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Infectious diseases > dif to remember > Flashcards

dif to remember Flashcards

1
Q

common cause of pneumonia in neonates (less than 4 weeks)

A
  1. S. agalactiae

2. E. coli

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2
Q

common cause of pneumonia in children (4wks - 18yr) (in order)

A
  1. viruses (RSV)
  2. mycoplasma
  3. C. trachomatis (infants - 3 years)
  4. C. pneumoniae (school-aged children)
    S. pneumoniae
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3
Q

common cause of pneumonia in adults (18-40yr) (in order)

A
  1. mycoplasma
  2. C. pneumoniae
  3. S. pneumoniae
  4. viruses (eg. influenza)
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4
Q

common cause of pneumonia in adults (40-65yr) (in order)

A
  1. S. pneumoniae
  2. H. infuenzae
  3. Anaerobes
  4. viruses
    5, Mycoplasma
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5
Q

common cause of pneumonia in elderly (in order)

A
  1. S. pneumoniae
  2. Influenza virus
  3. Anaerobes
  4. H Influenzae
  5. Gram (-) robs
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6
Q

Carbapenems - toxicity

A
  1. GI distress
  2. skin rash
  3. CNS toxicity (seizurs) at high plasma levels (less risk with meropenem)
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7
Q

progressive disseminated histoplasmosis - how to diagnose

A

urine or serum histoplasma antigen
also pancytopenia
- cultures takes 4-6 wks

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8
Q

progressive dissaminated histoplasmosis - treatment

A

amphotericin B for 1 week –> after clinical improvement –> oral intraconazole for 1 year

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9
Q

Amphotericin B - toxicity

A
  1. fever/chills (shake and bake)
  2. Hypotenesion
  3. nephrotoxicity
  4. arrhythmias
  5. anemia
  6. IV phlebitis
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10
Q

Malaria - treatment for every situation

A
  1. Chloroquine (for sensitive species)
  2. Mefloquine or atovaquone/proquanil (for resistant)
  3. IV quinidine or artesunate (If life threatening) –> test for G6PD
  4. P. vivax/ovale add primaquine for hypnozoite –> test for G6PD
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11
Q

treatment for all protozoal infections (except malaria)

A

Giardiasis –> Metronidazole
amebiasis –> metronidazole, iodoquinol for asymptomatic cyst passers
cryptosporidium –> prevention by filtering city water supplies, nitazoxanide in immunocompetent, no clear treatment for aids
Toxoplasma gondi –> Sulfadiazine+pyrimethamine
Naegleria fowleri –> Amphotericin B
Trypanosoma brucei –> Suramin for blood-borne disease or melarsoprol for CNS penetration
Babesia –> atovaquone + azithromycin
Tripanosoma cruzi –> Benzidazole or nifurtimox
Leishmania donovavi –> amphotericin sodium stibogluconate
trichomonas vaginalis –> Metronidazole for patient and partner (prophylaxis)

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12
Q

Babesia - treatment

A
  • atovaquone + azithromycin

- Quinine + clindamycin (if severe)

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13
Q

malaria prevention

A

travelers new to endemic areas require chemoprophylaxis
atovaquone - proguanil, doxycycline or melfoquine (2 weeks prior to travels, continued during statyy, discont 4 weeks after returning
other measures to protect from mosquitos

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14
Q

Antihelmintihic therapy - drugs

A
  1. Menbendazole
  2. Pyrantel paomate
  3. Ivermectin
  4. Diethylacarbamazine
  5. Praziquantel
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15
Q

neurocysticercosis - presentation and treatment

A 
1. seizures  2. focal neurological deficit 
hydrocephalus 
treatment: 1. seizure/ICH management
2. antiparasaitic: albendazole
3. corticosteroids
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16
Q

Echinococcus granulosus - treatment

A

albendazole
percutaneous therapy (if more than 5 cm or septations)
- if rupture: surgery

17
Q

pediatric septic arthritis - organisms and treatment

A
  • 0-3 momths:staph, agalacte, gram (-) bacilli): antistaphylococcal + GEentamicin or cefotamice
  • older than 33 months: staph, Strep pyogenus, strep pneumoneia: nafcillin, clindamycin, cefazolin or vancom
18
Q

neonatal sepsis - diagnosis / treatment

A

blood, urine, CSF culture

parenteral antibiotic therapy (eg. ampicillin + gentamycin)

