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hammer19 Flashcards

1
Q

What do carbapenems cover? What do they treat?

A

(imipenem, meropenem, ertapenem, doripenem) gram negative bacilli, including many that are resistant, anerobes, streptococci and staphyllcocci. Used to treat neutropenia and fever.

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2
Q

What antibiotic for cystitis and pyelonephritis?

A

Ciprofloxacin

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3
Q

What fluoroquinolone can be used as a single agent for diverticulitis?

A

Moxifloxacin. The others need to add metronidazole.

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4
Q

What is the sideeffect of quinolones?

A

Bone growth abnormalities in children and pregnant women, tendonitis and achilles tendon rupture,

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5
Q

What are some aminoglycosides? What can’t they treat?Sideeffects?

A

Gentamicin, amikacin, tobramycin, Treat gram negative bacilli but not anerobes because they need oxygen. Nephrotoxic and ototoxic.

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6
Q

What are indications for doxycycline and what are adverse effects?

A

Borrelia, ehrlichia, mycoplasma. Lyme disease, Tooth discoloration, fanconi syndrome (type 2 RTA), photosensitivity, esophagitis/ulcer.

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7
Q

What are the adverse effects of TMP/SMX?

A

Rash, G6PD hemolysis, bone marrow suppression (folate antagonist)

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8
Q

What are treatments for MRSA?

A

Vancomycin, Linezolid (reversible BM toxicity), daptomycin (elevated CPK), tigecycline, ceftaroline), telavancin

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9
Q

Which antibiotics cover anerobes above diaphragm?

A

Penicillin, Clindamycin

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10
Q

Which antibiotics cover anerobes below diaphragm?

A

Metronidazole, betalactam/lactamase combinations

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11
Q

Whic antibiotics cover gram negative bacilli?

A

Quinolones, aminoglycosides, carbapenems, piperacillin, ticarcillin, aztreonam, cephalosporin

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12
Q

What is unique about CSF findings for TB meningitis?

A

Protein level is markedly elevated. Glucose level may be low.

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13
Q

When do you do a bacterial antigen detection (latex agglutination test)?

A

When th epatient has received antibiotics prior to LP and the culture may be falsely negative

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14
Q

What are diagnsotic tests for cryptococcus?

A

INdia ink (60-70% sensitive), cryptococcal antigen (more than 95% sensitive and specific), Fungal culture (100% specific)

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15
Q

What is the best initial treatment for bacterial meningities? Most common neurological deficit?

A

Ceftriaxone, vanco, steroids. Add ampicillin if immunocompromised for Listeria. .CN8 nerve deficit or deafness.

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16
Q

What is additional managment of Neisseria meningitis?

A

Respiratory isolation. Rifampin, ciprofloxacin or ceftriaxone to close contacts.

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17
Q

What is the most accurate test for hepres encephalitits? What is the best treatment?

A

PCR of CSF. Acyclovir. Foscarnet for acyclovir resistant herpes.

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18
Q

What is the most sensitive finding for otitis media? What meds besides amoxicillin if they are resistant or recently treated?

A

Tympanic immobility. Amoxicillin/clavulanate, azithromycin, cefuroxime, loracarbef, levofloxacin, gemifloxacin

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19
Q

What is the first line treatmetn for both otitis and sinusitis?

A

Amoxicillin/clavulanic acid, doxycycline, TMP/SMX

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20
Q

What is the treatment for pharyngitis? If allergic or anaphlyactic?

A

Penicillin or amoxicillin, IF allergic cephalexin only if rash is reaction. Clindamycin or macrolide if reaction is anaphylaxis.

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21
Q

When do you treat the flu with oseltamivir and zanamivir?

A

Less than 48 hours of symptoms.

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22
Q

Which one is the most accurate test for infectious diarrhea? What are other tests?

A

Stool culture. Stool lactoferrin which has a better sensitivity than stool leukocytes

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23
Q

What is the presentation and treatment of scromboid?

A

Rapid onset. Wheezing, flushing rash. Found in fish. Treat with antihistamines.

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24
Q

What is the treeatment for Giardia? Cryptosporidiosis?

A

Netronidazole, tinidazole. For Cryptosporidiosis, nitazoxanide

25
Q

What is the best initial diagnostic for Hepatitis A,C,D,E?

A

IgM antibody for acute infection and IgG to detect resolution of infection

26
Q

What is the only negative value in Hep B for acute or chronic infection?

A

Surface antibody

27
Q

What is the only positive value in Hep B after vaccination?

