ID

Question 1

first line abx for otitis media?
what if it recurs?
what if recurs > 3x/6 months or 4x/12 mo?

what if theyre allergic to that?

Answer 1

amoxicillin.

recurs: amox-clavulanate
rerecurs: tympanoplasty

if anaphylactic to penicillins, use azithromycin
if just a little allergic, use cephalosporin (cefdinifir)

Question 2

person comes in with ear infection and also swelling behind ear or anteriorly rotated ear. what is treatment?

Answer 2

prompt surgical eval.

it’s mastoiditis

Question 3

if person has anaphylactic reaction to pencillins, what abx that may not seem obvious is NOT ok to give??

Answer 3

cephalosporin

Question 4

besides vanc and linezolid, what covers MRSA? (1)

Answer 4

daptomycin

doxycycline is kiind of

Question 5

3 abx that cover pseudomonas

Answer 5

zosyn
cefepime
carbapenems

Question 6

person comes in with pneumonia (this is more for real life) guidelines say hcap isnt a thing, only cap. so what 2 abx do you give them?

Answer 6

ceftriaxone

azithromycin

Question 7

abx for UTI

Answer 7

tmp-smx first line, then nitrofurantoin.

amoxicillin is first line if pregnant

Question 8

person is dx with osteo and you put them on abx and have surgical evaluation. what else should you do?

Answer 8

get ESR and CRP levels. use to track WEEKLY to gauge response to therapy

Question 9

tx of gas gangrene

Answer 9

debridement, PCN + clinda

Question 10

irl what abx do you give empirically for nec fasc? (2)

what do you pick on test? (3)

Answer 10

IRL - vanc + zosyn

test is more narrow - 3rd gen cephalosporin + clindamycin + ampicillin

Question 11

what qualifies a cystitis UTI as complicated, and how does it affect treatment?

Answer 11

the 3 Ps: penis, plastic (catheters), procedure (urologic), pyelonephritis

tx: 7 days of abx. whereas uncomplicated is 3 days.

Question 12

“ambulatory pyelo” - young healthy woman with pyelo who isnt super toxic. how do you treat?

Answer 12

outpatient, PO Cipro

also according to uworld, if they are inpatient, if sx improve after 48 hours on iv ceftriaxone, can transition to PO trim/sulf (or cipro..?)

Question 13

treatment of pyelnephritis

Answer 13

admit inpatient

IV ceftriaxone OR IV amp + sulbactam

Question 14

patient is in hospital for pyelo, but not getting better with abx. what do you do next?

Answer 14

look for abscess. Ultrasound for pregnant or renal failure patients. otherwise CT abd -> drainage, cont abx

Question 15

what abx to use for pencillin sensitive strep viridans/mutans infectious endocarditis?

Answer 15

IV pencillin G or IV ceftriaxone

Question 16

if you’re worried about TB and person has pleural effusion, what levels can you test in tapped fluid?

Answer 16

ADA (adenosine deaminase)

if high, think HIV or TB

Question 17

alternative abx for primary syphilis if they’re anaphylactic allergic to pencillin?

Answer 17

Doxycycline oral

Question 18

what unique features of cryptococcal meninigitis set it apart from other meninigitis causes? (3) especially from viral where you also wouldnt see anything on gram stain of CSF

Answer 18

1. subacute presentation. not usually severe acute.
2. immunocompromised pt
3. elevated opening pressure on LP

Question 19

“halo sign” in lung (nodules with surrounding ground glass opacities) is indicative of what infection?

Answer 19

INVASIVE aspergillosis

not that you can have chronic pulmonary aspergillosis without this sign. it’s specific but not sensitive for the exam lol

Question 20

systemic blastomycosis (remember broad based budding bi-budd (2 buds attached to each other)) and coccidoides can both have skin and bone involvement besides lungs. but how can u tell difference in a question?

Answer 20

LOCATION:
blastomycosis - MidWest. great lakes. WISCONSIN
coccidoides- southwest US

also coccidoides can cause valley fever (meninges involvement)