ID Rx regimens and Step 1

[xjacob]

---

Members do not see this ad.

I don't want this to be one of the potentially annoying, vague "what's on the test" questions, but I think this is a reasonable thing to ask:

How deep does step 1 go into treatment of infectious diseases? I realize that we prob. won't be asked for 3rd line antibiotic choices, but I noticed that 90% of the bugs I know can be trated with one of 4 main Abx (erythromycin, tetracycline, sulfas (+TMP), penicillin), with the other just being variations on the theme (can't use penicillin -> use cephalosporin etc.). That seems alarmingly too little. I also know it is a good idea to know the options for the main bugs (strep, staph, pseudomonas, h. pylori,...). But how far do they go with those (to me) annoying gram negative rods? Memorizing the Rx differences for campylobacter vs. serratia vs. klebsiella vs... drives me crazy.
Any advice would be appreciated, since I'm taking it in 2 days. Thanks.

 

[PuGanDoo]

I actually didn't get any in-depth questions tx regimens. I would focus on knowing your main mechanisms of action and specific features of the drugs and which drugs are effective for gram (+) vs. gram (-)-- i.e. the big picture stuff. This was more high yield for me than wasting time with regimens at this stage of the game.

Good luck!

 

[xjacob]

Thanks for the answer PuGanDoo, it reads nicely after I just took the exam 🙂
Anyway, at least I can answer myself.
No, the antibiotics that I got were pretty simple, no odd combinations for odd bugs. Side-effects and resistance mechanism were probably the hardest things. (e.g. what alternative should you use if someone is allergic to penicillin for a particular bug etc.).

 

[PuGanDoo]

Sorry about the late response... haven't been to this board in awhile! Perhaps it will help someone else out.

Congrats on finishing. Now it's time to relax, forget about it, and move on to better things! Enjoy.

 

[Pegsie]

I don't want this to be one of the potentially annoying, vague "what's on the test" questions, but I think this is a reasonable thing to ask:

How deep does step 1 go into treatment of infectious diseases? I realize that we prob. won't be asked for 3rd line antibiotic choices, but I noticed that 90% of the bugs I know can be trated with one of 4 main Abx (erythromycin, tetracycline, sulfas (+TMP), penicillin), with the other just being variations on the theme (can't use penicillin -> use cephalosporin etc.). That seems alarmingly too little. I also know it is a good idea to know the options for the main bugs (strep, staph, pseudomonas, h. pylori,...). But how far do they go with those (to me) annoying gram negative rods? Memorizing the Rx differences for campylobacter vs. serratia vs. klebsiella vs... drives me crazy.
Any advice would be appreciated, since I'm taking it in 2 days. Thanks.

Most of my questions were like that, too--but I got two questions on prophylaxis for close contacts, which I hadn't thought about at all. And, some of the drugs could actually be reasoned out; for example, for meningitis you need something that is cidal (not static)--and I think most cidal drugs affect the cell membrane.

 

[lord_jeebus]

I had two of these kinds of questions.

One was an antibiotic indication that everyone should know reflexively.

The other case was very strange and unique, and the drug choices were not the kinds of drugs that would be first line for many things. I think they needed to make the case weird so some more common drug would not suffice. It might be useful to study the most common situation in which you would use classic USMLE antibiotics.

 

[freddydpt]

I had two of these kinds of questions.

One was an antibiotic indication that everyone should know reflexively.

The other case was very strange and unique, and the drug choices were not the kinds of drugs that would be first line for many things. I think they needed to make the case weird so some more common drug would not suffice. It might be useful to study the most common situation in which you would use classic USMLE antibiotics.

Ok, so these are things "I've heard" are on the exam:

Itraconazole for Sporothrix
and Ceftriaxone for Gonorrhea
Also, know uses for Penicillin and Metronidazole