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1
Q

SPICE (HAM) organisms and treatment

A

Serratia, Providencia, Indole-positive Proteus, Citrobacter, Enterobacter, Hafnia, Acinetobacter, Morganella

Rx: Carbapenem, TMP-SMX, Fluoroquinolone (FQ), Aminoglycoside (AG)

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2
Q

ESBL organisms and treatment

A

E. coli, Klebsiella Rx: Carbapenem, TMP-SMX, FQ, AG (if sensitive)

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3
Q

CPE Rx

A

Colistin, AG, Tigecycline, Call ID (TMP-SMX or FQ if lucky)

INFECTION CONTROL

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4
Q

MRSA Rx

A

Vancomycin, Doxycycline, TMP-SMX, Clindamycin, Linezolid, Daptomycin, Ceftobiprole

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5
Q

Pseudomonas Rx

A

Pip/Tazo, Ceftazidime, Cefepime, Carbapenems (not Ertapenem), Ciprofloxacin, AG, Aztreonam, Colistin

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6
Q

Enterococcus Rx

A

Vanco (not VRE), Linezolid, Daptomycin (amp/piperacillin if lucky)

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7
Q

Gram positive cocci

A

in clusters – S. aureus or CNST (Coag Neg Staph)

in pairs/chains – Streptococcus or Enterococcus

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8
Q

Gram positive bacilli

A
  • spore forming – Bacillus or Clostridium
  • non-spore forming – e.g. Corynebacterium, Listeria
  • Branching – Actinomyces, Nocardia
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9
Q

Gram negative cocci

A

Neisseria meningitides/gonorrheae, Moraxella

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10
Q

Gram negative bacilli

A
  • Lactose fermenters – Klebsiella, E. coli, Enterobacter

* Non-lactose fermenters – Pseudomonas, Stenotrophomonas

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11
Q

Length of treatment for bacterial meningitis with following organisms:
S. pneumoniae
N. meningitidis
Listeria monocytogenes

A

S. pneumoniae–> 10-14 days
N. meningitidis–> 7 days
Listeria 21 days–> monocytogenes

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12
Q

CAP treatment healthy outpt

A

– Amox 1g TID(strong,moderate)
– Doxy 100mg BID(conditional,low)
– Azithro 500mg and then 250mg (or Clarithro)

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13
Q

CAP treatment outpt with co-mordbidites (ex. etoh, DM)

A 
Amoxclav
OR 
Cephalosporin(Cefpodoxime,cefuroxime) +macrolide
OR
Doxy (conditional, low)
OR
Resp FQ (strong,moderate)
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14
Q

TB, who should be tested?

A
  • Contacts of active case of pulmonary TB
  • Immigrants from countries with high TB incidence
  • Travelers to countries with high TB incidence
  • Aboriginal communities
  • Injection drug users
  • Homeless
  • Health care workers
  • Residents of long-term care facilities or correctional facilities
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15
Q

Empiric treatment for Necrotizing Fasciitis

A

Vanco + clinda + PipTazo

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16
Q

Organisms associated with water: salt, fresh, fish tank, hot tub

A

Vibrio vulnificus (salt water)
Aeromonas spp. (fresh water)
M. marinum (fish tank exposure)
M. fortuitum (hot tub exposure)

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17
Q

Organism associated with rose garden

A

Sporothrix schenckii

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18
Q

Organism associated with bites

A 
Eikenella corrodens (humans)
Pasteurella spp., B. henselae, Capnocytophaga (animals)
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19
Q

Oral hairy leukoplakia (EBV): patient population and findings

A

HIV+ patient with white plaque on lateral aspect of tongue; does not scrape off

20
Q

Features of Cryptococcus neoformans

A

Umbilicated lesions, HIV (CD4 < 50), sub-acute meningitis, ↑ opening pressure

21
Q

How do you treat Lyme disease?

