ID Flashcards
Abx for sinusitis?
1) Amoxicillin/clavulinic acid, Doxycycline, TMP/SMX
What is the organism that causes pneumonia as a complication of influenza?
S. aureus
What is treatment for CMV encephalitis?
IV ganciclovir +/- foscarnet
What sign is seen with Neisseria meningitidis?
petechial rash in lower extremities
ABX that is good at crossing BBB?
ceftriaxone
What test can be used to make initial diagnosis of disseminated histoplasmosis?
urine and serum polysaccharide antigen test
Signs seen with histoplasmosis?
fever, weight loss, hilar lympadenopathy, hepatosplenomegaly, pancytopenia
treatment for mild pulmonary histo?
supportive or itraconazole
Treatment for chronic cavitry lesions?
itraconazole for 1 year
Treatment for severe acute pulmonary disease or disseminated disease>
Lipsomoal aphotericine B x 14 days followerd by itraconazole x1 year
What are presentations of CMV>
CMV retinitis- retinal detachment (floaters)
GI and hepatobiliary involvement
CMV pneumonitis
CNS involvement
Treatment for CMV
ganciclovir
What will Labs show with MAC infections?
hypoalbuminemia
Increased serum alk phos
increased LDH
biopsy will shows foamy macrophages and acid fast bacilli
Treatment for MAC?
Clarithryomycin (1)
ethambutol +/- rifabutin is sexond line
Gram negative diplococci?
gonorrhea
What can disseminated disease for gonorrhea present with?
Monoarticular septic arthritis
tenosynovitis
hemorrhagic painful pustules
Treatment for gonorrhea
ceftriaxone IM or cefixime PO
What is the acute illness that can result due to treatment of syphillis?
Jarisch Herheimer reaction- flu like
Described as a beefy red ulcer with a characteristic rolled edge of granulation tissue
Klebsiella granulomatis
What is treatment of klebsiella granulomatis
doxycycline or azithromycin
Treatment for pyelonephritis
fluroquinolones
Treatment for anthrax
ciprofloxacin or doxycycline
can you give doxycycline to preggos and childrens?
no
What is treatment for RMSF?
doxycylcine
or chloramphenicol
What organisms cause otitis externa
pseudomonas and enterobacteriaciae
Is their pain when you tug on pinna in otitis externa
yes, no pain for otitis media
What is treament for lyme disease
doxycyline
amoxicillin
advanced disease- ceftraixone
fatigue, fever, sore throat, posterior , cervical lympadenopathy, bilateral upper eyelid edema
Infectious mononucleosis
predisposing factors for Infective endocarditis caused by Staphylococcus aureus?
prosethic valves
intravascular catheters
implanted devices
injection drug users
Predisposing factors for Infective endocarditis caused by viridans group streptococci?
dental procedures
incision or biopsy of respiratory tract
Predisposing factors for infective endocarditis caused by coagulase negative staphylococci?
intravascular catheters
prostetic valves
pacemakes or defibrillators
Predisposing factors for infective endocarditis caused by enterococci?
nosocomial urinary tract infections
predisposing factors for infective endocarditis caused by streptococcus bovis?
colon carcinoma
chronic indwelling catheters
prolonged antibiotic therapy
hospital acquired endocarditis associated with intravascular catheters?
Staphylococcus epidermidis ( coagulase neg)
What is the abx for bacillary angiomatosis?
erthromycin
- gram negative bacillus
Streptococcus sanguinis
S. mitis, S. oralis, S. mutans, S. sobrinus. S milleri are all part of what group
Viridans group streptococci
healthcare associated endocarditis associated with nosocomial urinary tract infetions
enterococcus faecalis
aerobic, gram positive, partially acid fast branching rods tx?
norcardia
TMP-SMX
What region of brain do you see ring enhancing lesions in toxoplasmosis?
basal ganglia
Presence of EBV DNA in csf is characteristic of what condition
CNS lymphoma
PML lesions are non enhancing or enhancing
non enhancing
HIV positive with bloody diarrhea, abdominal cramps
CMV
Reverse effects of warfarin
give FFP
sudden onse of sharply demarcated, erythematous, edematous, tender skin with raised borders in a febrile patient?
erysipelas- Group A streptococcus
arizona, california, fever, dry cough, weight loss, pleuritic chest pain, erytherma multifrome, erythema nodosum, arthralgias
cocccidiodomycosis
Abx for prophylaxis and treatment of infections caused by human bite
amoxicillin-clavulanate
- covers gram positive, gram negatives, anaerobes
What does clindamycin cover
gram positive and anaerobes
what does ciprofloxacin
gram negatives
Drug of choice for lyme in preggos and kids
amoxicillin
reddish nodule that later ulcerates and spread along the lymphatics forming subcutaneous nodules and ulcers
sporothrix schenckii
When do you give prophylaxis is HIV person for CMV
give ganciclovir if CD4 is less than 50 and CMV IgG is positive or positive biospy
Adverse effect of Nucleoside reverse trancriptase inhibitor as class
lactic acidosis
Adverse effect of Zidovudine (NRTI)
anemia
Adverse effect of didansosine(NRTI)
Pancreatitis and peripheral neuropathy
Adverse effect of Stavudine (NRTI)
pancreatitis and neuropathy
Adverse effect of Lamivudine
none
Adverse effect of Abacavir ( NRTI)
rash
Adverse effect of tenovair (NRTI)
Renal toxicity
Adverse effect of protease inhibitors as class
hyperglycemia, hyperlipidemia
Adverse effect of indinavir (protease inhibitor)
Kidney stones
A
Adverse effects of NNRTIs as class
drowsiness - specfically efavirenz
Raltegravir, elvitegravir, and dolutegravir are what type of inhibitors
integrase inhibitors
treatment for needlestick
HAART for a month
why is ritonavir added if a protease inhibitors such as atazanavir or darunavir is used?
it inhibits hepatic p450 systems- route through which protease inhibitors are metabolized
which HIV medications is avoided in pregnancy
efavirenz-NNRT
