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Infectious Diseases > Awesome Review > Flashcards

Awesome Review Flashcards

1
Q

Broad Spectrum Abx for Prosthetic Valve Endocarditis

A

Vancomycin Rifampin Gentamycin

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2
Q

Broad Spectrum Abx for Native Valve or IVDA Endocarditis

A

Vancomycin Gentamycin

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3
Q

Indications for Surgery in Endocarditis

A

Severe CHF, persistent bacteremia (blood cultures positive after 7 days), recurrent emboli, valve abscess, large fungal vegetation

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4
Q

Abx Ppx for Endocarditis

A

High Risk Conditions and High Risk Procedures
Amoxicillin 2 grams PO 1 hour before
If PCN allergy- Azithromycin or Clindamycin

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5
Q

What is considered high risk condition needing Endocarditis prophylaxis? (5)

A

Prosthetic Valve
History of IE
History of Congenital Heart Disease repair within 6 months or with prosthesis/patch
History of unrepaired shunted congential Heart Disease
Heart Transplant with valvular disorders

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6
Q

Abx in Suspected Meningits if head trauma or neurosurgery

A

Vancomycin Cefepime (cover for pseudomonas)

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7
Q

Abx in Suspected Meningitis if > 50 yo

A

Ampicillin Ceftriaxone Vancomycin (in case it’s resistant)

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8
Q

If you see RBCs in Lumbar Puncture, wtd?

A

Thinks HSV encephalitis and start IV Acyclovir

Dx: PCR of CSF

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9
Q

If you are Suspecting Strep Pneumo Meningitis, what else do you give (15 minutes before Abx)

A

Dexamethasone!

Pneumococcal meningitis can cause hearing loss and seizure

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10
Q

What the eff is Mollaret’s Meningitis?

A

Benign and recurrent Lymphocytic meningitis caused by HSV-2

Multiple episodes, lethargy with meningeal signs

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11
Q

Diagnose West Nile Encephalitis

Absent Deep Tendon Reflexes!

A

West Nile virus IgM antibody in CSF

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12
Q

If you suspect NMDA Encephalitis, what’s next?

A

Check Ultrasound Abdomen to look for ovarian teratoma and remove it!

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13
Q

Treat complicated UTI with ESBL

A

Forfomycin x 1 dose

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14
Q

How do you treat STI?

Chlamydia or Gonorrhea

A

Ceftriaxone 250 mg IM and Azithromycin 1 gram

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15
Q

If Ceftriaxone or Azithromycin doesn’t work for sexually transmitted disease (urethral discharge) what is it?

A

Mycoplasma Genitalium

Give Moxifloxacin

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16
Q

Why is Trichomonas tricky?

A

Strawberry cervix
Give Flagyl 2 grams x 1 dose or Tinidazole 2 grams x 1 dose
Test of cure in 3 months
AND treat partner (tricky to find that partner- Slut!)

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17
Q

Treat pregnant candidiasis

A

Topical Clotrimazole for 3-7 days

(Not preggo- fluconazole 150 mg x 1 dose

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18
Q

How to treat Lymphogranuloma Venereum or Granuloma inguinale (klebsiella granulomatis) ?

A

Doxy 100 mg BID x 21 days

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19
Q

Complication of Erysipelas

A

Endocarditis!

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20
Q

Organism in sickle cell Osteomyelitis

A

Salmonella

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21
Q

What if it seems like Vancomycin isn’t working? (Although it worked in the past?)

A 
Check Epsilon (e test) to accurately measure MIC
If > 2, vancomycin is useless- use Dapto instead
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22
Q

Horrible complication of infectious Mononucleosis?

A

Splenic rupture!

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23
Q

How do you save the day by picking up inhalational Anthrax?

A

CXR with widened mediastinum and pleural effusions

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24
Q

Blood Test for PCP?

A

Beta D glucan test

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25
Q

Treating cryptococcal meningitis with HIV?

A

LP to alleviate pressure

Amphotericin B and 5 Flucytosine induction and switch to long term fluconazole

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26
Q

Treating MAI or Mycobacteria marinum?

A

Clarithromycin, Ethambutol, +/- Rifabutin

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27
Q

What ART med causes Fanconi Syndrome?

A

Tenofovir

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28
Q

HIV patient needs a statin, which one?

