ID Tx

Question 1

CAP

Answer 1

Azithromycin or clarithromycin or fluoroquinolones
(cover atypicals)

If > 60 yo can use cephalosporin b/c less chance atypicals

Question 2

Vent-Associated Pneumonia

Answer 2

1- cefepime, pip-tazo OR imipenem

2- aminoglycoside or fluoroquinolone

3- linezolid or vanc

Question 3

Tb

Answer 3

2 mo - RIPE, then 4 mo rifampin and ING only

If pos PPD w/o active disease … 9 mo INH for ppx

**Give pyridoxine w/ INH

Question 4

Meningitis

Answer 4

Ceftriaxone + Vanc (ADD ampicillin ifinfant < 3 mo or > 50 yo)

+ steroids if cerebral edema present

Question 5

Encephalitis

Answer 5

CMV - ganciclovir or foscarnet

HSV - acyclovir 2-3 wks

Question 6

Chronic Hep C

Answer 6

IFN-alpha and ribavirin

New genotype specific tx

Question 7

Chronic Hep B

Answer 7

Interferon - alpha and lamivudine

Question 8

Uncomplicated UTI

Answer 8

Bactrim 3 days

Fosfomycin sngl dose

Nitrofurantoin 5-7 days

Cipro 3 days

Question 9

UTI In Preg Women

Answer 9

amp, amox or oral cephalosporin x 7-10 days

Question 10

Pyelonephritis

Answer 10

IV amp + gentamicin

OR IV cipro

Switch to 14 to 21 day course oral abx once afebrile 24 hrs

Question 11

Prostatitis

Answer 11

Mild - Bactrim, fluoroquinolone 4-6 wks

Septic - IV abx

Question 12

Chlamydia

Answer 12

Azithromycin x1 or doxy x 7 days

Question 13

Gonorrhea

Answer 13

Ceftriaxone IV or IM x 7 days + tx for chlamydia

Question 14

HIV PPX

Answer 14

PCP - give Bactrim once CD4 < 200

MAC - give azithromycin once CD4 < 100

Toxo - Bactrim once < 100

Question 15

HSV

Answer 15

No cure, acyclovir 7-10 days for symptoms and as ppx

Question 16

Syphilis

Answer 16

PCN G (1 dose IM)

If allergic to PCN, oral doxy x 2 wks

If latent or tertiary give PCN 3 doses IM once a wk then recheck non-treponemal tests every 3 mo (titers should dec 4-fold in 6 mo)

Question 17

Chancroid

Answer 17

Azithromycin or ceftriaxone

Question 18

Lymphogranuloma Venereum

Answer 18

21 days of doxy

Question 19

Cellulitis

Answer 19

Oxacillin, nafcillin or cefazolin IV –> switch once signs of infection improve –> 2 wks oral

Question 20

Tetanus

Answer 20

Diazepam for tetany

Sngle dose of tetanus immunoglobulin

Active tetanus-diphtheria toxoid shot

Question 21

Osteomyelitis

Answer 21

Cefazolin, ceftriaxone, cefuroxime (bone penetration)

vanco, linezolid, clindamycin

Question 22

Lyme

Answer 22

Oral doxy 21 days (amox or cefuroxime if pregnant)

Question 23

Rocky Mt Spotted Fever

Answer 23

Doxy 7 days

Question 24

Malaria

Answer 24

Chloroquine (unless resistant)

Then quinine sulfate and tetracycline (IV if falciparum)

Primaquine for dormant hypnozoites

Question 25

Rabies

Answer 25

Tetanus vaccine

Passive IgG

Active immunization

Question 26

Tularemia

Answer 26

IM streptomycin or gentamicin

Question 27

Erlichiosis

Answer 27

oral doxy x 1 wk

Question 28

Aspergillus

Answer 28

If invasive - IV amphotericin B, voriconazole or caspofungin

Question 29

Cryptococcus

Answer 29

Amphotercin B + flucytosine x 2 wks

Question 30

Sporotrichiosis

Answer 30

Potassium iodide 1-2 mo

OR itraconazole 3-6 mo

Question 31

Toxic Shock Syndrome

Answer 31

Nafcillin, oxacillin, vanco AND REMOVE SOURCE

Question 32

Entamoeba Histolytica

Answer 32

metro for liver abscess

Question 33

Giardia

Answer 33

Metro

Question 34

Tapeworm & Schistomiasis

Answer 34

praziquantel

Question 35

Pinworm, hookworm, ascariasis lumbricoides

Answer 35

mebendazole OR pyrantel pamoate