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Awesome Review Flashcards

1
Q

Initial antibiotics for endocarditis with prosthetic valve

A

Vanco
Gent
Rifampin

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2
Q

antibiotics for endocarditis with prosthetic valve and MSSA sensitivity

A

Ceftriaxone/nafcillin
Gent
Rifampin

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3
Q

antibiotics for endocarditis with prosthetic valve and MRSA sensitivity

A

Vanco
Gent
Rifampin

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4
Q

antibiotics for endocarditis with prosthetic valve and PCN sensitive streptococcus

A

Ceftriaxone / nafcillin

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5
Q

antibiotics for endocarditis with prosthetic valve for PCN resistant streptococcus

A

Ceftriaxone

Gent

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6
Q

Initial antibiotics for endocarditis in native valve or IVDU

A

Vanco

Gent

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7
Q

antibiotics for endocarditis in native valve or IVDU with MSSA sensitivities

A

Ceftriaxone / nafcillin

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8
Q

antibiotics for endocarditis in native valve or IVDU with MRSA sensitivities

A

Vanco

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9
Q

antibiotics for endocarditis in native valve or IVDU with PCN sensitive streptococcus

A

Ceftriaxone / nafcillin

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10
Q

antibiotics for endocarditis in native valve or IVDU with PCN resistant streptococcus

A

Ceftriaxone

Gent

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11
Q

5 Indications for surgery when there is endocarditis

A 
Severe CHF
Persistent bacteremia (repeat blood Cx in 7 days +? That is time for surgery)
Recurrent emboli
Valve abscess 
Large fungal vegetation
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12
Q

Medication used in RIGHT side endocarditis with septic emboli

A

Daptomycin

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13
Q

Side effects of linezolid

A 
Thrombocytopenia 
Neutropenia
Serotonin syndromes
Lactic acidosis 
Optic neuritis
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14
Q

Enterococcus Infective endocarditis usually affects which valve

A

Aortic

Lower mortality

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15
Q

Endocarditis affecting which valve is associated with conduction defects?

A

Aortic

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16
Q

Replace valve if endocarditis causes the following:

A

Severe CHF not responsive to medical Rx
Severe aortic regurgitation
Valvular abscess

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17
Q

Patient with endocarditis develops first degree heart block - next step?

A

TEE r/o valvular abscess

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18
Q

Antibiotic prophylaxis for these following six patient conditions

A 
Prev endocarditis 
Congenital heart disease
Repaired CHD within 6 mo
Repaired CHD w/prosthesis or patch or residual defect 
All prosthetic valves
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19
Q

High risk procedures that need endocarditis prophylaxis consideration

A

Dental procedures involving bleeding and increased risk of inducing bacteremia

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20
Q

Antibiotic of choice for endocarditis prophylaxis

A

Amoxicillin 2g one hr prior

IV ampicillin

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21
Q

Antibiotic of choice for endocarditis prophylaxis if PCN allergic

A

Azithromycin or Clindamycin

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22
Q

Post procedure antibiotics for endocarditis prophylaxis

A

Nothing

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23
Q

Patient with staph aureus BACTEREMIA - what next ?

A

Reflex TEE

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24
Q

Echo neg for vegetation and antibiotics given for staph aureus bacteremia but blood cx positive after 72 hours on antibiotics

A

Continue antibiotics X 4 weeks

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25
Q

Echo neg for vegetation and antibiotics given for staph aureus bacteremia but blood cx negative in

A

Continue antibiotics X 2 weeks

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26
Q

Echo neg for vegetation and antibiotics given for staph aureus bacteremia but blood cx positive in immunocompromised patient

A

Continue antibiotics X 4 weeks

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27
Q

Echo neg for vegetation and antibiotics given for staph aureus bacteremia but blood cx positive in patient with prosthetic valve or cardiac device or arthroplasty

A

Continue antibiotics x 4 weeks

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28
Q

Echo POSITIVE for vegetation and antibiotics given for staph aureus bacteremia how long do u continue antibiotics

A

6-8 weeks

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29
Q

What other medication is good for right sided endocarditis in IVDU if no vanco available

A

Daptomycin

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30
Q

Empiric treatment of meningitis if + head trauma (organism and Med)

A

MRSA
S. Pneumo
GNR

Vanco
Cefepime

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31
Q

Empiric treatment for meningitis for patient >FIFTY (50)

Name organism and Medication

A

Listeria
S. Pneumo
N. Meningitidis

Ampicillin
Ceftriaxone
Vanco

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32
Q

Empiric treatment for meningitis in a teenager / young adult

Name organism and Medication

A

S. Pneumo
N. Meningitidis
H. Influenza

Ceftriaxone

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33
Q

Empiric treatment for meningitis for a baby

Name organism and Medication

A

S. Agalactiae
Listeria
E. Coli

Ceftriaxone
Ampicillin

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34
Q

Best treatment for confirmed listeria meningitis

A

Ampicillin and gentamicin

Synergistic

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35
Q

If PCN resistant S. Pneumo suspected in meningitis what is replacement Med for ceftriaxone ?