A

Doxy x14 days OR if CNS or CVS involvement–>CTX x14 days

22
Q

Empiric treatment for ventriculitis

A

Vanco + Ceftazidime OR meropenem x14days

23
Q

Sensitivity pattern for C. albicans (azole, echino, Ampo B)

A

sensitive to all

*consult optho, Tx x14 days, consider TTE if not clearing

24
Q

Sensitivity pattern for C. galbrata, krusei (azole, echino, Ampo B)

A

Resistant to azoles, sensitive to echino and ampho

*consult optho, Tx x14 days, consider TTE if not clearing

25
Four pathogens that you must initiate airborne precautions
* TB (confirmed/suspected pulmonary TB, pleural/laryngeal TB) * Disseminated VZV * Primary or disseminated varicella * Measles
26
Seven pathogens that you must initiate droplet (mask) precautions
* SARS coronavirus * Mumps * Meningococcus * Ebola Virus Disease * Invasive GAS (TSS/NF/pneumonia/meningitis) * Diphtheria (pharyngeal) * Seasonal influenza
27
Pathogens that you must initiate contact (gloves, gown) precautions
* Disseminated or primary and extensive HSV * C. difficile * AROs (including MRSA, VRE, ESBL, CRE) * Norovirus * Scabies
28
Feature of Cryoglobulinemia? What virus and hematolgic conditions is it associated with?
Arthralgia, purpura, peripheral neuropathy, GN - HCV - MGUS, MM, Waldenstroms
29
When to start HARRT for pts with HIV and TB: CD4<50, CD4>50, TB meningitis
CD4<50--> within 2 weeks CD4>50--> within 8 weeks TB meningitis--> defer for 8 weeks give risk of IRS
30
How do you treat Typhoid?
IV CTX, cipro or Azithro
31
How do you treat Vibrio cholerae?
Doxycycline
32
How do you treat Yersina enterocolitica?
TMP-SMX (alternative Cefotaxime or ciprofloxacin)
33
How do you treat mild/moderate malaria (falciparum and non. fal)?
CS: Chloroquine CR: Atovaquone-proguanil OR Quinine + doxycycline * If P. vivax or P. ovale, add primaquine (check G6PD level first) to treat hypnozoite stage
34
How do you treat severe malaria?
IV artesunate X 48h then PO • Atovaquone-proguanil OR • Doxycycline OR • Clindamycin
35
Treatment of Strongyloides?
Ivermectin 200 mcg/kg PO day 1, 14
36
Are you pretty?
What kind of a question is that, I'm the pretty girl ever to walk the Earth.
37
What medications must you avoid in Dengue?
NSAIDs
38
Side effects of active TB treatment
RMP - drug interaction, rash1, hepatitis3 INH - rash3, hepatitis2, neuropathy PZA - hepatitis1, rash2, arthralgia EMB - eye toxicity, rash4
39
When do you do a TOC in treatment of G & C?
TOC NOT indicated if treatment completed and symptoms resolve! Otherwise, TOC with culture done 1 week post-treatment in patients with: • Persistent symptoms • Pharyngeal infection • Treatment other than cephalosporin • Known partner with drug-resistant infection * Positive Gram stain > 72 hours after treatment * Positive culture > 72 hours after treatment * Positive NAAT 2-3 weeks after treatment
40
Treatment for LGV (Chlamydia)?
Doxycycline 100mg PO BID X 21d; Rx partner(s)!
41
Treatment of genital warts?
Nothing! Cryotherapy.
42
Treatment of Bacterial vaginosis and Trichomonas vaginalis?
Metronidazole 2g PO X 1 dose OR 500mg PO X 7 days; If Trichomonas, treat partner!
43
Treatment length for aspergillus? (Aspergilloma, Chronic Cavitary Pulmonary Aspergilosis (CCPA), Invasive aspergillosis)
Aspergilloma and Chronic Cavitary Pulmonary Aspergilosis (CCPA) = 6 mos Invasive aspergillosis= Usually Voriconazole x 6 weeks
44
Treatment of Blastomycosis, Histoplasmosis, Coccidiodomycosis
Itraconazole (mild to moderate), Amphotericin B (severe)
45
Which antibiotics should you avoid if concern for pyleonephritis?
– Nitrofurantoin or Fosfomycin
46
How do you treat GAS?
PCN and clinda | *also the treatment for clostridium

2020 (13 decks)

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