GI/GU infect Flashcards
who woudl you treat for diarrhea
- Sick immunocompetent patients with bacillary dysentery (frequent scant bloody stools, abdominal pain, tenesmus, fevers), suggestive of Shigella
- Recent travel with high fever (≥ 38.5) and/or sepsis
- Sick immunocompromised patients
camphylobacter first choice
azithro
salmonella enterica typhi /paratyphi tx
CTX/Cipro
Shigella tx
AZITHRO OR CIPRO OR CEFTRIAXONE
VIBRIO CHOLERA TX
DOXYCYCLINE
YERSINIA ENTEROLITICA TX
TMP SMX
WHAT’S C DIFF COLONZIATION
do you treat ?
positiveC. diff stool test in absence of clinical
syndrome
don’t treat
why is fidaxomicin good
less recurrence
when to use PR vancomyicin in cdiff
if paralytic ileus or bowel discontinuity
1st c diff relapse tx options
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
> 2nbd relapse tx options
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
size of intra abdo collection managed with atb alone
Collections 3cm or smaller can be attempted to be managed with antibiotics alone
acute prostatitis treatment
FQ, tazocin, 3rd gen cephalo
how long do you treat chronic prostatitis?
- 4-6 weeks w/ FQ
- 8-12 weeks other atb
atb to use for chronic prostatitis
- fq
- tmp smx
gonorhea
- incubation time
- which type of infection more asymptoamtic
- women vs men : asymptomatic usually?
- 2-7 days
- rectal & pharynx
- women
chlam
- subtype of aggresssive chlam
LGV
epideididymitis : chlam vs gono
chllam»>
DGI
- complication sx
- more common in who
- arthritis, dermatitis, endocarditis, meningitis
- pregnant woman, MSM
chlam
- incubation
- asx % in woman and women
- LGV
- 2-6 weeks
- 50% men , 70% woman
- more invasive !!!
DGI tx
ceftriaxone 1-2mg IV/IM DIE x 7 dAYS
LGV TX ?
doxycycline 100 mg po BID x 21 days
TOC gono ?
after 2 weeks
TOC chlamyd
- how long after
- indication
- 3-4 weeks
- LGV, unclear compliance, alt regimen, pregnancy
pregnancy vs chlamydia tx option
azithro
argyll robertson pupils specific to which disease ?
syphilis
primary syphilis presentation and time span
3w-90 days
painless chancres, regional LN
secondary syphilis and presentation
-?timeline
Fever, malaise, rash, alopecia, uveitis, meningitis, LN, hepatitis, arthralgias, condylomata lata
-12w to 6M
latent , what is it , and how can you split it
latentn syphilis - asymptomatic with positive serology
- early <1 y
- late >1y or unknown
tertiary syphilis presentation
gummatous
aortitis
late neurosyphilis : tabes dorsalis and general paresis
which stage can neurosyphilis occur and manifestations ?
- any !!
- argyl robertson pupil, meningitis, otitis symptoms, headache, ocular sx, dementia, etc
primary , secondary, early latent tx
- pen G 2.4 MU x 1
( or doxy x 14 days, ctx x 10 days)
late latent, tertiary syphilis
- pen G 2.4 MU weekly x 3
( or doxy x 28 days, ctx x 10 days)
neuro syphilis tx
aqueous penicillin q4 x 14 days
if not –> desensitize or ctx x 10-14 d
LP indications for syphilis
Neurologic, ocular, or auditory symptoms
Inadequate serologic response to treatment
Tertiary syphilis
(HIV with CD4 < 350 or RPR >1:32 maybe)
which syphilis testing is specific to syphilis and persists ?
TT
which syphilis testing is non specific and released ddduring infection
ntt
meds for mpox ?
self resolve
tecovirimat
what ddo you give mpox post exposure /high risk people?
imvamune
