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ID Flashcards

1
Q

clindamycin covers

A

most gram positive, some MRSA coverage

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2
Q

antibiotics that cover enterococcus

A

vancomycin, linezolid, ampicillin, rifampin and quinolones

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3
Q

first generation cephalosporin antibiotics

A

cephalexin (keflex), Cefazolin (acne)

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4
Q

first generation cephalosporins coverage

A

staph and strep, no MRSA, some gram negative (proteus, E. coli, Klebsiella)

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5
Q

2nd generation cephalopsorin antibiotics

A

cefaclor, cefuroxime, cefotetan, cefoxitin

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6
Q

2nd generation cephalosporin coverage

A

no gram positive but better gram negative (h. flu, enterobacter, Neisseria, proteus, E. coli, klebsiella)

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7
Q

3rd generation cephalosporin antibiotics

A

ceftriaxone, cefotaxime, ceftazidime, cefpodoxime

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8
Q

3rd generation cephalosporin coverage

A

good for hospital acquired gram negative infections and meningitis, ceftazidime is good for pseudomonas

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9
Q

4th generation cephalosporin antibiotic

A

cefepime

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10
Q

macrolides side effect

A

increased GI motility

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11
Q

carbapenems used for

A

ESBL producing organisms such as Enterobacter

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12
Q

metronidazole used for

A

GET BCG

Giardia, Entamoeaba, Trichomonas, Bacteroides, Clostridium, Gardnerella

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13
Q

treatment for enterococcus faecalis

A

vancomycin, linezolid, ampicillin, rifampin or quinolone

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14
Q

enterococcus faecalis is a

A

G+ diplococcus

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15
Q

listeria monocytogenes is a

A

G+ diphtheroid (rod)

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16
Q

listeria monocytogenes treatment

A

ampicillin

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17
Q

clostridium tetani treatment

A

tetanus immunoglobulin + metronidazole OR penicillin

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18
Q

corynebacterium diphtheria treatment

A

erythromycin or penicillin G

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19
Q

alpha hemolytic strep species

A

strep viridans and strep pneumoniae

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20
Q

beta hemolytic strep species

A

strep agalactiae and strep pyogenes

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21
Q

strep agalactiae causes

A

GBS

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22
Q

strep progenies causes

A

GAS skin infection

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23
Q

rheumatic fever is caused by

A

strep pharyngitis only

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24
Q

post infectious glomerulonephritis is caused by

A

strep pharyngitis OR strep skin infection

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25
Q

peritonsillar abscess treatment

A

IV clindamycin or Unasyn, once drained PO augmenting

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26
Q

most common organism causing peritonsillar abscess

A

grp A strep (but also cover for anaerobes)

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27
Q

retropharyngeal abscess presents most commonly in

A

younger kids (<6 years) with fever, LAD, hyperextension of neck and drooling

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28
Q

most common organism causing retropharyngeal abscess

A

grp A strep

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29
Q

xray of retropharyngeal abscess

A

widening of retropharyngeal space

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30
Q

scarlet fever is due to what organism

A

grp A strep

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31
Q

scarlet fever rash description

A

rash in the creases that is initially sandpaper but then more erythematous. pink or red lines near creases called pasties lines. strawberry or white tongue. rash does not hurt

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32
Q

most common organism that causes occult bacteremia

A

strep pneumoniae (don’t treat if no symptoms/found incidentally)

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33
Q

most common cause of pneumonia in kids

A

strep pneumo

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34
Q

most common cause of pneumonia in kids with CF

A

staph aureus or pseudomonas aeruginosa

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35
Q

early onset GBS timeline

A

within first 6 days of life

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36
Q

most common cause of early onset GBS

A

pnuemonia

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37
Q

late onset GBS timeline

A

after 6 days and up to the first 90 days of life

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38
Q

most common infections in late onset GBS

A

usually focal (meningitis, cellulitis, osteomyelitis)

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39
Q

confirmed GBS treatment

A

penicillin G

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40
Q

band:neutrophil count ratio suggestive of infectio

A

> 0.2

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41
Q

rectovaginal GBS screening at

A

36 to 37 6/7 weeks

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42
Q

intrapartum antibiotic prophylaxis must be given how low before delivery to be considered adequate

