Questions and Answers
Which antibiotic is commonly used to treat bacterial conjunctivitis?
What is the primary bacterium that causes trachoma?
Which of the following is NOT a common bacterial infection?
What is the usual duration of bacterial conjunctivitis before it resolves on its own?
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Which antibiotic is used to treat H.pylori infection?
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What is the primary presentation of trachoma?
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Which of the following is NOT a treatment for trachoma?
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What is the primary cause of otitis media?
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What is the common pathogen causing otitis externa?
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What is the first line of treatment for strep throat in a patient allergic to penicillin?
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What is the treatment of choice for peritonsillar abscess?
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What is the etiology of catarrhalis?
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What is the common symptom of otitis externa?
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What is the treatment of choice for impetigo?
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What is the complication of tonsillitis?
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What is the antibiotic of choice for otitis media in a patient allergic to penicillin and cephalosporins?
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What is the primary bacterium responsible for causing Rocky Mountain Spotted fever?
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What is the treatment of choice for Lyme disease in non-pregnant individuals?
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What is the mode of transmission of Cellulitis?
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What is the treatment of choice for MRSA infections?
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What is the etiology of Pyogenes?
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What is the primary site of infection for Rocky Mountain Spotted fever?
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What is the treatment of choice for animal bites?
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What is the etiology of CAP pneumonia?
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What is the primary treatment for gonorrhea?
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What is the presentation of syphilis in the secondary stage?
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What is the most common cause of UTIs?
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What is the treatment for chlamydia?
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What is the term for asymptomatic bacteriuria?
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What is the treatment for syphilis in penicillin-allergic patients?
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What is a characteristic symptom of prostatitis?
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What is the term for UTIs that occur in non-pregnant outpatient women without abnormalities or instrumentation?
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What is the treatment for a previously healthy individual with community-acquired pneumonia who has not taken antibiotics in the past three months?
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What is the primary cause of urethritis?
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What is the treatment for severe C. difficile infection?
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What is the typical presentation of diverticulitis?
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What is the primary cause of community-acquired pneumonia?
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What is the treatment for H. pylori infection?
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What is the risk factor for developing C. difficile infection?
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What is the bacterium that colonizes 100% of people with duodenal ulcers and 80% of gastric ulcers?
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Study Notes
Antibiotics
- Cell wall inhibitors: PNCs, cephalosporins, carbapenems
- Protein synthesis inhibitors: AGs, tetracyclines, macrolides, linezolid, mupirocin
- Antifolate drugs
- Fluoroquinolones
Common Bacterial Infections
Bacterial Conjunctivitis
- Inflammation of conjunctiva from infection
- Self-limited, resolves in 5-7 days
- Presentation: conjunctival erythema, eyelid edema, mucopurulent discharge, crusting
- Treatments: Tobramycin ophthalmic solution, Neomycin/Polymixin/Gramicidin ophthalmic solution, Moxifloxacin ophthalmic solution
Trachoma
- Highly contagious ocular infection caused by Chlamydia trachomatis
- Presentation: roughening of inner surface of eye, corneal breakdown, eye discharge, light sensitivity
- Treatments: Azithromycin single dose, Sulfacetamide ophthalmic solution, Tetracycline ophthalmic solution/ointment
Otitis Media
- Typically follows viral URI which can directly cause viral OM or predispose to bacterial OM
- Etiology: S.pneumo (35%), H.influenzae, M.catarrhalis, viruses
- Presentation: Immobile, erythematous TM; otalgia, otorrhea, fever
- Treatment: mild-to-moderate resolves within 1 week without tx; NSAIDs, Amoxicillin, Cefdinir, Azithromycin
Otitis Externa
- Results from combo of heat and retained moisture with desquamation and maceration of epithelium of canal
- Etiology: P.aeruginosa, S.pneumo
- Presentation: Ear discharge, pain with palpation of tragus/pinna, ear canal edema and discomfort
- Treatment: Topical otic abx ± topical steroids, Neomycin/Polymyxin/Hydrocortisone otic suspension, Ciprofloxacin/Dexamethasone otic suspension
Streptococcal Pharyngitis
- Pharyngeal infection caused by GAS aka S.pyogenes
- Presentation: Sore throat, fever, chills, purulent tonsillar exudate, cervical LAD
- Treatments: Penicillin V, 1G cephalosporin (Cephalexin) if PCN allergic, Clindamycin if allergic to PCN + cephalosporins due to resistance to macrolides
Peritonsillar Abscess
- Also called quinsy, complication of tonsillitis
- Consists of collection of pus in peritonsillar space; considered an ENT emergency
- Etiology: Oral flora including anaerobes, GAS
- Presentation: Severe U/L sore throat, dysphagia, dysphonia, referred otalgia, “hot potato voice”, LAD, trismus
- Treatment: Surgical I&D + abx, Clindamycin or Metronidazole + Benzathine Penicillin G
Impetigo
- Superficial skin infection seen in young children
- Etiology: S.aureus, S.pyogenes
- Presentation: Red papular lesions that evolve to pustules, honeycomb-like crusting affecting facial areas
- Treatment: Mupirocin topical, Dicloxacillin or Cephalexin if extensive
Cellulitis
- Bacterial infection of skin; bacteria enter through cuts, scratches, burns, incisions, catheters, etc.
