double star Flashcards
BETA LACTAMS
pencillins
cephalosporins
LEVOFLOXACIN (LEVAQUIN) – CLASS
fluroquinolone
CEFTRIAXONE (ROCEPHIN) – CLASS
cephalosporin
AZITHROMYCIN (ZITHROMAX) – CLASS
macrolide
CLARITHROMYCIN (BIAXIN) – CLASS
macrolide
ERYTHROMYCIN – CLASS
macrolide
CAP: mgmt for under 65 x4
MACROLIDE - 1 of the following:
- azithromycin (Zithromax)
- clarithromycin (Biaxin)
- erythromycin
OR
TETRACYCLINE: doxy
CAP: mgmt 65+ or comorbs x4
FLUOROQUINOLONE
- levofloxacin (Levaquin)
- ciprofloxacin (Cipro)
- moxifloxacin (Avelox)
- gemifloxacin (Factive)
Pseudomonas pneumonia: inpt ICU mgmt (rx only)
antipneumococcal/antipseudomonal beta lactam
- piperacillin-tazobactam (Zosyn)
- cefepime (Maxipime)
- meropenem (Merrem)
PLUS
- ciprofloxacin (Cipro)
//or//
- levofloxacin (Levaquin)
pneumonia: inpt ICU mgmt (rx only)
BETA LACTAM
- ceftriaxone (Rocephin)
PLUS
- fluroquinolone
//or//
- azithromycin (Zithromax): resistance likely, avoid
community acquired MRSA pneumonia: rx x2
vancomycin
//or//
linezolid
CA-MRSA cellulitis
choices:
Bactrim
Doxy/mino
Clindamycin
Group A Strep cellulitis
choices:
Bactrim + beta lactam (pcn, amoxicillin, Keflex)
Doxy/mino + beta lactam (same as above)
Clindamycin
! – same as CA-MRSA + BLs – !
cephalexin (Keflex): class + generation of that class
1st generation cephalosporin
most common causes of cellulitis: outpatient
Strep pyogenes (group A) -- usually Staph aureus (less common) Strep etc. (B, C, G) - rare
most common causes of cellulitis: inpatient
- gram negs: E Coli, Klebsiella, Pseudomonas, Enterobacter
- S. aureus (MRSA? CA-MRSA? possibilities endless)
- Strep
gram positive organisms
bacillus clostridium enterococcus listeria staph strep (strep pneumo is pneumococcus)
gram negative organisms
E coli Enterobacter Haemophilus Pseudomonas aeruginosa Moraxella Neisseria
abx with gram neg coverage
Azithromycin (both)
Cephalosporins (both)
Penicillins (both)
abx with gram pos coverage
Azithromycin (both) Bactrim Cephalosporins (both) Clindamycin Doxycycline Linezolid Minocycline Penicillins (both) Vanc
azotemia lab value
BUN 100+
syphilis treatment
Penicillin G
if allergic: doxycline or erythromycin
chlamydia treatment
azithromycin or doxycycline
co-treat with gonorrhea (ceftriaxone)
gonorrhea treatment
ceftriaxone
azithromycin (to cover chlamydia)
chancroid treatment
azithromycin
ceftriaxone
ciprofloxacin
1 underdiagnosed psych disorder
depression
which is the priority for patient who can’t make own decision: next of kin or advanced directive?
next of kin - ask if they want to go with advanced directive
Top 4 Killers of adults
1: CAD
2: cancer
3: lower resp disease (asthma, COPD)
4: CVA
1 mortality in US blacks
CAD
1 mortality in US women
CAD
1 cancer mortality in women
lung
leading gyn cancer mortality in women
ovarian
leading cancer incidence in women
breast
top 2 cancer mortalities in men
lung
prostate
top 2 cancer mortalities in all US adults
lung
colorectal
TSH normal
0.4 - 5.0
FT4 normal
0.8 - 2.8
Tot T4 normal
4.5 - 11.5
T3 normal
80 - 230
urine Na normal
10 - 20
serum osm normal
285 - 295
MCV normal
80 - 100
MCH normal
26 - 34
MCHC normal
32 - 36
hct normals
M 40 - 54
F 37 - 47
TIBC normal
240 - 450
ferritin high in anemia
100+
fibrogen low in DIC
less than 170
FDP high in DIC
45+
PT normal + prolonged
11 - 14 sec
19 sec
PTT normal + prolonged
25 - 35 sec
42 sec
albumin normal
3.5 - 5
BPH normal
under 4.5
phosphorous normal
3.5 - 5
Ca (total x2)
- 5 - 10.5 mg/dL
2. 2 - 2.6 mmol/L
Ca (ionized x2)
- 5 - 5.5 mg/dL
1. 1 - 1.4 mmol/L
CO/CI in hypovolemic shock?
↓
CVP in hypovolemic shock?
↓
PCWP in hypovolemic shock?
↓
SVR in hypovolemic shock?
↑
SVO2 in hypovolemic shock?
↓
CO/CI in cardiogenic shock?
↓
CVP in cardiogenic shock?
↑
PCWP in cardiogenic shock?
↑
SVR in cardiogenic shock?
↑
SVO2 in cardiogenic shock?
↓
CO/CI in septic shock?
↑ then ↓
CVP in septic shock?
↓ then ↑
PCWP in septic shock?
↓ then ↑
SVR in septic shock?
↓
SVO2 in septic shock?
↓ then ↑
CO/CI in anaphylactic shock?
↓
CVP in anaphylactic shock?
↓
PCWP in anaphylactic shock?
↓
SVR in anaphylactic shock?
↓
SVO2 in anaphylactic shock?
↓
CO/CI in neurogenic shock?
↓
CVP in neurogenic shock?
↓
PCWP in neurogenic shock?
↓
SVR in neurogenic shock?
↓