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Infections Flashcards

1
Q

how to treat suppurative conjuctivitis?

A

opthamalic tx FQ ocular solution: gatifloxacin, levofloxacin, moxifloxacin.

polymix B + trimepthoprim or azithromycin solution

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2
Q

open angle glaucoma symptoms

A

slowlt progressive, seldom have symptoms, eventual loss of vision is periphery and tunnel vision. on exam see excessive cupping of optic disk. diagnostic if IOP > 25 mmgHg, cup: disk ratio > 0.3

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3
Q

angle closure glaucoma symptoms

A

red eye, paindrul, change in acuity, blindness ensues 3-5 days

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4
Q

anterior uveitis symptoms

A

painful red eye dull, visual change, constricted pupil and nonreactive and irreg shaped.

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5
Q

Tx glaucoma

A

referal fir rekuefubc IAP and meds.

meds: beta adrenergic antagonists topical (timolol), alpha 1 agonists (brimonidine), PG analogues (latanoprost), surgery.

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6
Q

tx uveitis

A

pupillary dilation and corticosteroiids.

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7
Q

what is a hordeolum?

A

stye caused by staph infection of hair follice

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8
Q

what is chalazion?

A

inflamm condition on lid margin. hard and nontender slling of lide.

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9
Q

tx hordeolum?

A

warm compress, rarely incision or drainage needed. hordeolum complicated - antibiotics. if develop cellulitis. systemic antibiotic!

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10
Q

tx chalazion

A

warm compress, if unsubsided intrlesion corticosteroid injection or excision.

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11
Q

what is the subjective persception of altered equilibrium?

A

dizziness

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12
Q

what is perception that the person or environment is moving?

A

vertigo

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13
Q

Meineres disease symptoms?

A

ringing in ears. pressure sensation in ear, vertigo. resolve after membrane repaired and sodium and K concentrations restored. sign nystagmus, weber laeralizes to unaffected ear. rhine normal with air escreeding bone condutino. pneum otoscoptyp can elcit syptoms and cause nystagmus.

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14
Q

Tx meineres disease or syndrome?

A

antihistamines, antiemetics, benzo if anxious. corticosteroouds.

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15
Q

what HPV strain is increased risk for oral cancer?

A

HPV 16

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16
Q

What should one assume if a pt has hx allergy t PCN?

A

allergy to cephalosporin

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17
Q

what are two classess that have lower risk for alletgy?

A

quinolones and macrolides

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18
Q

most common allergy to what class of drug?

A

beta lactam drugs: PCN, cephalosporins.

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19
Q

otitis externa organisms include:

A

gram +, fungi: candida, or aspergillus, P aeruginosa, enterobacteriaceae, proteus spp

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20
Q

What are signs of fugal otitis E

A

itchy more, thickrt and white to gray discharge.

and then also pain on tragus palpation, redness, and edema on ear canal, purulent or serous discharge.

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21
Q

Tx otitis externa?

A

otic suspension FQ (ofloxacin, ciprofloxacin), polyxin B plus neomycin with or with out hydrocortisone

MRSA concern - TMP-SMX, tetracycline, or clindamycin

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22
Q

organisms common cause of AOM?

A

S pneum.
H influ
M catarrhalis

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23
Q

what class is S pneum likely to NOT have resistance against?

A

rep FQ (remember this for AOM and strep)

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24
Q

what does M catarrhalis and H. influe have that makes it resistant at times?

A

production beta lactamase. cant use PCNs.