19
Q

endocarditis - viridans susceptivle to penicillin - next step

A

treated with IV penicillin G or IV ceftriaxone for 4 wks

never oral in the beginning

20
Q

vaccines for adults with HIV

A
  1. HBV
  2. HAV: chronic liver disease, men sex men, IV drugs
  3. HPV if 11-26
  4. influenza: inactivated, annually
  5. Mening: all
  6. Pneumonioc: PCV13 once, PPSV23 8 ks later, 5 yyears later + at age 65
  7. Tdap as needed and each pregnancy
21
Q

HIV Protease inhibitors - toxicity

A
  1. hyperglycemia
  2. GI tolerance (nausea, vomiting)
  3. Lipodystrophy (Cushing-like syndrome)
  4. Nephropathy (indinavir)
  5. hematuria (indinavir)
  6. inhibit cytochrome P-450 (ritonavir)
22
Q

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) - side effects

A
  1. Bone marrow suppression
  2. peripheral neuropathy
  3. lactic acidosis (nucleosides)
  4. anemia (ZDV)
  5. pancreatitis (didanosine)
23
Q

Non-nucleoside reverse transcriptase inhibitors (NNRTI) - toxicity

A
  1. rash
  2. hepatotoxicity
  3. vivid dreams (efavirenz)
  4. CNS sympoms (efavirenz)
  5. contraindicated in pregnancy (Delavirdine and efavirenz)
24
Q

TB - PPD - when is (+) at 5 or more mm

A
  1. HIV (+),
  2. recent contacts of known TB case
  3. Nodular of fibrotic changes on chest x-ray (previous healed TB)
  4. organ transplant or other immune
25
Q

leprosy - diagnosis and treatment

A

diagnosis: full thickness biopsy of skin lesion
treatment: dapsone + rifampin, add clofazimine if sever

26
Q

M. intracellulare-avium - prophylaxis and treatment

A

prophylaxis: azithromycin, rifabutin
treatment: Azithromycin or clarithromycin + ethambutol
Can add rifabutin or ciprofroloxacin

27
Q

human monocytic ehrlichiosis - labs

A

leukopenia + thrombocytopenia

- elevated liver enzymes + LDH

28
Q

high risk wild animals for rabies

A
  1. bat
  2. racoon
  3. skunk
  4. fox
  5. coyote
29
Q

low risk wild animals for rabies

A
  1. squirrel
  2. chipmunk
  3. mouse/rat
  4. rabbit
30
Q

vibrio vulnificus - treatment

A

empiric in those with likely illness as highly fatal

IV ceftriaxone + doxycycline

31
Q

vibrio vulnificus - diagnosis

A

blood + wound cultures

32
Q

Legionella - clinical clues

A
  • fever (higher than 39)
  • Bradycardia relative to high fever
  • neurological symptoms (esp confusion)
  • GI symptoms (esp diarrhea)
  • Uneresponsive to beta lactam + aminoglycoside
33
Q

Legionella - Labs

A
  • low Na+
  • hepatic dysfunction
  • hematuria + proteinuria
  • Sputum gram stain showing many neutrophils, but few or no organisms
34
Q

PCV - recommended vaccines for adults

A
  • if 65 or older: 1 dose of PCV13 followed by PPSV23 at 6-12 months later
  • 19-64: PPSV23 alone in heart or liver disease, DM, smoker, alcoholic
    OR both (LIKE OLDER THAN 65) in very high risk: CSF leak, cochlear implants, SCD, aspenia, immne, kidney disease, HIV
35
Q

Hospital acquired pneumonia treatment

A

vancomycin + tazosin

36
Q

MRSA pneumonia - people?

A

superinfection in young people with inf infection

  • rapidly progressive necrotizing pneumonia, often fatal
  • malitlobular cavitary infiltrates
  • often causes leukopenia
37
Q

bacterial mengitis empiric therapy in older than 50 … (common organisms)

A

S. pneum, N. menig, Listeria

vancom + 3rd gener ceph + Ampicillin

38
Q

bacterial mengitis empiric therapy in immonocompromised … (common organisms)

A

S. pneum, N. menig, Listeria, gram (-) robs
vancom + Ampicillin + cefepime
alternative to cefepime: meropenem or ceftazidime

39
Q

bacterial mengitis empiric therapy in neurosurgery/penetrating skull trauma … (common organisms)

A

Gram (-) robs, MRSA, coagulase (-) staph

Vancom + cefepime

Infectious diseases (13 decks)

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