A

Pravastatin

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29
Q

Earliest change seen in HIV therapy failure

A

Increasing viral load

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30
Q

Diagnose and treat:
Painful genital ulcers
Tender Inguinal suppurative lymphadenopathy
Microscopy- schools of fish or box car = gram neg bacillus

A

Haemophilus ducreyi

Ceftriaxone 250mg X 1
Azithromycin 1 gram X 1
Erythromycin 500 mg QID X 7 days

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31
Q

What organism causes Lymphogranuloma venereum?

A

Chlamydia trachomatis

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32
Q

What organism causes Granuloma Inguinale?

Microscopy- Donovan bodies (bipolar safety pin shaped intracytoplasmic inclusions)

A

Klebsiella granulomatis

Looks horrible!

33
Q

How to treat early latent syphillis?

A

Benz penicillin 2.4 million units X 1

34
Q

How to treat late latent syphilis?

A

2.4 million units weekly X 3

35
Q

Diagnose and Treat: Macular Rash, starting at distal extremities and progressing centrally, becoming petechial. Thrombocytopenia and transaminitis, lymphocyte predominant …

CAMPING

A

Rocky Mountain Spotted Fever
Doxycycline/Tetracycline
Chloramphenicol in pregnancy

36
Q

Difference btwn Ehrlichiosis and Anaplasmosis?

A

Ehrlichiosis is Human Monocytic ehrlichiosis via Lone Star Tick
Anaplasmosis is Human Granulocytic Anaplasmosis via Ixodes tick and have morulae (basophilic inclusion bodies made of bacteria clusters)

37
Q

Diagnose and Treat:
Fever, HA, myalgia, arthalgia, meningismus, leukopenia, thrombocytopenia, transaminitis

CAMPING

A

Ehrlichia

38
Q

Diagnose and Treat:
HA, fatigue, myalgias
hemolytic anemi, transaminitis, thrombocytopenia,
Maltese cross/tetrads in RBCs
Giemsa stain showing trophozoite ring inside RBC

A

Babesiosis via Ixodes Tick

Mild-Moderate: Atovaquone and Azithromycin
Severe: Quinine and Clindamycin x 6 weeks

39
Q

Patient with Early Disseminated Lyme but with 2nd or 3rd degree heart block, OR meningitis, treatment?

A

IV
Ceftriaxone or Penicillin G

If only 1st degree heart block or cranial nerve palsy- PO Doxy is fine

40
Q

How to treat Post Lyme Disease/Chronic Lyme?

S/Sx: fatigue, insomnia, diffuse pain, malaise

A

Supportive care

41
Q

SSTI Organism and Tx?
Liver Disease/transplant, exposure to saltwater/freshwater and seafood
HEMORRHAGIC BULLAE

A

Vibrio Vulnificus

3rd gen cephalosporin or Tetracycline/Gentamicin

42
Q

SSTI Organism and Tx?
Ulcerative papular lesions, ascending lymphatic spread
Swimming instructor or fish tank cleaner

A

Mycobacterium Marinum

Clarithromycin and Ethambutol and/or Rifabutin

43
Q

SSTI Organism and Tx?
Multiple nodules on forearm along lymph channels
Florist/Gardener

A

Sporothrix schenkii
If Local- Itraconazole
If Disseminated- Amphotericin B

44
Q

SSTI Organism and Tx?

Folliculitic Rash, history of jacuzzi/hot tub

A

Pseudomonas aeruginoas
SELF LIMITED
ONLY Pseudomonas you don’t treat

45
Q

SSTI Organism associated with cats?

SSTI Organism associated with dogs, especially asplenic patients?

A 
Pasteurella multocida (Augmentin) 
Capnocytophagia canimorsus
46
Q

Diagnose and Next Step?

Hyperesthesia over right forehead and single vesicular lesion on erythematous base on tip of right side of nose

A

Herpes Zoster with Hutchinson Sign

Worried about Zoster Opthalmicus and refer to Opthalmologist for emergency

47
Q

Treat Post Herpetic Neuralgia

A

Desipramine

48
Q

Type of isolation for single dermatome Herpes?

Type of isolation for more than 2 dermatomes Herpes?

A

Contact

Contact and Airborne

49
Q

Western United States/British Columbia causing Tick Borne Relapsing Fever

A

Borrelia hermsii

50
Q

MC organism after a fist fight?

