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Internal Medicine Shelf > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Meningitis… most common bugs? tx?

A

Strep pneumo, H. influenza, N. meningitidis

ceftriaxone and vanc

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2
Q

Meningitis bug associated with young and old? tx?

A

Lysteria

Ampicillin

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3
Q

Meningitis in people s/p brain surgery? Tx?

A

Staph

Vanco

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4
Q

Meningitis best first step?

A

Start empiric treatment.

Add steroids if you think it is bacterial

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5
Q

Diagnostic test for Meningitis?

A

Exam elevated ICP/CT, then LP

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6
Q

Diagnostic LP for meningitis?

A

+ Gram Stain, >1000 wbc

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7
Q

LP supportative for bacterial meningitis?

A

High protein and low glucose

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8
Q

Tx of roommate of the kid in the dorms who has bacterial meningitis and petechial rash?

A

Rifampin

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9
Q

Suspect pneumonia, best 1st step?

A

CXR

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10
Q

PNA most common bugs? Tx?

A

Pneumococcus

Macrolide, Fluroquinalone, 3rd Cephlasporin

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11
Q

PNA most common bug healthy young people? Assc w/? Tx?

A

Mycoplasma
Cold agglutinins
Macrolide, Fluroquinalone, Doxy

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12
Q

PNA hospitalized w/in 3 months or in the hospital >5-7 days? Tx?

A

Pseudomonas, kelbsiella, E. Coli, MRSA

Piperacillin/tazobactam or imipenem + Vanc

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13
Q

PNA old smokers w/ COPD? Tx?

A

H. influenzae

2nd-3rd Ceph

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14
Q

PNA alcoholics w/ currant jelly sputum? Tx?

A

Kelbsiella

3rd Ceph

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15
Q

PNA old men w/ HA, confusion, diarrhea, and abdominal pain? Dx?

A

Legionella
Urine antigen
Macrolide, fluroquinalone, doxy

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16
Q

PNA just had the flu?

Tx?

A

MRSA

Vanc

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17
Q

PNA just delivered a baby cow and have vomiting and diarrhea? Tx?

A

Q-fever. Coxiella burnetti

Doxy

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18
Q

PNA just skinned a rabbit? Tx?

A

Franciella tularensis

Streptamycin, gentamycin

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19
Q

Symptomatic TB best test?

A

CXR

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20
Q

Screening TB?

A

> 15mm
10mm if prison, HC, nursing home, DM, EtOH, chronically ill
5 mm AIDs, immune suppressed

21
Q

Screening TB w/ + PPD?

22
Q

Screening TB w/ +PPD, +CXR?

A

Acid fast stain of sputum

23
Q

Screening TB w/ +PPD, +CXR, +Acid fast stain?

A

Treat w/ 4 drug RIPE for 6 months (12 for meningitis and 9 if pregnant)

24
Q

Rifampin side effects?

A

Body fluids turn orange/red, induces CYP450

25
INH side effects?
Peripheral neuropathy and sideroblastic anemia (prevent by giving B6. Hepatitis w/ mild bump in LFTs)
26
Pyrazinamide side effects?
Benign hyperuricemia
27
Ethambutol side effects?
Optic neuritis, other color vision abnormalities
28
Acute endocarditis most common bug?
Staph aureus seeds native valves from bacteremia
29
Subacute native valve endocarditis, most common valve? Predisposition?
Mitral Valve | MVP
30
Subacute native valve endocarditis, most common bug?
Viridens group strep
31
IVDU endocarditis, most common valve?
Tricuspid valve | Murmur worse w/ inspiration
32
IVDU endocarditis, most common bug?
Staph Aureus
33
Endocardtitis diagnosis?
Blood cx, TTE then TEE. Major and minor criteria
34
Endocarditis complications?
CHF #1 cause of death, septic emboli to lungs or brain
35
Endocarditis strep viridens tx? Staph tx?
4-6 weeks PCN | Naf + gent or vanc
36
When do you do prophylaxis for endocarditis?
Prosthetic valve, hx of EC, or uncorrected congenital lesion
37
What is the next step if you find strep bovis bacteremia?
Colonscopy
38
What is acute retroviral syndrome?
2-3 s/p HIV exposure but 3 weeks before seroconversion
39
Symptoms of acute retroviral syndrome?
Fever, fatigue, lymphadenopathy, headache, pharyngitis, N/V/D +/- aseptic meningitis
40
When to suspect HIV in a young person?
New/bilateral Bell's palsy Unexplained thrombocytopenia unexplained weight loss >10% Thrush, zoster, or kaposi sarcoma
41
In a HIV patient when do you start HAART?
CD 4 < 350 | Viral Load > 55000 (pregnant start > 1000)
42
Zidovudine side effects?
GI, leukopenia, macrocytic anemia
43
Didanosine side effects?
Pancreatitis, peripheral neuropathy
44
Abacavir side effects?
HS rash, fever, n/v, muscle aches, SOB in 1st 6 week
45
When do you stop abacavir?
SOB in 1st 6 weeks
46
Indinavir side effects?
Nephrolithiasis | Hyperbilirubinemia
47
Efavirenz side effects?
Sleepy, confused, psycho
48
HIV post exposure prophylaxis?
AZT, lamivudine, nelfinavir for 4 wks

Internal Medicine Shelf (4 decks)

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