A

at least 4 hours prior

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43
Q

early onset GBS meningitis treatment

A

ampicillin, gentamicin and cefotaxime

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44
Q

early onset GBS bacteremia, sepsis or pneumonia treatment

A

ampicillin and gentamicin

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45
Q

late onset GBS bacteremia treatment

A

ampicillin and gentamicin (or vancomycin and cefotaxime)

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46
Q

late onset GBS meningitis treatment

A

ampicillin, gentamicin and cefotaxime

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47
Q

late onset GBS cellulitis treatment

A

nafcillin and gentamicin (or vancomycin and cefotaxime)

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48
Q

late onset GBS septic arthritis or osteomyelitis treatment

A

nafcillin and cefotaxime (or vancomycin and cefotaxime)

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49
Q

gram positive organism in clusters on gram stain

A

staph aureus

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50
Q

treatment for coagulase negative staph

A

vancomycin

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51
Q

rash presentation of Rocky Mountain spotted fever

A

starts on palms, wrists and soles, then spreads to trunk within hours

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52
Q

RMSF treatment

A

doxycycline

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53
Q

enterobacter

A

hospital acquired gram negative urinary or respiratory infection, often ESBL requiring carbapenem but if not can use cephalosporin

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54
Q

citrobacter freundii

A

brain abscess

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55
Q

small nontender papule or ulcer that resolves then a tender lymph node appears that ruptures and drains for months but relieves the pain

A

lymphogranuloma venereum (chlamydia trachomatis)

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56
Q

chlamydia trachomatis STD treatment

A

azithromycin x1 or doxycycline x 7 days

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57
Q

chlamydia conjunctivitis treatment

A

PO erythromycin (to eradicate nasopharyngeal colonization that can lead to pneumonia)

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58
Q

lymphogranuloma venereum

A

small nontender papule or ulcer initially that resolves and then a tender lymph node forms, pain resolves once it drains and it can drain for months

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59
Q

lymphogranuloma venereum treatment

A

doxycycline or erythromycin

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60
Q

common phrase for chlamydia

A

intracytoplasmic inclusions (its an intracellular organism)

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61
Q

most common bacterial STD

A

chlamydia

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62
Q

most common STD overall

A

HPV

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63
Q

most common reported STD

A

chalmydia

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64
Q

first line treatment for chlamydia pneumonia

A

macrolide (azithromycin or erythromycin) no matter age

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65
Q

risk of macrolide in infant <2 weeks

A

risk of infantile hypertrophic pyloric stenosis with erythromycin and azithromycin but still use in chlamydia pneumonia bc benefits outweigh risks

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66
Q

bird exposure plus atypical pneumonia

A

chlamydia psittasci pneumonia

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67
Q

chlamydia psittasci pneumonia treatment

A

doxycycline or macrolides

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68
Q

tachypnea, staccato cough +/- eye discharge in child less than 2 months

A

chlamydia pneumonia

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69
Q

infections caused by mycoplasma pneumonia

A

atypical pneumonia or bulls myringitis (some get near symptoms after infection)

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70
Q

mycoplasma pneumonia diagnosis

A

PCR or serum IgM titers

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71
Q

mycoplasma pneumonia treatment

A

macrolide

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72
Q

gram stain description of h. flu organism

A

pleomorphic organism

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73
Q

h. flu treatment

A

ceftriaxone

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74
Q

CBC w/ pertussis

A

lymphocytosis (WBC <20K)

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75
Q

diagnosis of pertussis

A

PCR w/ nasopharyngeal swab

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76
Q

treatment of pertussis

A

erythromycin, azithromycin or clarithromycin (if <1 month azithromycin) bactrim alternative if <1 month

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77
Q

use of antibiotics in pertussis

A

shorten early URI catarrhal stage, does not shorten whooping/paroxysmal stage

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78
Q

anti-psuedomonal antibiotics

A

ceftazidime, cefepime, ticaricillin, carbenicillin, piperacillin, gentamycin, tobramycin, ciprofloxacin, levofloxacin

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79
Q

rash of lyme shows up how long after bite

A

1 to 2 weeks (titers often still negative at this time)

