7/22/16 Flashcards
abx for uncomplicated UTI
nitrofurantoin for 3 days
abx for pyelonephritis until culture results are known
amp and gent
abx for acute prostatitis until culture results are known
TMP/SMX or fluoroquinolones (-floxacin)
what two organisms if found in blood culture in a pt with bacterial endocarditis should be followed by colonoscopy?
clostridium septicum and strep bovis
in who should you suspect strep viridans endocarditis and what is the tx?
pts with previously damaged heart valves; ceftriaxone
abx for culture negative endocarditis
ceftriaxone
most common neurological manifestations of Lyme disease
bilateral facial nerve (CN7) or Bell palsy (can also cause encephalitis or meningitis)
most common cardiac manifestation of Lyme disease
transient AV heart block
tx of cardiac or neurologic manifestations of Lyme disease other than facial nerve (CN7) palsy
ceftriaxone (doxycycline in earlier stages)
abx for neonatal meningitis
amp and gent
abx for adult meningitis
ceftriaxone and vancomycin
gram positive cocci in pairs vs gram negative cocci in pairs
gram positive diplococci: strep pneumo
gram negative diplococci: neisseria
gram negative coccobacilli (small rods)
haemophilus
plump gram negative rod with thick capsule (mucoid appearance)
klebsiella
gram positive rods that form spores
clostridium, bacillus
fluoroquinolones that provide atypical pneumonia coverage
levofloxacin and moxifloxacin
abx for community-acquired pneumonia
macrolide (azithromycin, clarithromycin), doxycycline, third-generation cephalosporin (ceftriaxone, ceftazidime) with a macrolide or doxycycline
how to identify and tx H. influenzae pneumonia
gram negative coccobacilli on sputum gram stain; amoxicillin or second- (cefuroxime, cefoxitin, cefotetan) or third-generation (ceftriaxone, cefazidime) cephalosporin
what organisms cause pneumonia in cystic fibrosis pts?
staph aureus and pseudomonas
currant jelly sputum pneumonia
klebsiella
abx for pseudomonas
ticarcillin, piperacillin plus beta lactamase inhibitor (clavulanic acid or tazobactam)
pneumonia with positive cold agglutinin antibody titers
mycoplasma
tx for pneumocystis jiroveci pneumonia (PCP)
TMP/SMX
tx for CMV pneumonia
valganciclovir
pneumonia after exposure to a parrot or exotic bird
chlamydophila psittaci
fungus ball/hemoptysis after TB or cavitary lung disease
aspergillus
fever, muscle pain, eosinophilia, and periorbital edema after eating raw meat
trichinella spiralis
cellulitis after dog/cat bites (organism and ppx)
pasteurella multocida; amox-clav to anyone who gets a bite
tiny white spots on buccal mucosa 3 days after fever, cough, runny nose and conjunctivitis in an unimmunized pt
rubeola (measles)
medications that improve long-term survival in pts with left systolic dysfunction (ejection fraction less than 40%)
ACE-i/ARBs, beta blockers, aldosterone antagonists (combination of hydralazine and nitrates in African-American pts)
what are two problems encountered by female pts with primary hypothyroidism?
menstrual irregularities (due to decreased FSH and LH) and hyperprolactinemia (TRH-incuced stimulation of lactotrophs)
when does the first-line tocolytic change? what are they (name and type of medication)?
less than 32 weeks: indomethacin (COX inhibitor)
32-34 weeks: nifedipine (calcium channel blocker)
a mom develops FLUSHING, headache, tachycardia, palpitations after receiving a tocolytic. what medication (name and type) was she given?)
nifedipine (calcium channel blocker) causes peripheral vasodilation which leads to these side effects
what are the side effects of indomethacin when it is used as a tocolytic? compare maternal vs fetal
maternal: gastritis, platelet dysfunction
fetal: oligohydramnios, closure of ductus arteriosus
what kind of drug is terbutaline and what is a dangerous side effect?
beta agonist used as second-line tocolytic; pulmonary edema
dx and tx for pts who have yellowish streaks on their palms, milky and opalescent blood samples, and who presents with pancreatitis after partying
hypertriglyceridemia; fenofibrate
combination OCPs increase the risk for ________ and decrease the risk for ________
increase: breast and cervical cancer (slightly), HTN, venous thrombosis
decrease: endometrial and ovarian cancer
what is the initial tx for torsades de pointes?
magnesium sulfate