- Etiology: MRSA, MSSA, P.multocida (cat/dog bites), Eikenella cordoned (human bite), P.aeuginosa (penetrating injury)
- Presentation: Localized pain, erythema, swelling, heat
- Treatment: Depends on the cause, Amoxicillin/Clavulanate for animal bites, Dicloxacillin or Oxacillin for MSSA, Clindamycin, Vancomycin, or Linezolid for MRSA
Rocky Mountain Spotted Fever
- Tick/mite-born illness
- Transmitted by American dog tick (Dermacentor variabilis) and Rocky Mountain wood tick (D.andersoni)
- Etiology: R.rickettsii
- Presentation: Evolving macular rash; rarely CNS involvement, hypovolemia, HoTN, renal failure
- Treatment: Doxycycline, Chloramphenicol if pregnant or allergic
Lyme Disease
- Spirochetal infection transmitted by ticks (Ixodes scapularis)
- Etiology: Borrelia burgdorferi
- Presentation: ECM (stage 1), nonspecific sx like HA, muscoskeletal pain, neurologic deficits (stage 2), arthritis (stage 3)
- Treatment: Doxycycline, Amoxicillin, Cefuroxime, or Erythromycin are alternative agents
Community-Acquired Pneumonia (CAP)
- Infection of lung parenchyma
- Etiology: S.pneumo, H.influenzae, S.aureus, K.pneumoniae, P.aeruginosa; atypicals like M.pneumoniae, C.pnuemoniae, Legionella spp.
- Presentation: Fever, chills, cough, sweats, pleuritic CP, and dyspnea
- Treatment: Clarithromycin, Azithromycin, or Doxycycline if previously healthy and no abx in past 3 mo, Respiratory fluoroquinolone (e.g., Moxifloxacin or Levofloxacin) if co-morbidities or previous abx use (alt: high-dose Amoxicillin/Clavulanate plus Macrolide)
Diverticulitis
- Digestive disease in which pouches form within the bowel wall
- Etiology: Enterobacteriaceae, P.aeruginosa, Bacteroides spp., and enterococci
- Presentation: LLQ pain + tenderness, fever, elevated WBC count
- Treatment: Ciprofloxacin plus Metronidazole, Alternative agents include TMP/SMX, Amoxicillin/Clavulanate
H.Pylori Infection
- Colonizes 100% of people with DU, 80% of GU
- Etiology: H.pylori
- Presentation: Burning epigastric pain 90min to 3hr after eating (DU) or worse with eating/ unrelated (GU)
- Treatment: Quadruple therapy first-line
C.Difficile Colitis
- Diarrheal illness
- Most commonly acquired in hospital
- All abx has risk of CDI
- Etiology: C.difficile
- Presentation: Malodorous diarrhea, up to 20 BMs/day
- Treatment: Metronidazole for mild-moderate disease, Vancomycin for severe disease
Urethritis
- Commonly caused by N.gonorrhea or C.trachomatis
- Presentation: Mucopurulent urethral discharge
- Treat while symptoms are present
- Treatment: Gonorrhea: single dose of Ceftriaxone IM + Azithromycin single dose PO, Cefpodoxime PO, or Cefixime PO, Chlamydia: Azithromycin single dose PO, Doxycycline PO x 7 days
Syphilis
- Spirochetal infection caused by T.pallidum
- Presentation: Painless chancre (1º), skin/mucous membrane rash (2º), symptomless (latent), neurologic/ cardiovascular sx (3º)
- Treatment: Benzathine Penicillin G single dose, Tetracycline or Doxycycline x 2 weeks if allergic
Urinary Tract Infections (UTIs)
- Term encompasses cystitis, pyelonephritis, prostatitis, and asymptomatic bacteriuria
- Uncomplicated UTI refers to acute disease in non-pregnant outpatient women without abnormalities or instrumentation; complicated UTIs refers to all other UTIs
- Etiology: E.coli (75-90%), S.saprophyticus, Klebsiella spp., Proteus spp., Citrobacter spp.
- Presentation: Dysuria, freq/urgency (cystitis); fever, LBP, CVAT, N/V (pyelo); dysuria, freq, chills, prostatic/perineal pain (prostatitis)
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Description
This quiz covers types of antibiotics, including cell wall inhibitors and protein synthesis inhibitors, as well as common bacterial infections such as conjunctivitis, pneumonia, and cellulitis.