A

Surface antibody

28
Q

What is the only positive value in Hep B during window period?

A

Core antibody (positive IgM, then IgG)

29
Q

What is the only positive values in Hep B after resolved infection?

A

Core and surface antibody

30
Q

What value will become abnormal first after acquiring hepatitis B infection?

A

Surface antigen

31
Q

Which is the most direct correlate with the amount of active HepB viral replication and best indication for treatment in chronic disease?

A

E-antigen

32
Q

Which indicates a patient is no longer at risk for transmiting HepB?

A

No surface antigen

33
Q

What is the presentation and treatmetn for cervicitis?

A

Inflamed strawberry cervix on physical exam. Ceftriaxone and azithromycin

34
Q

What is the physical finding of chancroid and how is it diagnosed and treated?

A

Painful ulcer, Stain and culture on specialized media. Azithromycin

35
Q

What is the physical finding of lymphogranuloma and how is it diagnosed?

A

Tender and suppurating lymph nodes. Complement fixation titers in blood. Nucelic acid amplification testing on swab. Doxycycline

36
Q

What is the presentation of secondary syphilis?

A

Palmar and solar rash, alopecia areata, mucous patches, condylomata lata

37
Q

What is the presentation of tertiary syphilis?

A

Neurosyphilis (stroke from vasculitits), tabes dorsalis, general paresis, argyll orbertson pupil), aortitis and gummas

38
Q

What is the treatment for genital warts (condylomata acuminata)? Pediculosis (crabs) and scabies?

A

Physical removal, podophyllin or trichloroacetic acid. Imoqid to slough off lesion.

39
Q

What is the treatment for Pediculosis (crabs) and scabies?

A

Permethrin

40
Q

What is the treatment options for pyelonephritis?

A
  1. Ceftriaxone or ertapenem 2. Ampicillin and gentamicin until culture results arrive 3. Ciprofloxacin
41
Q

What is the treatment for chronic prostatitis?

A

Ciprofloxacin or TMP/SMX for 6 to 8 weeks

42
Q

What is the most common cause of culture negative endocarditis and best initial treatment? What is the treatement for HACEK organisms?

A

Coxiella and bartonella. Vancomycin and gentamicin. Ceftriaxone

43
Q

When is prophylaxis for endocarditis? Treatment?

A

Significant cardiac defect (prosthetic valve, previous endocarditis) and risk of bacteremia (dental work with blood). Amoxicillin or if allergic clindamycin, azithromycin or clarithromycin,

44
Q

When do you use Doxycycline vs ceftriaxone for lyme?

A

Use ceftriaxone for cardiac and neurologic manifestations other than CNVII palsy. Use doxycyclein and amoxicillin or cefuroxime for joint, CNVII palsy

45
Q

What is the best initial test for HIV? How is it confirmed? How are infected infants diagnosed?

A

ELISA. Western blot testing. Infected infants are diagnosed with PCR or viral culture.

46
Q

What are the indications for treatment in an HIV patient? Which classes of meds are used?

A
  1. CD4 below 500 2. Viral load is vey high 3. Opportunistic infections occur . 3 drugs from atleast 2 differetn classes (NNRTIs, RTIs, protease inhibitors)
47
Q

What are the best initial drug regimen for HIV?

A

Emtricitabine, tenofovir and efavirenz

48
Q

What is the side effect of abacavir?

A

Dangerous with HLA B5701 mutation

49
Q

What is the use of ritonavir?

A

Given is small doses to boost the levels of other protesase inhibitors like Darunavir or atazanavir.

50
Q

What are viral entry inhibitors in HIV?

A

Enfuviritide and maraviroc

51
Q

What are integrase inhibitors in HIV?

A

Raltegravir, dolutegravir, elvitegravir with cobicistat

52
Q

What is the adverse effect of zidovudine?

A

Anemia

53
Q

What is the adverse effect of stavudine and didanosine?

A

peripheral neuropathy and pancreatitis

54
Q

What is the adverse effect of protease inhibitors (navirs)?

A

Hyperlipidemia and hyperglycemia

55
Q

What is the adverse effect of indinavir?

A

Nephrolithiasis

56
Q

What is the adverse effect of tenofovir?

A

Renal insuficciency

57
Q

What medication should the baby receive in an HIV + mother during and after delivery? Which drug should be avoided in pregnancy?

A

Zidovudine during delivery and for 6 weeks afterward. Efavirenzt (teratogenic in animals)

58
Q

What is the viral cutoff in pregnancy for c section in HIV + patients?

A

Above 1000/microliter

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