A

Vanco + rifampin instead

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36
Q

Eponym for benign recurrent lymphocytic meningitis. What causes it? Treatment?

A

Mollert’s meningitis
HSV2
Supportive Rx (no antiviral)

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37
Q

Confirmation for and treatment of herpes encephalitis ?

A

CSF PCR

IV acyclovir

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38
Q

Deep tendon reflexes absent in a patient with suspected meningitis of what cause?

A

West Nile virus

Test IgM antibiodies

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39
Q

Most important prognostic factor for west Nike virus ?

A

Age >75

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40
Q

Suspect HSV meningitis s/ Rx but HSV PCR negative and pt now with choreaform movements

A

NMDA receptor encephalitis

Rule out ovarian teratoma

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41
Q

What trophozoite can invade cribiform plate when u are swimming in lake? Treatment!?

A

Naeglaria fowleri

Miltifosinefrom CDC

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42
Q

Patient with confirmed meningococcal meningitis who to prophylaxis and with which antibiotic

A

Household contacts
Day care/nursery contacts

Rifampin 600 BID X 2 days (jealous drug like St. John’s wort)
If no rifampin, cipro X 1 dose
If pregnant - ceftriaxone 250 mg X 1 dose

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43
Q

Precautions for meningococcal meningitis

A

DROPLET precaution X 24 hrs while on antibiotics

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44
Q

How to treat recurrent UTIs after coitus

A

Daily bactrim

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45
Q

Treatment of Asymptomatic bacterURIA only for …

A

Pregnant women

Post transplant patient

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46
Q

Treatment for complicated uti with ESBL

A

PO phoshomycin x 3 days

If no improvement give meropenam

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47
Q

Which HSV causes meningitis and encephalitis

A

2 meningitis

1 encephalitis

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48
Q

Treatment for uncomplicated cystitis

A

Bactrim
Or
Cipro
Or Nitrofurantoin

X THREE (3) days

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49
Q

Symptoms of uncool cares cystitis persist after 3 days of antibiotics, what next

A

Get culture and sensitivity

Treat for SEVEN (7) days

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50
Q

Treatment for cystitis In Pregnancy

A

Nitrofurantoin
Or
Amoxicillin

X SEVEN (7) days

However according to MKSAP Nitrofurantoin is contraindicated in 3rd trimester (#21)

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51
Q

Treatment for uncomplicated pyelonephritis

A

Fluoroquinolone

X 7-10 days

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52
Q

Treatment for pyelo when pregnant

A

Admit
IV ceftriaxone
Or IV ampicillin and gentamicin

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53
Q

Treatment for pregnant lady with pyelonephritis and PCN allergy

A

Aztreonam

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54
Q

Treatment for prostatitis

A

Flouroquinolone

X 4-6 WEEKS

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55
Q

Treatment for gonorrhea

A

Ceftriaxone 250 mg IM X 1

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56
Q

Treatment for chlamydia

A

Azithromycin 1 g X 1 day

Or

Doxycycline 100 BID X 7 days

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57
Q

Strawberry cervix seen - what is organism and how to treat

A

Anaerobic trichomonas

Metronidazole 2g ONCE

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58
Q

Treatment for Candidiasis in pregnant female

A

Topical clotrimazole

X SEVEN 7 days

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59
Q

Cause of and treatment for bacterial vaginosis

A

Gardenerella
Metronidazole 500 BID
X SEVEN 7 days

Or

Metro gel 0.75%
X FIVE 5 days

Or

Clindamycin cream 2% daily
X SEVEN 7 days

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60
Q

Which test is used to detect chlamydia

A

Urine PCR

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61
Q

When should you recheck for chlamydia reinfection if you treated it recently ?

A

Check after 3 weeks post treatment

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62
Q

Treatment for mycoplasma genitalium?