80
Q

treatment of lyme is oral if

A

acute arthritis, disseminated erythema migrans or bells palsy (doxycycline if >8, amoxicillin if <8)

81
Q

treatment of lyme is IV if

A

carditis, neuritis or recurrent arthritis (penicillin or ceftriaxone)

82
Q

common location of arthritis in lyme

A

large joints ex: knees

83
Q

if lyme antibody titers are positive confirm with

A

western blot

84
Q

bells palsy aka

A

unilateral facial nerve (CN 7) palsy)

85
Q

jarisch-herxheimer reaction

A

fever, chills, hypotension, headache, myalgia and exacerbation of skin lesions during antibiotic treatment of a bacterial disease (usually spirochetes) due to large quantities of toxins released into b ody

86
Q

leptospirosis is spread via

A

urine of animals

87
Q

leptospirosis diagnosis

A

blood cultures if during first week, urine if after first week

88
Q

leptospirosis treatment

A

penicillin

89
Q

conjunctiva suffusion diagnosis

A

leptospirosis

90
Q

leptospirosis presentation

A

multisystem complaints including nonexudative conjunctivitis (conjunctival suffusion), abdominal pain, headache, transient rash, liver/renal failure

91
Q

unstable ICU patient with sepsis due to fungemia should be treated with

A

amphotericin B (liposomal amphotericin if there is renal disease)

92
Q

types of infections associated with cryptococcus

A

pneumonia and meningitis

93
Q

areas associated with cryptococcus

A

northwest US

94
Q

animal associated with cryptococcus

A

birds (pigeon droppings)

95
Q

diagnose cryptococcus via

A

india ink staining

96
Q

treatment of cryptococcus

A

for meningitis or disseminated - amphotericin first, then fluconazole

97
Q

broad based budding yeast

A

blastomyces

98
Q

location blastomyces is often found

A

near water

99
Q

illness blastomyces causes

A

pneumonia or flu like illness, skin lesions

100
Q

blastomyces treatment

A

azole (itraconazole is first line)

101
Q

illness caused by coccidioidmycosis

A

pneumonia or flu-like illness

102
Q

areas associated with coccidioidmycosis

A

west - california, Arizona, texas

103
Q

treatment for coccidioidmycosis

A

amphotericin or azole(fluconazole, ketoconazole

104
Q

type of illness caused by histoplasmosis

A

flu like illness

105
Q

area associated with histoplasmosis

A

Ohio and mississippi

106
Q

xray findings with histoplasmosis

A

hilar calcifications that look like TB or pulmonary fibrosis

107
Q

histoplasmosis associated with what exposure

A

bird droppings

108
Q

histplasmosis treatment

A

amphotericin or azole (fluconazole, ketoconazole)

109
Q

aspergillus in an immunocompetent patient

A

hypersensitivity reaction - allergic bronchopulmonary aspergillosis (ABPA) - especially asthmatics and CF

110
Q

allergic bronchopulmonary aspergillosis treatment

A

itraconazole and steroids

111
Q

diagnosis of allergic bronchopulmonary aspergillosis

A

increased eosinophilia and lung infiltrates

112
Q

chronic eosinophilia pneumonia

A

caused by aspergillum in immunocompromised, causes peripheral infiltrates on CXR

113
Q

treatment of invasive aspergillus

A

voriconazole or isavuconazole, long term steroids, negative pressure room

114
Q

mycobacterium TB diagnosis

A

acid fast staining

115
Q

positive PPD if no risk factors

A

> 15 mm

116
Q

positive PPD if xray findings

A

> 5 mm

117
Q

treatment for TB if +PPD but no xray findings

A

INH x9 months

118
Q

treatment for TB if +xray

A

rifampin, isoniazid, pyrazinamide (may get ethambutol x2 months)

119
Q

PPD check in newborns of mom with +PPD neg CXR

A

every 3 months

120
Q

treatment for kid with neg PPD and CXR but close +TB contact

A

INH prophylaxis x12 weeks

121
Q

treatment for kid with + PPD, neg CXR and + TB close contact

A

INH prophylaxis x 9 months

122
Q

treatment for kid with + PPD, +CXR and +TB close contact

A

triple or quadruple therapy

123
Q

treatment for kid with TB meningitis

A

triple or quadruple therapy plus steroids plus streptomycin

124
Q

R supraclavicular node drains what

A

mediastinum and lungs (more likely to show adenopathy with lung infection)

