Most common cause of CAP

S. pneumoniae

Most common causes of HCAP

GNR (E. coli, pseudomonas) S. aureus

PNA in the upper lobe a nursing home pt...think of this bug

Pseudomonas

Uncomplicated CAP give this abx

Azithromycin or clarithromycin

CAP with comorbidities give this abx

fluoroquinolone

HCAP tx is taylored towards G(-) so give this abx

Ceftazidime or cefipime Imipenem Pipercillin/tazoctam (zosyn)

Toxicity common to all TB drugs

Hepatotoxicity

What is the common empiric treatment algorhythm for suspected bacterial meningitis in all age groups

1. **Cefotaxime (kids),** or **Ceftriaxone (adults),** or **Ceftazidime (immunocomp)** 2. **Vancomycin** 3. **Ampicillin** (add aminoglycoside in neonates)

A patient with head, fever mailaise, myalgias, changes in alertness and behavior. MRI shows increased signals in frontotemporal area

HSV encephalitis

Tx for uncomplicated pyelonephritis

TMP/SMX or a fluoroquinolone for G(-) Rods Amoxicillin for G(+) Cocci

Prophylactic agents for MAC pna in AIDS cd4 \<100

Clarithromycin and azithromycin

Infectious Dz Flashcards

(71 cards)