ID Flashcards
pt in hemodyalisis has fever and neutrophilia but no signs of infection - management
vanco + cefepime
do not remove catheter
when to remove catheter in HD pts with fever
- severe sepsis
- unstable
- metastatic infection (endoc)
- pus a tthe exit site of catheter
- symptoms after 72 hours of empiic
syphillis + neuro symptoms
LP
syphilis treatment
primary, secondary, early latent (less than 12 months): IV single penicillin late latent (more than 12 mths), uknown or gumatus CV: 3 IV penicillin
neurosyphilis treatment
IV peniciilin q4 for 2 wks
com acq pneumonia - outpatient treatment
amoxc or doxyc (healthy
fluoro or betam lactam + macrolide (comorb)
com acq pneumonia - inpatient treatment
Fluoroquinolone (IV)
beta lactam + macrolide
com acq pneumonia - icu treatment
Fluoroquinolone (IV) + macrolide
beta lactam + macrolide
respi fluoroquin
levo / moxi
Curb 65 criteria
- confusion
- urea more tha 20
- resp more than 30
BP less than 90 or 60
age more than 65
0-1: outpatient
2: admit
3-5: ICU
medical personel + for TB skin test and clean chest - next
can go back to work
HIV positive - what to step before start anti-retrovial
HBV (some treatments target both)
TB medications SE
Rifampin: GI, orange urine, rash, cytpenias
Isoniazide: neuropathy, liver
Pyrazinamide: Liver, uric acid
Ethambutol: optic neuropathy
TB exposure - what to do
skin test now and in 10 wks
latent tb treatment
rifambin 4 months
Diagnostic criteria for acute bact rhinosinusitis
any of the following
- symptoms more than 10 days witout improvement
- severe symptoms (high fever more than 39,, purulent discharge, fascial pain more than 3 days
- worsening symtpoms more than 5 days after initial improvement of viral URI
acute bact rhinosinusitis - treatment
amox / clav
altern: fluoroquin or doxo
Exposure to HBV - managment
immunized: nothing
nonimmunized: Globulin and vaccine
No antiretrovirals for prophylaxis
how many medications for HIV prophylaxis
3
4 weeks
HIV associated thrombocytopenia - tretment
anti-retrovirals
Inpatient zoster - what precautions
standard for localized disease
contact and airborn if dissaminated
IM with airway obstruction
admitt and steroids
nasal packing patient with shock and fever
toxic shock syndrome
sporotrichosis - treatment
intraconazole
role of skin test in TB
can diagnose latent but not active
ifn rease in TB
cannot differentiate active from latent
invasive pulm aspergilosis diagnosis
- CT chest: nodules with ground glass opacity (halo sign) and cavitations with air fluid levels
- serum biomarkers: galactomannan, beta-d-glucan
- sputum sampling for fungal stain and culture
cutaneous cryptococcosis
advance HIV (less than 100)
rapid onset of multiple papular lesions with a central umbilication and central hemorrhage necrosis
REQUIRES BIOPSY
PCP with high alv - arterial gradient (more than 35) or O2 less than 70
steroids
HIV TMP SXM prophylaxis
to prevent PCP if lower than 200 and toxop if lower than 100