125
Q

L smupraclavicular node drains what

A

thorax and abdomen (more likely to be lymphoma)

126
Q

which lesions usually appear first in hand, foot mouth

A

mouth lesions (coxsackie = enterovirus)

127
Q

HHV 6 aka

A

roseola

128
Q

high fever and then a rash develops a few days after the fever subsides

A

HHV 6 (roseola)

129
Q

EEG with HSV meningitis

A

PLEDs (periodic lateralizing epileptiform discharges)

130
Q

CT scan with HSV meningitis

A

temporal lobe lesions

131
Q

rash of varicella zoster

A

comes in crops at different times, goes to the trunk and then the face and extremities, lasts 7 to 10 days. leaves minimal scars

132
Q

rash of small pox (variola)

A

lesions all appear at the same time and limited to the face/extremities, lasts 3-4 weeks and leaves a lot of scars

133
Q

things that require negative pressure rooms

A

Measles, Mycobacterium Tuberculosis, Varicella, Aspergillus

134
Q

pregnant women with HIV treatment

A

zidovudine or nevirapine

135
Q

testing of babies at high risk of HIV (mom not treated)

A

DNA PCR at birth and 2 weeks, start zidovudine within 72 hours and continue for 6 weeks

136
Q

testing of lower risk babies of HIV (Mom treated during pregnancy)

A

DNA PCR starting at 2 weeks

137
Q

HIV antibodies in newborns

A

maternal antibodies can last u to 18 months, test at 12-18 months to ensure they have cleared, if positive do a genetic material test

138
Q

prophylaxis once diagnosed with HIV

A

bactrim for PCP prophylaxis immediately

139
Q

cough, conjunctivitis, coryza

A

measles aka rubeola (also koplik spots)

140
Q

last symptoms of measles to appear

A

rash (starts at the head/hairline and progresses down), resolves after ~5 days

141
Q

major cause of death in measles

A

pneumonia

142
Q

time you are contagious with measles

A

4 days prior to onset of rash until 4 days after rash appears

143
Q

measles post exposure prophylaxis for someone <6 months

A

IGIM if <6 days since exposure

144
Q

measles post exposure prophylaxis for 6 to 11 month old

A

MMR if 3 days or less since exposure, IGIM if 4-6 days since exposure

145
Q

how long do you have to wait to give MMR after giving IGIM

A

5 months

146
Q

German measles aka

A

rubella virus

147
Q

rash of rubella

A

maculopapular. starts on the face and spreads to the trunk and extremities within 24 hours. face rash disappears as the body rash starts. rash resolves within 3 days.

148
Q

who should not get MMR vaccine

A

pregnant women (live)

149
Q

zika virus is transmitted by

A

aedes mosquito

150
Q

diffuse ring enhancing lesions on head CT

A

toxoplasma gondii

151
Q

periventricular lesions on head CT

A

CMV

152
Q

oral rehydration solution contents

A

2% glucose and 90 mEq NaCl

153
Q

only diarrhea that can have loperamide

A

traveler’s diarrhea (enterotoxigenic E. coli)

154
Q

diarrhea in older child associated with raw seafood

A

norwalk

155
Q

diarrhea that can cause HUS

A

shiga toxin producing e coli (STEC)

156
Q

enterotoxigenic E. coli description

A

travelers diarrhea - non bloody diarrhea with cramps abdominal pain, sometimes fever and vomiting. treat with azithromycin if lasting >1 week, ok to use loperamide

157
Q

high fever, bloody diarrhea, tenesmus, seizures and rectal prolapse caused by

A

shigella infections (gram negative)

158
Q

CBC in shigella infection

A

high neutrophils and bandemia (blood and WBC in stool)

159
Q

shigella treatment

A

azithromycin or ceftriaxone if ill

160
Q

diseases that cause tenesmus

A

shigella and entamoeba histolytica

161
Q

green malodorous diarrhea after eating at a picnic (especially eggs) or playing with an iguana is caused by

