Questions and Answers
What is the primary mode of action of antibiotics such as cephalosporins and carbapenems?
Which of the following antibiotics is commonly used to treat bacterial conjunctivitis?
What is the primary cause of trachoma?
Which of the following is NOT a common bacterial infection?
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What is the typical duration of bacterial conjunctivitis?
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Which of the following antibiotics is commonly used to treat trachoma?
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What is the primary cause of otitis media?
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Which of the following is a common complication of trachoma?
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What is the primary cause of otitis externa?
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What is the primary bacterium responsible for causing Lyme disease?
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What is the treatment for peritonsillar abscess?
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Which of the following antibiotics is NOT a treatment option for MRSA?
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What is the etiology of strep throat?
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What is the typical presentation of pyogenes?
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What is the name of the topical otic antibiotic suspension used to treat otitis externa?
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What is the name of the antibiotic suspension used to treat otitis media?
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Which of the following is NOT a typical etiology of cellulitis?
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What is the primary treatment for Rocky Mountain Spotted fever?
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What is the consequence of untreated peritonsillar abscess?
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Which of the following is a secondary complication of Lyme disease?
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What is the treatment for impetigo?
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What is the common etiology of otitis media?
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What is the typical etiology of CAP pneumonia?
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Which of the following antibiotics is a treatment option for animal bites?
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What is the first-line treatment for H. Pylori infection?
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Which of the following is NOT a common cause of urethritis?
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What is the primary etiologic agent of diverticulitis?
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What is the treatment of choice for severe C. difficile colitis?
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Which of the following is a common symptom of diverticulitis?
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What is the risk factor for developing C. difficile colitis?
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What is the treatment of choice for community-acquired pneumonia in a previously healthy individual?
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What is the characteristic presentation of C. difficile colitis?
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What is the primary causative agent of syphilis?
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What is the treatment for uncomplicated UTIs in non-pregnant women?
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What is the common presentation of trachomatis infection?
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What is the treatment for Chlamydia infection?
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What is the most common cause of UTIs?
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What is the presentation of secondary syphilis?
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What is the treatment for Gonorrhea infection?
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What is the term that encompasses cystitis, pyelonephritis, prostatitis, and asymptomatic bacteriuria?
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Study Notes
Antibiotics and Bacterial Infections
- Antibiotics can be classified into different categories, including:
- Cell wall inhibitors (e.g., PNCs, cephalosporins, carbapenems)
- Protein synthesis inhibitors (e.g., AGs, tetracyclines, macrolides, linezolid, mupirocin)
- Antifolate drugs
- Fluoroquinolones
Common Bacterial Infections
- Bacterial conjunctivitis:
- Inflammation of conjunctiva from infection
- Self-limited, usually 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. pneumoniae (35%), H. influenzae, M. catarrhalis, viruses
- Presentation: immobile, erythematous tympanic membrane; otalgia, otorrhea, fever
- Treatment: mild-to-moderate resolves within 1 week without treatment; NSAIDs, amoxicillin, cefdinir, azithromycin
- Otitis externa:
- Results from combination of heat and retained moisture with desquamation and maceration of epithelium of canal
- Etiology: P. aeruginosa, S. pneumoniae
- Presentation: ear discharge, pain with palpation of tragus/pinna, ear canal edema and discomfort
- Treatment: topical otic antibiotics ± topical steroids; neomycin/polymyxin/hydrocortisone otic suspension, ciprofloxacin/dexamethasone otic suspension
- Strep throat:
- Pharyngeal infection caused by GAS (S. pyogenes)
- Presentation: sore throat, fever, chills, purulent tonsillar exudate, cervical lymphadenopathy
- 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 unilateral sore throat, dysphagia, dysphonia, referred otalgia, "hot potato voice", lymphadenopathy, trismus
- Treatment: surgical I&D + antibiotics; 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), E. corrodens (human bite), P. aeruginosa (penetrating injury)
- Presentation: localized pain, erythema, swelling, heat
- Treatment: depends on the cause; amoxicillin/clavulanate, dicloxacillin, clindamycin, vancomycin, or linezolid
- 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, hypotension, renal failure
- Treatment: doxycycline, chloramphenicol if pregnant or allergic
- Lyme disease:
- Spirochetal infection transmitted by ticks (Ixodes scapularis)
- Etiology: B. burgdorferi
- Presentation: ECM (stage 1), nonspecific symptoms like headache, musculoskeletal pain, neurological deficits (stage 2), arthritis (stage 3)
- Treatment: doxycycline, amoxicillin, cefuroxime, or erythromycin as alternative agents
- CAP pneumonia:
- Infection of lung parenchyma
- Etiology: S. pneumoniae, H. influenzae, S. aureus, K. pneumoniae, P. aeruginosa; atypicals like M. pneumoniae, C. pneumoniae, Legionella spp.
- Presentation: fever, chills, cough, sweats, pleuritic chest pain, and dyspnea
- Treatment: clarithromycin, azithromycin, or doxycycline if previously healthy and no antibiotics in past 3 months; respiratory fluoroquinolone (e.g., moxifloxacin or levofloxacin) if co-morbidities or previous antibiotic use
- Diverticulitis:
- Digestive disease in which pouches form within the bowel wall
- Etiology: Enterobacteriaceae, P. aeruginosa, Bacteroides spp., and enterococci
- Presentation: left lower quadrant 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 duodenal ulcer, 80% of gastric ulcer
- Etiology: H. pylori
- Presentation: burning epigastric pain 90 minutes to 3 hours after eating (duodenal ulcer) or worse with eating/unrelated (gastric ulcer)
- Treatment: quadruple therapy first-line
- C. difficile colitis:
- Diarrheal illness
- Most commonly acquired in hospital
- All antibiotics have risk of C. difficile infection
- Etiology: C. difficile
- Presentation: malodorous diarrhea, up to 20 bowel movements per day
- Treatment: metronidazole for mild-moderate disease, vancomycin for severe disease
- Urethritis:
- Commonly caused by N. gonorrhea or C. trachomatis
- Presentation: mucopurulent urethral discharge
- 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 (1°), skin/mucous membrane rash (2°), symptomless (latent), neurological/cardiovascular symptoms (3°)
- Treatment: benzathine penicillin G single dose, tetracycline or doxycycline x 2 weeks if allergic
- 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, frequency/urgency (cystitis); fever, flank pain, costovertebral angle tenderness, nausea/vomiting (pyelonephritis); dysuria, frequency, chills, prostatic/perineal pain (prostatitis)
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Description
This quiz covers the classification of antibiotics and common bacterial infections, including conjunctivitis. Test your knowledge of cell wall inhibitors, protein synthesis inhibitors, and more.