A

Moxifloxacin

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63
Q

Most common organism for epididymitis?

A

35 ecoli enterobacter

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64
Q

Treatment for epididymitis

A

35 levofloxacin

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65
Q

Genital herpes treatment for first attack; second attack and frequent recurrences

A

First - acyclovir X 10 days
Second - acyclovir X 5 days
Recurrent - acyclovir prophylaxis indefinitely

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66
Q

Treatment for haemophilus ducreyi

A

Ceftriaxone 250 mg IM X 1

Or

Azithromycin 1 g X 1

Or

Erythromycin 500 QID X 7 days

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67
Q

Which gram negative bacillus is described as “school of fish” or “box car appearance”

A

Haemophilus ducreyi

68
Q

Painless ulcer causing buboes fistulas and rectal scarring

A

Lymphgranuloma venereum (chlamydia)

69
Q

Treatment for lymphgranuloma venereum

A

Doxycycline 100 BID X 21 days

70
Q

Painless ulcers that look like carcinoma of the penis revealing Donovan bodies (bipolar safety pin intracytoplasmic inclusions)

A

Granuloma inguinale

Klebsiella granulomatis

71
Q

Treatment for granuloma inguinale

A

Doxycycline 100 BID X 21 days

Or

Bactrim

Or

Erythromycin

72
Q

RPR negative one year ago now 1:8 what to do

A

Early latent syphilis

Rx Benz PCN 2.4 million units ONCE

73
Q

RPR negative >1 year ago now 1:8 what to do

A

Late latent syphilis

Rx Benz PCN 2.4 million units WEEKLY X 3

74
Q

Test preferred to be used to check for secondary syphilis

A

VDRL / RPR

because FTA positive for life

75
Q

If you suspect neurosyphilis but spinal tap VDRL negative but WBC super high what do you do?

A

Treat as if positive with PCN G 2 million units q4 hours X 2 weeks

76
Q

Patient has neurosyphilis but is PCN allergic what now?

A

Desensitize and recheck spinal tap q6 months till WBC CSF normalize

77
Q

Patient experiences jarisch herxheimer reaction what to do?

A

Continue PCN for syphilis Rx
Bedrest
Aspirin

78
Q

Illness to treat with doxycycline (Name five)

A 
Chlamydia 
RMSF
Lyme's disease 
Anaplasma 
Ehrlichia
Lymphgranuloma venereum (chlamydia)
Granuloma inguinale (kleb)
Cat scratch disease (bartonella henslae)
Plague
Leptospirosis
Brucellosis
Q fever
79
Q

Treatment for tick borne illness associated with Maltese cross or tetrads under microscope

A

Mild babesia
Atoquavone
Azithromycin

Severe babesia
Quinine
Clindamycin

80
Q

Name of rash for stage 1 Lyme

A

Erythema chronicum migrans

81
Q

Stage 2 Lyme heart block treatment

A

Ceftriaxone X 10-28 days

82
Q

72 hours after hiking you found a tick but u have no rash and no other symptoms do you treat?

A

Yes, doxycycline 200 mg ONCE

83
Q

How to treat tick induced paralysis

A

Remove the tick

84
Q

Must follow which lab test weekly when on daptomycin?

85
Q

Best imaging for confirming necrotizing fasciitis

86
Q

Treatment for vibrio vulnificus

A

Aggressive debridement

IV cephalosporin 3rd gen

Or

Tetracycline/Gentamicin

87
Q

Treatment for fish tank cleaner with mycobacterium marinum

A

Clarithromycin
Ethambutol
+/- Rifabutin

88
Q

Treatment for rose gardener with sporotrichosis

A

Itraconazole

Or

Amphoteric in B if disseminated

89
Q

Treatment for pseudomonas associated hot tub folliculitis

A

Nothing

Self limited

90
Q

Patient using indoor hot tub now with cough and CXR with thin walled cavities

A

MAI causing hypersensitivity pneumonitis

91
Q

Neutropenia patient with black central ulceration and cellulitis - worry about what?

A

Ecthyma gangrenosum caused by pseudomonas

92
Q

Antibiotics for pseudomonas (4)

A

Zosyn
Ceftazidime
Cefepime
Meropenem

93
Q

What kind of isolation for herpes zoster?

