GI/GU infect

Question 1

who woudl you treat for diarrhea

Answer 1

1. Sick immunocompetent patients with bacillary dysentery (frequent scant bloody stools, abdominal pain, tenesmus, fevers), suggestive of Shigella
2. Recent travel with high fever (≥ 38.5) and/or sepsis
3. Sick immunocompromised patients

Question 2

camphylobacter first choice

Answer 2

azithro

Question 3

salmonella enterica typhi /paratyphi tx

Answer 3

CTX/Cipro

Question 4

Shigella tx

Answer 4

AZITHRO OR CIPRO OR CEFTRIAXONE

Question 5

VIBRIO CHOLERA TX

Answer 5

DOXYCYCLINE

Question 6

YERSINIA ENTEROLITICA TX

Answer 6

TMP SMX

Question 7

WHAT’S C DIFF COLONZIATION
do you treat ?

Answer 7

positiveC. diff stool test in absence of clinical
syndrome

don’t treat

Question 8

why is fidaxomicin good

Answer 8

less recurrence

Question 9

when to use PR vancomyicin in cdiff

Answer 9

if paralytic ileus or bowel discontinuity

Question 10

1st c diff relapse tx options

Answer 10

Fidaxomicin 200mg PO BID x 10d OR BID x 5d then q2d x 20d

Vancomycin Taper + Pulse

Vancomycin 125mg PO QID x 10d (14d)

Metronidazole 500mg PO TID x 10-14d

Bezlotoxumab 10mg/kg IV x 1

Question 11

> 2nbd relapse tx options

Answer 11

Fidax 200mg PO BID x 10d OR BID x 5d then q2d x 20d

Vancomycin Taper + Pulse

Vanco 125mg PO QID x 10d then Rifaximin 400mg x 20d

Bezlotoxumab 10mg/kg IV x 1

FMT (≥3 episodes)

Oral Vancomycin Suppression

Question 12

size of intra abdo collection managed with atb alone

Answer 12

Collections 3cm or smaller can be attempted to be managed with antibiotics alone

Question 13

acute prostatitis treatment

Answer 13

FQ, tazocin, 3rd gen cephalo

Question 14

how long do you treat chronic prostatitis?

Answer 14

• 4-6 weeks w/ FQ
• 8-12 weeks other atb

Question 15

atb to use for chronic prostatitis

Answer 15

• fq
• tmp smx

Question 16

gonorhea
- incubation time
- which type of infection more asymptoamtic
- women vs men : asymptomatic usually?

Answer 16

• 2-7 days
• rectal & pharynx
• women

Question 17

chlam
- subtype of aggresssive chlam

Answer 17

LGV

Question 18

epideididymitis : chlam vs gono

Answer 18

chllam»>

Question 19

DGI
- complication sx
- more common in who

Answer 19

• arthritis, dermatitis, endocarditis, meningitis
• pregnant woman, MSM

Question 20

chlam
- incubation
- asx % in woman and women
- LGV

Answer 20

• 2-6 weeks
• 50% men , 70% woman
• more invasive !!!

Question 21

DGI tx

Answer 21

ceftriaxone 1-2mg IV/IM DIE x 7 dAYS

Question 23

LGV TX ?

Answer 23

doxycycline 100 mg po BID x 21 days

Question 25

TOC gono ?

Answer 25

after 2 weeks

Question 26

TOC chlamyd - how long after - indication

Answer 26

- 3-4 weeks - LGV, unclear compliance, alt regimen, pregnancy

Question 27

pregnancy vs chlamydia tx option

Answer 27

azithro

Question 28

argyll robertson pupils specific to which disease ?

Answer 28

syphilis

Question 29

primary syphilis presentation and time span

Answer 29

3w-90 days painless chancres, regional LN

Question 30

secondary syphilis and presentation -?timeline

Answer 30

Fever, malaise, rash, alopecia, uveitis, meningitis, LN, hepatitis, arthralgias, condylomata lata -12w to 6M

Question 31

latent , what is it , and how can you split it

Answer 31

latentn syphilis - asymptomatic with positive serology - early <1 y - late >1y or unknown

Question 32

tertiary syphilis presentation

Answer 32

gummatous aortitis late neurosyphilis : tabes dorsalis and general paresis

Question 33

which stage can neurosyphilis occur and manifestations ?

Answer 33

- any !! - argyl robertson pupil, meningitis, otitis symptoms, headache, ocular sx, dementia, etc

Question 34

primary , secondary, early latent tx

Answer 34

- pen G 2.4 MU x 1 ( or doxy x 14 days, ctx x 10 days)

Question 35

late latent, tertiary syphilis

Answer 35

- pen G 2.4 MU weekly x 3 ( or doxy x 28 days, ctx x 10 days)

Question 36

neuro syphilis tx

Answer 36

aqueous penicillin q4 x 14 days if not --> desensitize or ctx x 10-14 d

Question 37

LP indications for syphilis

Answer 37

Neurologic, ocular, or auditory symptoms Inadequate serologic response to treatment Tertiary syphilis (HIV with CD4 < 350 or RPR >1:32 maybe)

Question 38

which syphilis testing is specific to syphilis and persists ?

Answer 38

TT

Question 39

which syphilis testing is non specific and released ddduring infection

Answer 39

ntt

Question 40

meds for mpox ?

Answer 40

self resolve tecovirimat

Question 41

what ddo you give mpox post exposure /high risk people?

Answer 41

imvamune