A

salmonella non-typhi

162
Q

treatment of salmonella typhii

A

ceftriaxone or cefotaxime

163
Q

treatment of campylobacter jejuni

A

erythromycin

164
Q

crampy abdominal pain, fever and inflammatory diarrhea caused by

A

campylobacter jejune (or shigella)

165
Q

diarrhea that starts within 8 hours is caused by

A

staph aureus or bacillus cereus

166
Q

fever and diarrhea after eating raw pork or unpasteurized milk is due to

A

yersinia enterocolitica

167
Q

yersinia enterocoliti results in

A

fever and diarrhea, pseudo appendicitis, erythema nodosum and reactive arthritis

168
Q

non bloody diarrhea ~10 hours after eating raw turkey or raw beef is from

A

clostridium perfringens (preformed toxins)

169
Q

antibiotics that cause c. diff

A

clindamycin, beta lactam, cephalosporins

170
Q

treatment of c. diff

A

oral metronidazole or oral vancomycin

171
Q

bloody diarrhea causes

A

salmonella, shigella, campylobacter, EHEC, EIEC, clostridioides difficle

172
Q

most common treatment for acute diarrhea

A

ceftriaxone, followed by azithromycin

173
Q

giardia diagnosis

A

string test + ELISA

174
Q

diardia treatment

A

metronidazole

175
Q

undigested food in poop

A

toddlers diarrhea

176
Q

toddlers diarrhea treatment

A

decrease carb intake/juice, increase fat and fiber intake

177
Q

diarrhea, emesis and malabsorption while on formula but not clears

A

food protein induced enteropathy

178
Q

food protein induced enteropathy treatment

A

if breastfeeding have mom stop drinking milk, if formula fed change to hydroxylate or amino acid derived formula, usually resolves once GI strict matures

179
Q

food protein induced enteropathy diagnosis

A

clinical - usually apparent after switching from breastfeeding to formula. not IgE mediated.

180
Q

food protein induced proctitis/colitis presentation

A

blood in stools but otherwise well (-itis of lower GI tract) more common in breastfed infants from cows milk in mom’s diet

181
Q

lactase deficiency diagnosis

A

hydrogen breath test (Eat carb load, if no lactase to digest then bacteria digest carbs and release hydrogen in breath - also diagnoses bacterial overgrowth)

182
Q

lactase deficiency treatment

A

soy milk (has sucrose instead of lactose)

183
Q

protein losing enteropathy with steatorrhea, low serum protein, low serum gamma globulin level, edema and possible lymphopenia

A

intestinal lymphangiectasia

184
Q

francisella tularensis gram stain

A

pleomorphic gram negative organism

185
Q

fever, HSM, LAD, ulcers, exposure to deer or rabbits

A

tularemia from francisella tularensis (tick-borne illness)

186
Q

francisella tularensis treatment

A

streptomycin + tetracycline

187
Q

atypical mycobacterium diagnosis/treatment

A

freely movable node, painless LAD, with some induration with PPD but not enough for TB, surgical excision is curative, no antibiotics

188
Q

brucellosis treatment

A

bactrim + rifampin if <8, doxycycline + rifampin, streptomycin or gentamicin if >8

189
Q

yersinia pestis treatment

A

streptomycin

190
Q

fever, painful and swollen LAD of inguinal and axillary region, in southwest US woods hunting

A

yersinia pestis

191
Q

sporotrichosis aka

A

rose pickers disease

192
Q

single painless movable nodular lesion that enlarges and then ulcerates, then other movable nodules appear along lymphatic chain

A

sporotrichosis from sporothrix schenckii

193
Q

sporotrichosis treatment

A

itraconazole or amphotericin B

194
Q

excision node biopsy findings of Hodgkins lymphoma

A

reed sternberg cells

195
Q

encapsulated organisms

A

Strep pneumo, Neisseria meningitidis, klebsiella pneumonia, h. flu, salmonella type, cryptococcus neoformans, pseudomonas aeruginosa
(some nasty killers have some capsule protection)

PBR (1 decks)

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