ID Flashcards
MCC of bacterial meningitis
Strep pneumoniae
H.influenza
N. meningitidis
Rx of meningitis
Ceftriaxone + Vancomycin
If elderly, neonate or immunocompromised add ampicillin for listeria.
Organism in pylonephritis from blood?
Staph
What to do if pylonephritis caused by staph?
Look for focus of infection and culture blood.
Hx of travel to South America / Mexico + bloody diarrhea? (Organism)
Entamoeba histolytica colitis
Amebic colitis classic
Gradual onset 1-2 weeks Diarrhea Watery / bloody diarrhea Abdominal pain Fever
Rx of influenza + exception
Sx < 48 HR
Oseltamivir
Sx > 48 HR
Symptomatic
Rx required for all patient worsening even if it’s > 48 HR.
Rx of suspect MRSA in endocritis?
IV vancomycin + gentamicin
Influenza like classic
Sudden
Fever + dry painful cough
Similar findings in family/household
Prostration = exhaustion
Risk in herpes zoster ophthalmicus?
Corneal infection due to involvement of nasociliary branch of V1
Elderly in nursing home with asymptomatic bacteriuria?
No need for Rx
Risk ass w/ Strp bovis?
Colon Ca
Rx of herpes zoster
High dose acyclovir 800 mg 5xday
1st line in otitis media
Amoxicillin
Rocky Mountain spotted fever classic
Camper/hiker
Tick
Rash moves centrally
Paralysis
Where is Rocky Mountain spotted fever?
Canada: British Columbia + saskatchewan
US: North Carolina + Arkansas + Missouri + Tennessee + Oklahoma
Rx of scabies
5% permethrin > lindane
Lindane has neurotoxic SE
Why a strep pharyngitis must be Rx?
Prevent rheumatic fever
Staph food poisoning
Start 1-6 hr after meal
Resolves 1-2 days
Indication of sever or lethal Rocky Mountain spotted fever
High creatinine due to renal failure
Predictor of vancomycin efficacy
Trough serum level > 10mg/L to prevent development of bacterial resistance
What derm disease associated w/ GAB infection
Guttate psoriasis
Center criteria for pharyngitis
Tonsillar exudate Tender cervical LN Fever No cough If > 2 points Rx w/ Abx 0-2 Rx symptomatic
Splenectomy increases risk of what infections?
Encapsulated organisms: S. pneumoniae HiB E. coli Staph Salmonella Klebsiella and
Hx of tick bite? Management
Remove parasite w/in 24-48 HR
By: medium tipped angled forceps
Trichinosis classic
10-15 days Hx of infection
1st = diarrhea
2nd = sever muscle weakness +/- CNS
Dx trichonsis
Muscle biopsy shows trichinella spiralis.
Other:
High CK
High eosinophils
High LDH
Dx of pseudomemebrenous colitis
Stop antibiotics
Start metronidazole
When to use oral vancomycin in pseudpmembrenous colitis?
Pregnancy / breastfeeding
Allergy to metro
Recurrent not responsive to metro
Subacute / atypical pneumonia + EM rash + hemolysis + low Na (organism)
Mycoplasma pneumonia
Legionella pneumonia clues
- Immunocompromised
- Hotels, water tanks
- Hepatic involvement
- Low Na + Low PO4
HIV classic
Young Oral thrush Ulcerative esophagitis Weight loss LN
MCC of HIV
Drug use
MCC of ulcerative esophagitis in HIV
CMV
HSV
Risk of pneumocystic jirovecii pneumonia?
In HIV (CD4 <200)
Rx of C. Botulinum
Antitoxin against neurotoxin A,B,C
MCC of bacteremia in elderly?
UTI
Risk of pneumocystic jirovecii pneumonia?
In HIV (CD4 <200)
MCC of c. Botulinum
Home - canned foods
Preservative that reduce oxygen like vacuum packaging
Sx of C. Botulinum
Bulbar paresis:
Dysarthria
Dysphonia
Flaccid facial expression
Rx of H. Pylori
Triple Rx for 14 days
Amoxicillin
Clarithromycin
Omeprazole
Other:
BMT = bismuth, metro, tetra
LAC = lansoprazole, amoxicillin, clarithromycin
Dx C. Diff
C. Diff cytotoxin essay
Dengue Fever
3-14 days Hx of travel to tropical area
+/- Hx of mosquito bite
Pro dorm: erythema mottling, facial flushing
Classic Sx:
Sudden fever, chills <10 days.
Sever headache (breakbone)
Maculopapular or petechial rash
Anti-TB needs acidic environment
Pyrazinamide
It’s inactive at natural PH 7.4
Work on acidic phagosomes of macrophages PH 5 I.e extra cellular TB
EBV association
Burkitts lymphoma
Hodgkin’s lymphoma
Large B cell lymphoma
Nasopharyngeal carcinoma
Rx of TB
8 weeks of: Rifampin Isoniazid Ethambutol Pyrazinamide
Infection from rabbits
Tularemia (Francisella tularensis)
Rx of tularemia
Streptomycin
Dx osteomyelitis
MRI
Leprosy classic
AFB +ve
De pigmentation
Loss of fine touch and pain sensation
Disfigured feature due to cartilage infection and granuloma formation
Prophylaxis in HIV+ve?
If CD4
< 200 PCP prophylaxis
< 100 toxoplasmosis
< 50 M. Avium
Opportunistic infection prophylaxis in HIV
Aziyhromycin for M. Avium
What must be r/o before TB prophylaxis
Active TB
HSV encephalitis location
Temporal area
Sx of HSV encephalitis
Gustatory hallucinations
Confusion
How C. Botulinum causes disease
Works on polysialoganglioside receptor
Rx of URTI with strep. Pneumoniae
Erythromycin
Most abundant site for HIV replication
GI tract
T/F: serum sickness reaction after HBV
T
Cause of ehrlichiosis
Lone star tick
Ixodes tick
Rx of pertussis
1st line Macrolides
2nd line TMP/SMX