25
what does S pneum mechanism of resistance?
via altered protein binding sites within microbe cell. resistant against PCN, ceph, and macrolides often. solution: use larger does amoxicillin and cephal.
26
what is most common organism isolated from mucoid serious middle ear effusion?
H influ
27
signs of AOM?
TM bulging or retracted, loss mobility. itching and crackling. less prom bony landmarks.
28
Tx AOM?
1. first line s if no antibioitcs prior - high dose Amox 100 mg TID alter: amox clauv 2000/125 BID or cephalosporin (cefidinir 300 mg BID or 600 mg daily; cefpodoximine proxetil 200mg BID; cefprozil 25-500 BID) if antibiotics prior 2. high dose amox-caluv or high dose FQ 5-7 days: levofloxacin 750 daily x 5 days moxifloxacin 400 mg daily 3. Allergy PCN: azithromycin (clarithromycin r TMP-SMX possible) note that many can resolve on own. look at guidelines.
29
incubation of S pyrogenes or GBHS?
3- 5 days.
30
Symptoms of Mycoplasma pneum phayngitis? why different from GABHS?
inflamm exudate, pharyngeal edema and erth, lynphaden, tonsillar enlargement, but dry cough r/t bronchitis similar organism. incubation 3 weeks.
31
group C and G carry less risk for what complication?
rheumatic fever or glomerlonephritis, can clear without antibiotics. but will hasten resolution.
32
how confirm diagnosis of peritonsillar abscess
symptoms with deviation and worsening one side of sore throat and muffled voice or drooling. can do CT scan or US to confirm.
33
tx peritonsillar abscess
FNA, antimicrobrial therapy.
34
when does scarlet fever rash occur?
complication ctars second day of illness. peels during recovery. starts on trunk.
35
TX exudative pharyngitis or GBHS? REMEMBER not GBHS do not treat as it is not bacterial it is viral!
first line: PCN V PO x 10 days or benzathine PCN IM x 1 dose or cefdinit or cefpodoxime x 5 days PCN allergy: macrolides (erythromycin, clarithy, azithro, clind) clindamycin x 10 days if resistance or unresolving or recurrent: Amox -clav or cephal (cefdinir etc), or clindamycin
36
what medication is useful in treating M pneum or chlanydia pneum pharyngitis (although less common strains?)
macrolide or FQ
37
symptoms in ABRS?
sinuses tender in palpation, purulent discharge, URi like sypmtoms 7-10 days with 1)maxillary facial pain, 2) purulent discharge, or double sickening.
38
TX ABRS?
start not until symptoms 7-10 days URI like symptoms. can treat if severe after 3-4 days. first line - Amox clauv 500 mg/125 mg PO TID or 875-125 BID second line - amox caluv 2000/125 BID doxycyclie 100 mg PO BID or 200 mg daily Beta lactam allergy: doxycycline levofloxacin 500 mg daily moxifloxacin 400 mg daily support: saline spray, nasal corticosteroids, NSAID for pain NO decongestants
39
organism responsible for ABRS most often?
s pneum.
40
tx ABRS if risk of resistance or failed intial therapy?
amox caluv 2000mg/125 mg BID levo 500 mg dialy mox 400 mg daily
41
what treatment for ABRS is not ok in pregnancy?
doxycycline!
42
incubation of mono, epstein barr virus?
30-50 days
43
symtpms of mono?
2-5 days of fever, HA, and ateror and posterior cervical lymph, splenomegly 50%, jaundice, periorbital edema, soft palata petechie and rubella rash can occur resolves 4-6 weeks
44
tx mono?
prednisone 40-60 mg/day fr 3 days
45
what causes a rash with mono?
amoxicilin and ampicillin
46
Tx of mild intermittent allergic rhinitis?
oral or local H2 blocker | intranasal decong
47
Tx of moderate severe intermittent allergic rhinitis
controller and rescue therapy: intranasal corticosteroid, local mast cell stabiliser (cromyln), or leukotrine modifier. + oral or local anthistamine and intra nasal decong or oral for rescue if severe can have short term oral corticosteroid.
48
Tx of mild persistent allergic rhinitis?
controller and rescue therapy: intranasal corticosteroid, local mast cell stabiliser (cromyln), or leukotrine modifier. + oral or local anthistamine and intra nasal decong or oral for rescue (sudafed)
49
tx severe persistent allergic rhinitis
controller and rescue therapy: intranasal corticosteroid or local mast cell stabiliser (cromyln), or leukotrine modifier. + oral or local anthistamine and intra nasal decong or oral for rescue (sudafed) if severe can have short term oral corticosteroid. can use anticholinergic spray (iptratropium) if severe bothersome and perfuse nasal discahrge.
50
Tx intermittent seaspnal allergic conjuctivitis?
cool compress, artificial tears, topical anthistamine or topical cromylyn or topical histamine combination with mast cell or vasoconstrictor or NSAID doesnt resolve - oral antihstamine
51
how lnog for nasal corticosteroid spray to work?
few days to a week
52
how do decongestants work?
vasoconstriction | avoid id HTN or CVD
53
what should use of leukotrine modiferes be for?
inflamm inhibitor
54
What viruses are implicated with AOM?
RSV, influenza, rhinovirus
55
what bateria are implicated with AOM?
S.pneum H influenza M. catarrhalis
56
what organisms common for ABRS?
s pneum H. influ M. catarrhalis
57
what bacterial organisms cause exudative pharyngitis?
S pyrogenes or Group A beta Hemolytic strep M. pneum C. pneum
58
what viruses cause pharyngitis?
groups C and G step

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