First Line Treatment

Question 1

Septic shock without focal cause

Answer 1

vancomycin 15 mg/kg q12 hr PLUS pip-tazo 4.5 g q8h OR cefepime 2g q8h

Question 2

Post-splenectomy sepsis

Answer 2

vancomycin 15 mg/kg q12 + ceftriaxone 2 g q 12h

Question 3

Bacterial meningitis < 50 yrs old

Answer 3

Vancomycin + ceftriaxone + dexamethasone 10 mg q6h for 4 days

Question 4

Bacterial meningitis > 50 yrs old

Answer 4

vancomycin + ceftriaxone + ampicillin 2g q4h + dexamethasone 10 mg q6h x 4 days

Question 5

Necrotizing fasciitis

Answer 5

vancomycin 15 mg/kg q12 + Pip-tazo + clindamycin 600 mg q8h

Question 6

Clostridium myonecrosis

Answer 6

Clindamycin 600 mg q8h + Penicillin 4 million Units q4h

Question 7

Bacterial endocarditis

Answer 7

vancomycin + pip-tazo or cefepime

Question 8

meningococcemia

Answer 8

Ceftriaxone 2g q12h OR penicillin 4 mU q4h

Question 9

Prophylaxis for close contacts of meningococcemia patients

Answer 9

rifampicin 600 mg q12h x 2 days OR ciprofloxacin 500 mg x 1 dose

Question 10

RMSF

Answer 10

doxycycline 100 mg BID

Question 11

Purpura fulminans (S. pneumonia, H. influenzae, N. meningitidis)

Answer 11

Vancomycin 15 mg/kg q12 + ceftriaxone 2g q12h

Question 12

Toxic shock syndrome by Grp A strep

Answer 12

Vancomycin 15 mg/kg q12 + Clindamycin 600 mg q8h

Question 13

Brain abscess, purulent CNS infections (staph, strep, anaerobes, G- bacilli)

Answer 13

Vancomycin 15 mg/kg q12 + metronidazole 500 mgq8h + ceftriaxone 2g q12

Question 14

Cerebral malaria

Answer 14

Artesunate 2.4 mg/kg IV q12 x 3 doses, then q24h; alternate: Aremether-lumefantrine PO

Question 15

Spinal epidural abscess (stap, G-Bacilli)

Answer 15

Vancomycin 15 mg/kg q12h + Pip-tazo 4.5 g q8h or cefepime 2g q8h

Question 16

MSSA

Answer 16

Oxacillin 2g q4h or Penicillin 4 million units q4h

Question 17

Empiric treatment for epididymitis

Answer 17

Ceftriaxone 500 mg IM x 1 and doxycycline 100 mg PO BID x 10 days

Question 18

Treatment for sustained SVT

Answer 18

6-12 mg of adenosine

Question 19

Treatment for sustained symptomatic bradycardia or AVB in urgent settings?

Answer 19

Atropine

Question 20

Empiric treatment for non-gonoccocal urethritis

Answer 20

1. Azithromycin or
2. Doxycycline

Question 21

Empiric treatment for gonococcal urethritis

Answer 21

IV ceftriaxone

Question 22

Outpatient management of PID

Answer 22

Ceftriaxone 500 mg IM x 1+
Doxycycline 100 mg PO BID x 14d +
Metronidazole 500 mg PO BID x 14 days

Question 23

Parenteral treatment for PID

Answer 23

Option A: cefotetan 2g IV q12 or cefoxitin 2g IV q6 + doxycyline 100 mg PO q12

Option B : clindamycin 900 mg IV q8 + gentamicin LD 2mg/kg, then ME 1.5 mg/kg q8

Question 24

Empiric treatment for genital herpes

Answer 24

Acyclovir
Valacyclovir
Or famciclovir

Question 25

Empiric treatment for genital herpes

Answer 25

Acyclovir
Valacyclovir
Or famciclovir

Question 26

Empiric treatment for syphilis

Answer 26

benzathine Penicillin G 2.4 mU IM x 1

Question 27

Empiric treatment for chancroid

Answer 27

Ciprofloxacin 500 mg PO x 1
Ceftriaxone 250 mg IM x 1 or
Azithromycin 1g PO x 1