Principles of Infectious Diseases

Question 1

Common organisms in alcoholics

Answer 1

Strep pneumonia, klebsiella pneumonia, staph aureus

Question 2

Common organism in post-viral infections

Answer 2

staph aureus

Question 3

Which bacteria does not have a cell wall?

Answer 3

mycoplasma

Question 4

What are the atypical organisms?

Answer 4

Chlamydia, Legionella and Mycoplasma pneumoniae

Question 5

What are some common anaerobes?

Answer 5

Bacteroides, Clostridium, Enterobacter, Lactobacillus

Question 6

What are the encapsulated bacteria?

Answer 6

Strep pneumo
h.influenza
klebsiella
neisseria

Question 7

cellulitis (staph aureus or epidermidis)

Answer 7

DOC - dicloxacillin (allergy - clindamycin)

alt. cephalexin

Question 8

cellulitis (strep pyogenes)

Answer 8

DOC - PCN (allergy - erythromycin)

alt. cephalexin

Question 9

diarrhea - bacillus cereus

Answer 9

food poisoning (reheated fried rice)
Tx: supportive

Question 10

diarrhea - campylobacter jejuni

Answer 10

fecal-oral (contaminated water) or unpasterized milk

DOC - azithromycin

Question 11

diarrhea - clostridium botulinum

Answer 11

honey (young kids), canned foods

Tx: trivalent antitoxin

Question 12

diarrhea - c.diff

Answer 12

nosocomial or abx associated

DOC - metronidazole or oral vanc

Question 13

bloody diarrhea - e.coli

Answer 13

uncooked beef

Tx: supportive

Question 14

diarrhea - enterotoxigenic e.coli

Answer 14

“traveler’s diarrhea” due to production of toxins

DOC - fluoroquinolones

Question 15

bloody diarrhea - shigella

Answer 15

DOC - AMP

Question 16

“rice water diarrhea” (vibrio cholorae)

Answer 16

contaminated water and seafood
Tx: fluid, glucose + Na (gatorade)
DOC - doxyclycline or fluoroquinolone

Question 17

diarrhea - CMV

Answer 17

immunocompromised

DOC - ganciclovir

Question 18

diarrhea - Norwalk virus

Answer 18

cruise ships, spreads fast!

Tx: supportive

Question 19

diarrhea - rotovirus

Answer 19

children
Rotazyme test
Tx: fluids +/-nitazoxanide (antiprotazoal)

Question 20

diarrhea - salmonella

Answer 20

raw poultry, eggs, meats

DOC - AMX

Question 21

diarrhea - giardia lamblia

Answer 21

protozoa
day care, hikers, anal-oral MSM
check stool antigen
DOC - tinidazole or nitazoxanide

Question 22

diarrhea - enterobius vermicularis

Answer 22

helminth
most common in US
eggs deposited outside anus (itching)
DOC - albendazole

Question 23

Most common bacteria for UTIs (ambulatory adults)

Answer 23

e.coli (up to 80%)

klebsiella/proteus (about 10%)

Question 24

What are the infections in ToRCHeS?

Answer 24

Toxoplasmosis, Other (Listeria, e.coli, GBS), Rubella, CMV, HIV, HSV type 2, Syphilis

Question 25

MRSA treatment (IV)

Answer 25

Vancomycin Telavancin Daptomycin Linezolid

Question 26

MRSA treatment (PO)

Answer 26

``` Minocycline Doxycycline TMP/SMX Clindamycin Linezolid ```

Question 27

Pseudomonas treatment (IV)

Answer 27

Piperacillin Ticarcillin Ceftazidime (Fortaz) 3rd gen Ceph Cefepime 4th gen Ceph

Question 28

Pseudomonas treatment (PO)

Answer 28

Cipro | Levo

Question 29

What are the bacteriostatic antibiotics?

Answer 29

"We're ECSTaTiC about bacteriostatics!" | E-mycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracyclines, Chloramphenicol

Question 30

What are the bacteriocidal antibiotics?

Answer 30

"Very Finely Proficient At Cell Murder" | Vancomycin, Fluoroquinolones, PCN, Aminoglycosides, Cephalosporin, Metronidazole

Question 31

What type of cells are needed to generate high affinity antibodies against strep pneumo?

Answer 31

helper T lymphocytes

Question 32

What drugs are used to treat atypicals?

Answer 32

Macrolides (clarithromycin…) FQs (Azithromycin…) Tetracyclines

Question 33

3rd generation cephalosporin with pseudomonas coverage?

Answer 33

Ceftazimine (Fortaz)

Question 34

What is the likelihood PCN allergic patients are also cross-sensitized with cephalosporins?

Answer 34

5-10% warrants close observation or possible alternative

Question 35

Which bacteria is most commonly seen in animal bites?

Answer 35

Pasteurella multicoda

Question 35

Most common CAP?

Answer 35

Mycoplasma pneumo ( b/c feel fine and out and about)

Question 35

What is the resistance mechanism for encapsulated bacteria?

Answer 35

Capsule helps bacteria evade the immune system.

Question 35

What makes atypicals unique?

Answer 35

They are IN the cell. Don't show up on gram stain and must use abx that penetrates.

Question 35

Strep agalactiae AKA

Answer 35

GBS (mostly babies)

Question 35

What bug is associated with infected caths and prosthesis?

Answer 35

Staph epidermidis

Question 35

What bug is associated with rigorous sex and multiple partners?

Answer 35

Staph saprophyticus

Question 35

What bug is of concern in meningitis in very young and old?

Answer 35

Listeria (add amp)

Question 35

Which bug causes "floppy baby"?

Answer 35

C. Botulinum

Question 35

Which macrolide can cause c.diff?

Answer 35

Clindamycin

Question 35

C.diff - DOC

Answer 35

``` #1 metronidazole 500 mg PO TID x 3 wks (1st-2nd episode) #2 vanc 500 mg PO QID (severe) +/- metro IV if inflamed colon or ileus ```

Question 35

Which abx get good intra cellular penetration?

Answer 35

Macrolides - azithromycin, clindamycin, erythromycin Telithromycin FQ Tetracycline (doxy)

Question 35

Which bug is most common in post-viral illness?

Answer 35

Staph aureus

Question 35

Strep pneumonia AKA

Answer 35

Alpha hemolytic strep

Question 35

Strep pyogenes AKA

Answer 35

GABHS

Question 36

4th generation cephalosporin with pseudomonas coverage

Answer 36

Cefepime