A

Eikenella Corrodens

51
Q

Diagnose and Treat:
Frontal HA, Retro-orbital pain, myalgia, arthalgia, spontaneous bleeding (purpura, melena or conjunctival injection), faint morbiliform rash on trunk
Leukopenia, thrombocytopenia, transaminitis

A

Dengue hemorrhagic Fever via IgM/IgG or reverse transcriptase PCR
Supportive treatment

52
Q

Patient with neutropenic fever and need to cover antifungal infection (ie invasive aspergillius)

A

Voriconazole

53
Q

Which anti fungal has shown to improve mortality when prophylaxed in patient with post chemotherapy neutropenia?

A

Posaconazole

54
Q

What organism?

Posttransplant lymphoproliferative disease causing fever, lymphadenopathy and extranodal mass

A

EBV

55
Q

Halo Sign on CT Chest

Dense core and rim of ground glass appearance

A

Aspergillosis

56
Q

Blood test for Aspergillosis?

A

Galactomannan

57
Q

Blood test for PCP?

A

Beta D-Glucan

58
Q

Post-transplant prophylaxis for CMV

A

Valganciclovir for 1 year

59
Q

Organism and Treatment?

Thin Wall cavity in lung, Nodular lesion on skin, Ring enhancing lesion in brain, filamentous, branching gram positive

A

Nocardia

Sulfonamides/Bactrim

60
Q

Diagnose and Treat:
Inhaled causing dyspnea, hemorrhagic meningitis, hemorrhagic lymphadenitis, CXR with widened mediastinum and pleural effusions
(Box Car Bacilli- gram positive)

A

Anthrax- Bacillus Anthracis

Tx: Fluoroquinolone or PCN

61
Q

Bioterrorism Organism and Tx?
Gram Negative Coccobacilli
Skin Contact or aerozolized causing splenomegaly, hepatitis, Lymphadenopathy with fever, sweats

A

Brucellosis

Doxy

62
Q

Bioterrorism Disease and Tx?
Rickettsia
Inhaled causing atypical PNA, HA, fevers
from contaminated soil and animal products

A

Q fever

Doxy

63
Q

Bioterrorism Organism and Tx?
Fever, Hepatitis/Jaundice, AMS, Renal Failure, ecchymosis, liver hemorrhage, conjunctiva suffusion
sewage worker or Veteranarian (or TMNT!)

A

Leptospirosis via rodents

Doxy

64
Q

Bioterrorism Organism and Tx?
Fever, HA, Splenomegaly, erythematous lesions
Butcher, fisherman

A

Erysipelothrix

Doxy

65
Q

Which organisms need droplet precautions?

A

Neisseria, Influenza, Plague

66
Q

Which organisms need airborne precautions?

A

Herpes Zoster more than 2 dermatomes, Measles, Varicella, MERS, MTB

67
Q

Screening test for HIV

A

HIV 1/2 antigen/antibody combination immunoassay and p24 antigen

Note: p24 antigen is positive 1 week before immunoassay

68
Q

Confirmatory test for HIV

A

HIV 1/2 antibody differentiation immunoassay

If negative, check NAAT (nucleic acid amplification test)

69
Q

Prophylaxis if CD4

A

PCP, give Bactrim, Dapsone of Atovaquone

70
Q

Prophylaxis if CD4

A

Toxoplasmosis, give Bactrim

71
Q

Prophylaxis if CD 4

A

Mycobacterium Avium Complex, give Azithromycin

72
Q

Name 3 diseases that cause ring enhancing lesions

A

Toxoplasmosis, Brain Abscess, Lymphoma

73
Q

Pre exposure prophylaxis

A

Tenofovir and Emtrictabine (Truvada)

74
Q

Best inhaled steroid to use in HIV Asthmatic?

A

Beclamethasone

75
Q

Best HIV medication to use along with Hepatitis C therapy?

A

Raltegravir

76
Q

Side Effect of Pyrazinamide

A

Hyperuricemia and GOUT

77
Q

Side Effect of Rifampin

A

Rash
Drug Interactions
Hepatotoxicity
Orange secretions

78
Q

Side Effect of Isoniazid

A

Hepatotoxicity
Peripheral Neuropathy
Lupus like Syndrome
Monoamine poisoning

79
Q

Side Effect of Ethambutol

A

Retrobulbar neuritis

Decreased red green color discrimination

Infectious Diseases (1 decks)

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