ID- MKSAP VI Flashcards
When do you post-exposure prophylax for Lyme? What is the ppx?
- 72 hours of tick removal
- tick on for at 36 hours
- doxy 200mg x1
What do you do if you are exposed to smallpox (variola)?
Vaccinia vaccination no more than 7 days (but preferably within 3) after presumed exposure
Infection of VZV in young person should prompt testing for _____.
HIV
How does Creutzfeldt Jakob present?
- rapidly presenting dementia, ataxia, myoclonus
- can have T-tau or 14-3-3 protein in CSF
- MRI findings are nonspecific
Do you treat EHEC (AKA Shiga-toxin producing E coli AKA STEC) with antibiotics?
No, increased risk of HUS
What can CMV infection cause?
Retinitis (common in AIDS), pneumonitis, hepatitis, bone marrow suppression, colitis with bloody diarrhea, esophagitis, adrenalitis
When do most surgical site infections occur?
within 30 days (90 days if it involves implant)
What do you sample to guide a superficial incisional infection?
culture of drainage from wound
Side effects of FQ
- tendonitis/tendon rupture
- CNS- HA, neuropathy, sleep and mood alterations
- QTC prolongation
- GI symptoms
Treatment for oropharyngeal/esophageal candidiasis
- oral fluconazole (7-14 days or 14-21 days if esophageal)
Most appropriate testing for genital ulcers caused by HSV.
NAAT for HSV-1 and HSV-2
Treatment of nec fasc for GAS
Clinda and PCN after surgical debridement
Treatment of Vibrio vulnificus necrotizing skin infection
Doxy and 3rd gen cephalosporin
How does Mediterranean spotted fever present?
Fever, myalgia, HA, maculopapular/petechial rash, distinct black eschar at site of inoculation
Caused by Rickettsia conorii, 2-14 days after tick bite
Often in Europe but also Africa, India, and Middle East
When does erythema migrans present after infection?
1-4 weeks afterwards
When do cardiac or neurologic symptoms occur in early disseminated disease?
2-10 weeks after erythema migrans rash
What is the “rule of 7s” for Lyme disease? (Meaning what makes it less likely Lyme)
HA <7 days, <70% mono in CSF, absence of 7th nerve palsy
CMV vs EBV in transplant patients
CMV does NOT cause hepatosplenomegaly or generalized LAD
What is posttransplant lymphoproliferative disorder (PTLD) and how does it present?
- caused by EBV and presents several years after transplantation with fever, pancytopenia, generalized LAD and hepatosplenomegaly
Abx of choice for purulent skin infections s/p I&D?
Bactrim and doxy (not clinda)
TB skin test cut off
High risk (HIV, recent contact, etc): > or = 5mm
High-prevalence countries, IVDU, residents/workers in high-risk settings: > or = 10mm
Low risk: > or = 15mm