A 
1 dermatome (contact)
2+ dermatomes (contact)(airborne)

But if patient is immunocompromised contact and airborne no matter what

94
Q

Treatment for post heretic neuralgia

A

Desipramine > gabapentin / pregabalin

95
Q

Single dermatomal rash herpes zoster with symptoms >72 hours - to treat or not to treat

A

Treat with acyclovir / valacyclovir / famciclovir only if >50 with new lesions appearing or with immunosuppression (HIV on steroids or TNFs)

96
Q

Shingles vaccine recommended by CDC starting at what age?

97
Q

How to differentiate smallpox from chickenpox on physical exam

A

Smallpox crops all same age

Chickenpox crops all different stages

98
Q

Isolation for chickenpox

A

Contact

Airborne

99
Q

Pregnant mom with chickenpox kid 1. What to do for immunosuppression kid 2 and her and yourself ?

A

Immunosuppressed kid 2 needs VZIG

Check titers in pregnant mom and yourself

If low, pregnant mom gets VZIG and treatment for symptoms
If low, you get vaccine

100
Q

Dx for Pustules on hands after letting them touch monkey at a fair or touching a wild dog

A

Monkey pox

101
Q

Hand foot mouth disease is caused by what?

A

Coxsackie virus A

102
Q

Rat feces aerosolized in south west USA now everyone had incr hematocrit and resp failure from what ?

A

Hanta virus

103
Q

Man with NO prior vaccinations gets bitten by a bat - what next ?

A

Rabies immune globulin now

Rabies vaccine now, day 3, day 7 and day 21

104
Q

Man with all prior vaccinations gets bitten by a bat - what next?

A

Rabies vaccine now and on day 3

105
Q

P falciparum prophylaxis

A

Mefloquine 1 week prior to departure and 4 weeks after landing back in USA

Or

Atovaquone/proguanil 1 DAY prior to departure and 1 week after landing back in USA

106
Q

Malaria treatment of p falciparum

A

Quinine
Doxy

Or

Atovaquone
Proguanil

Or

Quinidine
Clinda

Or

Artemisinin
Amodiaquine

107
Q

Mosquito bite in the Florida Keys area what illness are you worried about

A

Dengue

Fever
Rash
Anemia
Thrombocytopenia

108
Q

Dental caries
Tender mandible
Brawny edema
Neck tenderness

What is the eponym for this condition

A

Ludwig angina

Caused by peptostreptococcus + anaerobes

109
Q

Treatment of lugwig angina

A

Amox/clav

Or

Amp/sulbac

110
Q

Neutropenia fever - what medications to start empirically?

A

Cefepime or Meropenem
If IV line + or fever >3d Vanco
If fever >7d Voriconazole

111
Q

Anti fungal shown to improve mortality when given prophylactically to Pts with post chemo
Neutropenia

A

Posaconazole

112
Q

Treatment of aspergillosis

A

Voriconazole

113
Q

Treatment for weakly acid fast gram + filament and branching agent that affects the skin lungs and brain

A

Nocardia

Rx bactrim

114
Q

Beta D glucan used to rule out what?

115
Q

Galactomanin used to rule out what?

A

Aspergillosis

116
Q

Empiric treatment for osteomyelitis with prosthetic joint implant

A

Vanco
Gent
Rifampin

117
Q

Mucormycosis with right angle branching filaments in a poorly controlled diabetic pt - how to treat?

A

Surgical debridement

Amphotericin B

118
Q

Name three medications that can treat hospital grade MRSA

A

Vanco
Daptomycin
Quinupristine/dalfopristin

119
Q

Treatment for ESBL

A

Fosfomycin

Or

Meropenem

Or

Tigecycline (not good for urine)

Or

Colistin (polymyxin)

120
Q

Treatment for stenotrophomonas because it causes high mortality in cystic fibrosis patients

121
Q

Which organism can be treated with antibiotics WITHOUT d/c of central line?

122
Q

You suspect mono in a young patient but monospot negative for heteropjile antibodies - what now?

A

Monospot insensitive

Use EBV viral capsid antigen (VCA IgM)

123
Q

Monospot + with enlarging tonsils and shortness of breath - what Med to give ?

124
Q

Name gram positive rods

A 
Bacillus anthracis
Clostridium
Corynebacterium 
Listeria 
Mycobacterium 
Proprionibacterium
125
Q

Treatment of anthrax

A

PCN

Or

Fluoroquinolone

126
Q

Isolation precaution for person infected with anthrax

A

None

Not transmissible via person to person

127
Q

Hunter of rabbits develops tender nodes and ulcers and pneumonia. How to treat ?

