Principles of Infectious Disease and Antimicrobial Therapy + Summary

Question 1

Pathogenicity

Answer 1

ability to cause disease in host organism

Question 2

Virulence

Answer 2

extent or degree of pathogenicity

Question 3

gram positive stains _____

Answer 3

purple - peptidoglycan cell wall

Question 4

gram negative stains ________

Answer 4

pink - no cell wall

Question 5

what are the 4 groups of gram + bacteria

Answer 5

staphylococci
streptococci
enterococci
listeria monocytogenes

Question 6

what are the 3 groups of gram negative bacteria

Answer 6

enterobacteriales (gut bacteria)

respiratory tract gram negatives (H. influenzae, M. catarrhalis, N meningitidis)

lactose nonfermenting gram negatives (pseudomonas aeruginosa, stenotrophomonas maltophilia)

Question 7

what are the 3 types of resp tract gram negatives

Answer 7

H. influenzae, M. catarrhalis, N meningitidis)

Question 8

what are the 3 atypicals

Answer 8

legionella spp
mycoplasma spp
chlamydia/ chlamydophila spp

Question 9

what are the 3 oral anaerobes

Answer 9

peptostreptococci, fusobacterium, prevbotella

Question 10

what are the 2 gut anaerobes

Answer 10

bacteroides spp
closteridiodes spp

Question 11

what are some common bugs for CAP

Answer 11

s pneumoniae
respiratory viruses
m pneumoniae
c pneumoniae
h influenzae

Question 12

what are some common bugs for AOM

Answer 12

s pneumoniae
h influenzae
m catarrhalis

Question 13

what are some common bugs for UTI

Answer 13

E. coli
Proteus spp
S. saprophyticus

Question 14

what are some common bugs for furuncles/ carbuncles

Answer 14

S. aureus (MSSA, MRSA)

Question 15

what are some common bugs for cellulitis

Answer 15

streptococcal spp

Question 16

which antibiotics are DNA synthesis inhibitors

Answer 16

fluoroquinolones
nitroimidazoles (ex- metronidazole)wh

Question 17

which antibiotics are protein synthesis inhibitors

Answer 17

macrolides
aminoglycosides
lincosamides
tetracyclines
oxazolidinones

(MALTO)

Question 18

which antibiotics are cell wall inhibitors

Answer 18

penicillins
cephalosporins
carbapenems
glycopeptides (ex- vancomycin)
beta lactam beta lacatamase inhibitors
lipopeptides (daptomycin)
phosphonics (fosfomycin)

Question 19

which abx are folate synthesis inhibitors

Answer 19

TMP-SMX

Question 20

which abx are bactericidal

Answer 20

beta lactams
vancomycin
daptomycin
fluoroquinolones
metronidazole

Question 21

which abx are bacteristatic

Answer 21

tetracyclines
macrolides
clindamycin
linezolid

(too many close lines)

Question 22

which abx are high risk for ADRs

Answer 22

chloramphenicol
aminoglycosidesw

Question 23

which abx are mod risk for ADRs

Answer 23

macrolides
fluoroquinolones

Question 24

what is the spectrum of activity for PIP-TAZ

Answer 24

gram + and gram -
some oral anaerobes and some gut anaerobes

Question 25

which abx exhibit time dependent killing

Answer 25

beta lactams macrlides vancomycin

Question 26

which abx exhibit conc dep killing

Answer 26

quinolones aminogycosides

Question 27

which class of abx exhibits a post antibiotic effect (continued suppression fo normal growth with abx levels below MIC)

Answer 27

aminoglycosides

Question 28

what is conc dependent killing

Answer 28

bacterial killing determined by peak drug levels or AUC/MIC ratio

Question 29

AMG are ____ killing

Answer 29

concentration

Question 30

for gram + synergy dosing, AMG should be dosed every _____________

Answer 30

8-24 hrs depending on pathogen/ renal fxn

Question 31

AMG are commonly known for _____ against gram ___ organisms

Answer 31

PAE gram negative

Question 32

once daily dosing of AMG should be avoided in

Answer 32

pregnant pts, severe renal impairment, cirrhosis, burns

Question 33

what are the advantages and disadvantages of once daily dosing of AMG

Answer 33

pros; no need for peak levels, less risk of nephrotoxicity, similar efficacy for most infxns cons: may be associated with higher risk for ototoxicity compared to multiple daily dosing if used long term

Question 34

vancomycin is ____ and ____ dependent killing

Answer 34

time and concentration dependent

Question 35

which abx should be avoided in pregnancy

Answer 35

SMX/TMP Fluoroquinolones Macrolides Metronidazole AMG Tetracyclines Nitrofurantoin Safe Fetus MMeans Avoid These Now

Question 36

what is a type 1 hypersensitivity

Answer 36

immediate hypersensitivity, IgE mediated sx start within 1hr of ingestion of initial dose anaphylaxis

Question 37

what is a type 2 rxn

Answer 37

cytotoxic (IgG/IgM) mediated rxn sx: thrombocytopenia, interstitial nephritis, hemolytic anemia

Question 38

what is a type 3 rxn

Answer 38

immune complex formation (complement) serum sickness syndrome

Question 39

what is a type 4 rxn

Answer 39

cell mediated hypersensitivity (T cell) contact dermatitis, maculopapular eruptions, SJS sx start after days of tx

Question 40

what are the beta lactam beta lactamase inhibitor combinations

Answer 40

pip tazo amoxi/clav

Question 41

what are the 1st gen cephalosporins

Answer 41

cefazolin, cephalexin

Question 42

what are the 2nd gen cephalosporins

Answer 42

cefuroxime, cefoxitin, cefprozil, cefaclor

Question 43

what are the 3rd gen cephalosporins

Answer 43

ceftriaxone, cefixime, cefotaxime, ceftaxidime

Question 44

what is the 4th gen cephalosporin

Answer 44

cefepime

Question 45

what are the carbapenems

Answer 45

ertapenem, imipenem, meropenem, doripenem

Question 46

how should cloxacillin be administered

Answer 46

IV preferred PO = poorly absorbed, must take on empty stomach 1hr before or 2hrs after meals

Question 47

what is the drug of choice for staphylococcus (not MRSA)

Answer 47

cloxacillin

Question 48

Pip-Tazo is bacteri____

Answer 48

cidal

Question 49

what are the SPACE organisms

Answer 49

Serratia, pseudomonas, acinetobacter, citrobacter, enterobacter

Question 50

what are the SPICE organisms

Answer 50

Serratia, providencia spp, indole positive proteus spp, citrobacter, enterobacter

Question 51

what do 1st gen cephalosporins cover

Answer 51

G+ cocci, MSSA, streptococci S. epidermidis oral anaerobes

Question 52

what do 2nd gen cephalosporins cover

Answer 52

cefuroxime/ cefaclor: H influenzae (including b-lactam producing), M. catarrhalis, oral anaerobes, streptococci cefoxitin: covers PEcK + gut anaerobes (B fragilis) cefaclor, cefuroxime: URTIs cefoxitin: uncomplicated intraabdominal infxns, PID, surgical procedures, infxn due to G- _ anaerobes

Question 53

what do 3rd gen cephalosporins cover

Answer 53

more gram - coverage more H influenza and M catarrhalis

Question 54

which class of cephaalosporins have better CNS penetration

Answer 54

3rd

Question 55

what does cefepime cover

Answer 55

mixed infections (+/- , pseudomonas) difficult to tx organisms like SPICE/SPACE