ID Flashcards
What drugs cover MRSA?
daptomycin
linezolid
vanc
bactrim
Describe coverage of doxycycline
good for outpatient CAP
Describe cipro coverage
good gram neg coverage
What is the drug of choice for pneumocystis pneumonia?
TMP + SMX
What is the coverage of ampicillin and gentamicin
good against gram negative aerobes, used for abdominal infections
What is the treatment for a patient with latent TB? (no chest X ray findings)
9 months of treatment with isoniazid
what is the treatment for a tick found 24 hours after a hike?
doxycycline
What are the side effects of INH and how can they be prevented?
neuropathy - give pyroxidine
A patient shows up with fever, sore throat and thumbprint sign on lateral films. What should be your next steps?
admit to ICU and ENT consult
A type 2 diabetes patient complains of ear pain with purulant discharge. This is likely…
pseudomonas aeruginosa
A patient presents with fever, headache, retro-orbital pain, severe musculoskeletal pain and rash after travel to the Carribean. Wht is this and what causes this?
this is the immunologic phase of dengue (also get aseptic meningitis, HSM). caused by leptospirosis, a spirochete
A patient presents with influenzea illness, abdominal discomfort, constipation and some bloody diarrhea. they later develop rose colored macules. This is…
typhoid fever
A patient is suspected to have active TB. What should be your next steps?
respiratory isolation, sputum culture/AFB stain to confirm
What are the stages of lyme disease?
stage 1: erythema migrans,
stage 2: facial nerve palsy
stage 3: recurrent and destructive oligocarticular arthritis
What is the appropriate course of tx for uncomplicated cystitis?
3 days trimethoprim -sulbactam
A patient presents with low back pain after tx for pyelonephritis. What study should you do next?
MRI for osteo - commonly hematogenous spread to spine
What is the presentation of yersinia enterocolitica?
fever, abdominal cramps, no diarrhea - pseudoappendicitis
A patient presents with papules, vesicles and scabs in various stages of development. It is accompanied by pneumonia like process. This is
chickenpox
A patient with PMH HIV pw CD4 count 50, chronic bloody diarrhea. Biopsy shows large cells with eosinophilic intranuclear inclusions. This is likely…
CMV
A patient with HIV presents with bloody diarrhea and flask shaped colonic ulcers. This is…
entameba histolytica
A patient who was in septic shock presents with symmetric duskiness and coolness in the fingertips. This is likely caused by…
norepinephrine induced vasospasm
A patient in the south presents with tick bite, febrile illness, leukopenia and thrombocytopenia as well as elevated liver enzymes. This is …
ehrlichiosis
C3 deficiency predisposes patients for..
recurrent bacterial infections
C5-C8 deficiencies predispose patients for…
recurrent neiserria infections
Phagocytic deficienices (chronic granulomatous disease, etc) predipose patients for…
pyogenic bacterial infections
What vaccines should not be given to HIV positive patients?
BCG, anthrax, oral thyphoid, polio, varicella, zoster
A diabetic patient presents with right sided nasal congestion, necrosis of the right nasal turbinate and tenderness of the maxillary sinus as well as chemosis and proptosis. This is likely caused by…
rhizopus species - mucormycosis
What organisms most frequently cause osteomyelitis?
staph, pseudomonas
What antibiotic regimen can cover human bites?
amoxicillin clavulonate
What is the drug of choice for legionella?
erythromycin
What is the antibiotic regimen recommended for patients with febrile neutropenia?
IV cefipime - should cover pseudomonas
a patient presents with fatigue, fever, muscle aches. PBS shows large basophilic lymphocytes with vacuolated appearence. this is…
CMV
A patient with diabetes presents with slow growing non tender mass in the face with yellow pus. Culture shows gram pos branching bacilli. Tx with?
penicillin - this is cervicofacial actinomyces
A patient presents with fever and crusting lesions following an injury in the garden. What is the tx?
trimethroprim sulbactam for Nocordia (aerobic filamentous gram + rod)
A patient with cats presents with a rash over the right hand (pruritic vesicles) and swollen lymph nodes in the axilla. Positive Warthin Starry stain. Tx with
azithromycin for 5 days- this is cat scratch disease caused by bartonella hensale
What are the characteristics for pneumonias that should be hospitalized?
Confusion Uremia RR>30, BP65
A patient with AIDs from Ohio presents with fever, fatigue, weight loss, cytopenias, lymphadenopathy, and hepatosplenomegaly. What test should you order next and what treatment is preferred?
urine antigen test for Histoplasma - prescribe intraconazole
A patient presents with DM presents with painful swelling of her face as well as a warm tender red rash. What is this?
Erypselas - a specific type of cellulitis that affects epidermis. Caused by streptococcus
A patient presents with recurrent gross hematuria, proteinuria and sensorineural deafness as well as a history of renal disease. This is..
Alport’s syndrome
What medications are recommended for HIV patients?
influenza, hep B, pneumococcal, Hep A if MSM
Describe Tdap vaccination
TDAP and a booster ever 10 years afterward
A patient presents with chronic foul smelling stools after a trip to south America. Tx?
metronidazole - for tx of giardia
A patient presents with cramps, gas and fatigue and biopsy shows blunting of villi with chronic inflammatory cells. This is..
tropical sprue
A patient who is HIV pos. presents with hematuria and needle shaped crystals likelly caused by..
indinavir (protease inhibitor)
What is a common life threatening side effect of didanosine? (reverse transcriptase inhibitor)
pancreatitis
What is a common lt effect of abacavir?
hypersensitivity syndrome
What are common lt effects of NRTIs? (nucleoside reverse transcriptase inhibitors)
lactic acidosis
What are common lt effects of NNRTs? (non nucleoside)
steven johnson
What is a common lt effect of nevirapine? (NNRTI)
liver failure
A patient presents with symptoms of IE, a congenital heart murmer and no drug use. What valvular disorder is there?
mitral regurg
Severe odynophagia in an HIV infected patient is likely due to …
viral esophagitis
A patient with HIV presents with linear ulcers. this is… (how do you treat it?)