A

Rx tularemia with streptomycin X 7-10 days

128
Q

Isolation for plague

129
Q

What is the culprit in culture negative endocarditis with positive cryoglobulins but hep C negativity

130
Q

Patient from Middle East with enlarged liver - you are suspicious for ?

A

Hydatid cysts from Echinococcus granulosus

131
Q

Young veteran returns with ulcerated lesions with eschar and erythema around arms - what do you suspect

A

Cutaneous leishmaniasis

132
Q

Isolation for neissieria, influenza and plague

A

Standard

Droplet

133
Q

Isolation for MTB

A

Standard

Airborne

134
Q

Isolation for varicella

A

Standard
Contact
Airborne

135
Q

Isolation for measles

A

Standard

Airborne

136
Q

Isolation for scabies

A

Standard

Contact

137
Q

Isolation for c diff

A

Standard

Contact

138
Q

Isolation for HSV one dermatome

A

Standard

Contact

139
Q

Isolation for HSV >2 dermatomes

A

Standard
Contact
Airborne

140
Q

Isolation for MRSA And VRE

A

Standard

Contact

141
Q

ELISA + but western blot negative for HIV - what to tell patient with no symptoms

A

HIV negative

ELISA is like ANA
Western blot is like anti smith

142
Q

Symptomatic with cough lymphadenopathy and aphthous ulcers but ELISA for HIV and monospot negative - what to do ?

A

Check HIV RNA PCR for viral load r/o acute viral syndrome

143
Q

Nurse with needle stick by HIV positive patient - what is empiric treatment

A

Get baseline ELISA

Raltegravir + 2 NRTIs

Recheck HIV in 4 weeks
Negative ? Stop meds .

144
Q

Positive PPD if HIV + is how much induration

145
Q

TREATMENT of PCP with sulfa allergy

A

Cannot give bactrim

Clinda
Primaquine

146
Q

Addition of what medication for PCP treatment if PaO2

147
Q

Creatinine rises while on bactrim - what to do?

A

Normal
Trimethoprim inhibits tubular secretion
Continue medication

148
Q

PROPHYLAXIS of PCP with sulfa allergy

A

Dapsone

Or

Atovaquone

149
Q

How to treat toxoplasmosis

A

Sulfadiazine

Pyrimethamine

150
Q

Treatment for recurrent candidiasis on fluconazole

A

Itraconazole suspension

Or

Caspofungin

151
Q

Treatment for cryptococcal meningitis in HIV + patient with CD4

A

Amphotericin B
Flucytosine

Then switch to fluconazole

152
Q

Treatment of CMV retinitis in HIV patient with CD4

A

Ganciclovir

Or

Foscarnet

Or

Cidofovir

153
Q

PML caused by

154
Q 
Name the associated CD4 counts with these infections:
PCP
Esophageal candidiasis 
Cryptococcal meningitis 
MAI
CMV
A

PCP and esophageal candidiasis

155
Q

Name PPX and treatment of PCP

A

PPX
Bactrim
Dapsone
Atovaquone

Rx
Bactrim
Clindamycin + primaquine

156
Q

PPX and RX of MAI

A

PPX
Azithromycin

Rx
Clarithromycin
Ethambutol
+- Rifabutin

157
Q

Best statin for HIV hypercholesterolemia

A

Pravastatin

158
Q

Avoid which statin in HIV patients

A

Simvastatin

159
Q

Best drug for insulin resistance : hyperglycemia in HIV patients

A

Metformin (watch for lactic acidosis with NRTIs)

160
Q

Best Med to use in HIV and hepatitis C

A

Raltegravir

Integrase inhibitor

161
Q

Which drugs are jealous drugs

A

Rifampin

St. John’s wort

162
Q

Which drugs increase drug toxicity because they inhibit p450

A

These drugs like to parrrtayy

Grapefruit juice
Itraconazole
Ketoconazole

163
Q

Patient diagnosed with HIV and cryptococcal meningitis - which to treat first

A

Cryptococcal meningitis

Then ~5 weeks later start HAART

164
Q

Patient diagnosed with HIV and TB which to treat first?

A

Treat both immediately

165
Q

What CD4 count do you start to treat HIV?

A

if HIV positive treat regardless of CD4 count

166
Q

Name five (5) live vaccines we should AVOID in Pregnancy and HIV + patients

A 
Intranasal influenza
Oral polio 
MMR
Varicella 
HZV
Yellow fever

Infectious Disease (1 decks)

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