ID Flashcards
Most common cause of bacterial pharyngitis
Group A beta-hemolytic strep
CENTOR criteria for strep
Cough absent Exudative tonsils Nodes (anterior cervical chain) Temperature >38C Age <15 (+1) or >45 (-1)
score 0-2 –> no culture or abx
Score 3 = culture, tx if +ve
score >/=4 = culture, tx with abx on clinical grounds, d/c if culture negative
Abx for treatment of strep throat reduces risk of post-strep glomerulonephritis T/F
False
Metronidazole and EtOH reaction
Disulfiram-like toxicity
Chest pain, vertigo, vomiting, diaphoresis, metallic taste, erythema, conjunctival injection
3 important opportunistic infections related to HIV pts
Pneumocystis jiroveci pneumonia
Mycobacterium avium complex
Toxoplasmosis
PCP prophylaxis in HIV starts at CD4 count of
<200cells/mm3
Toxoplasmosis prophylaxis in HIV starts at CD4 count of
<100cells/mm3
Causes toxoplasmosis encephalitis (ring-enhancing lesions on CT head)
Myocbacterium avium infection prophyalxis starts at CD4 count of
<50 cells/mm3
PCP prophylaxis in HIV pts
Trimethoprim-sulfamethoxazole
Toxoplasmosis prophylaxis in HIV pts
Trimethoprim-sulfamethoxazole
TB prophylaxis
Used in pts with latent TB infection (secondary preventon)
Isonizid + pyridoxine (to avoid vit B6 dficiency) x 9mo
Amphotericin B
Tx for cryptococcal neoformans meningoencephalitis in AIDS patients
Prophylaxis against opportunistic infection of cryptococcal neoformans meningoencephalitis
Fluconazole
Prophylaxis against isoniazid-resistant TB
Rifampin
MAC prophylaxis agent
Azithromycin
Febrile neutropenia etiology
Pseudomonas (gram -ve)
Gram +ve organisms becoming more common
Parasite responsible for malaria
Plasmodium falciparum
Screening test for malaria
Falciparum screen
Tx for malaria
IV artesunate
Empiric abx for febrile neutropenia
Pip-tazo/Meropenem/Cefipime +/- vanco
Functional asplenism, increased susceptibility to encapsulated organisms
S.pneumoniae
N. meningitides
H. influenza
Salmonella
Pathogen commonly associated with cat bites
Pasterurella multocida (gram -ve rod)
Management of cat bite
Wash with water and soap, detergent or povidone iodine.Saline irrigation. debridement. Culture. Leave open (no suture) but banadage)
Only suture of on face or scalp
Culprit of Herpes Simplex Encephalitis in neonates
HSV-2
Acquired during birth from infected mother
Culprit of Herpes Simplex Encephalitis in children >3mo and adults
HSV-1
Abx of choice for E. histolytica
Metronidazole
Common causes of C.diff
Clindamycin
Fluoroquinolones
Cephalosporins
Penicillins
C. diff tx
Flagyl PO
Vanco PO
Fecal transplant
Most common cause of bacterial gastroenteritis
Campylobacter
Most common cause of chronic diarrhea in HIV pt with CD4 <200
Cryptosporidium parvum
Dx Cryptosporidium parvum
Acid fast staining of stool
Look for oocytes
Risk factors for meningitis
Asplenia Complement deficiency Glucocorticoid excess Diabetes mellitus EtOH-use HIV Recent infxn (esp resp or ear) Recent exposure to someone with meningitis IVDU Recent head trauma Otorrhea or rhinorrhea Recent travel
Empiric tx for meningitis
Adults: Ceftriaxone + Vanco + dex for first 4d
Continue dex if culprit is S. pneumo
Prophylaxis for H. influenzae meningitis contacts
Rifampin x 4d
Prophylaxis for meningococcal meningitis contacts
rifampin x 2d
OR single dose of cipro if >18yo
Prophylaxis for meningitis in pregnant patient contacts
Ceftriaxone 250mg IM single dose
Argyll Robertson Pupil
Accomodating but not reactive to light in neurosyphilis
Screening tests for syphilis
VDRL
Rapid plasma reagin
Enzyme immunoassay
Confirmatory tests for syphilis
T. pallidum immobilization assay
Fluorescent treponema Ab-absorption
Microhemagglutination assay
T. pallidum particle agglutination assay
Prophylactic abx for dental procedures in high risk pts
Amoxicillin 1h before
Most common primary immunodeficiency in adults characterized by increased susceptibility to bacterial infections
Common variable immunodeficiency
Dx: Quantitative measurement of immunoglobulin levels
Neurosyphilis positive serum VDRL result
> 1:32
Most common cause of neutropenic enterocolitis
Clostridium septicum
HIV testing in neonate to positive mom
HIV DNA PCR
48h after birth, >/= 1 mo and >/= 4mo
Botulism toxin MOA
Blocks ACh release at NMJ
Listeria gram stain
Gram + rods
H. influenza gram stain
Gram - coccobacilli
Empiric abx for meningitis for =28d
Amp + cefotaxime
Empiric abx for meningitis for 29d-3mo
Cefotaxime + Vanco
Empiric abx for meningitis for >3mo
Ceftriaxone + Vancomycin
+/- ampicillin if risk for L-monocytogenes + dex IV within 20min prior to or with first dose of abx (continue in pts with pneumococcal meningitis)
Acute pulmonary TB treatment
Isoniazid + rifampin + pyrazinamide + ethambutol x 2mo (initiation phase) then isoniazid + rifampin x 4mo in fully susceptible TB (continuation phase)
Extend for extra month if >65yo, pregnant or risk of hepatotoxicity
Latent TB test
Tuberculin skin test or IGRA
Active TB test
Sputum