CMV esophagitis - treat with ganciclovir
What medications are effective against pseudomonas?
pip tazo, azneotram, cipro, carbapenum, tobramycin, gentamicin, amikacin
A patient presents with a painless ulcer on his hand while gardening that eventually becomes ulcerated. He then has subcutaneous nodules extending up his right forearm. This is..
sporotrichosis
A patient presents with fever, weight loss and malaise in addition to several exophytic purple skin lesions on his abdomen and CT showing intrahepatic lesions. This is..
bartonella - bacillary angiomatosis
What malaria chemoprophylaxis should be used in areas with chloroquine resistant malaria?
mefloquine, doxy, atovaquone
What malaria chemoprophylaxis should be used in areas without P. falciparum?
primaquine
A patient was recently taking cipro and noticed achilles tendon pain.
fluoroquinolones are associated with tendinopathy
A patient shows up with elevated white count in the CSF, normal glucose, normal opening pressure and elevated protein in the setting of altered mental status, and a high fever. There are no organisms present in CSF. this is..
viral meningitis
A patient presetns with difficulty swallowing as well as vesicles and round ulcers. This is…
herpes simplex virus - treat with acyclovir
A patient presetns with severely pruritis lesions on his hands after changing the sand in the sandbox. The pruritic papules progress to serpinginous reddish brown lesions evident on the upper extremities. This is..
cutaneous larva migrans - helminthic disease (hookworm)
Describe tx recommendations for the flu
treat all confirmed or suspected within 48 hours or if at high risk of complications
What are the centor criteria?
tonsillar exudates, tender cervical lymphadenopathy, fever, absence of cough
A patient who recently traveled to Arizona presents with low grade fever, joint pain, dry cough and chest pain. He has tender nodules on both legs. This is…
coccidiomycosis
A patient who recently traveled to Mexico presetns with fever, malaise, weakness and unintentional weight loss. He has pleuritic chest pain and left pleural effusion as well as splenomegaly with splenic fluid. What is the cause?
endocarditis causing splenic abscess
A pig farmer presents with headaches and seizures and is found to have fluid filled cysts in his head. This is..
neurocystericosis - occurs when humans consume eggs of T solium and larvae spread hematogenously
A patient is discovered to have cryptococcal meningitis - how long should you wait before initiating antiretroviral therapy?
at least 2 weeks to px immune reconstitution syndrome
A patient presents with elevated opening pressure and CSF shows encapsulated yeast. What treatment should be initiated?
cryptococcus - amphoteracin plus flucytosine
What drugs can cause crystal induced kidney injury and how can it be avoided?
acyclovir, methotrexate, ethylene glycol, protease inhibors
A patient presents with dysuria and increased urinary frequency, multiple sexual partners. urine culture shows less than 100 colonies. this is..
chlyamdial urethritis
A patient presents with hematuria following a respiratory infection. How can IgA nephropaty be distinguished from post infectious glomerulonephritis?
IgA nephropathy - presents immediately afterwards
post infections - presents a few days later
A patient presents with pharyngitis, low grade fever, nasal discharge. there are pseudomembranes on the pharynx. this is..
diptheria
A patient with HIV presents with difficulty hearing. exam shows a hypomobile tympanic membrane. this could be due to..
a noninfectious effusion - otitis media from lymphadenopathy
A non-compliant diabetic patient presents with difficulty eating and ear discharge. exam shows ear granulations. she has facial assymetry and mouth downward droop. this is..
malignant otitis externa from pseudomonas
What is Ludwig’s angina?
infection in the submandibular space that can extend to the airway
What are the major complications of an infection in the parapharyngeal space?
involvement of carotid sheath, jugular thromblophlebitis
A patient presetns with progressively worsening sore throat, a harsh shrill on respiration, and palpable cervical lymph nodes. This could be..
epiglottitis caused by H. Flu or Strep pyogenes
A patient presents wtih blood and sputum cultures that grow partially acid fast gram positive branching rods - this is…
nocordia - tx with trimethoprim - sulfa
A patient presents with severe vomiting, diarrhea and dizziness. she had nasal bleeding that required packing 3 days ago and recently started feeling pressure under her eye. He has diffuse erythematous macules on her trunk and thrombocytopenia. this is..
toxic shock syndrome
A patient presents with fever, nausea, vomiting and a maculpapular rash on the hands and soles. Suspect
rocky mountain spotted fever
A young child presents with fever, headache sore throat. Over time, fine blanching papules appear all over the neck and trunk. This is..
scarlet fever
A patient has primary syphillis - what are the options for tx if he’s allergic to penicillin?
doxycycline
What is the preferred tx for herpes zoster?
valacyclovir or acylclovir
A patient without a spleen presents with body aches, fevers, loss of appetitie as well as hemolytic anemia. This could be…
babesiosis - RBC parasite
A patient presetns with HIV and a CD4 count of less than 30. She’s on antiretrovirals - what else should be added to the regimen?
azithromycin for MAC coverage
What is the tx for MAC complex?
clarithromycin and ethambutol
An HIV pos patient presents with acute onset high grade fever and pleural effusion. Suspect…
streptococcus pneumoniae
An immunocompromised patient presents with fever, dyspnea and the “halo sign” on CT - this is..
aspergillosis
A patient presents with diffuse watery diarrhea 7 days after surgery. What is the best test ot diagnose? What is the best course of tx?
dx with c diff toxin, tx with metronidizole
