Infectious Disease Flashcards
What is Anti-retroviral Syndrome? How do you Dx? Tx?
Acute HIV infection that presents w/flu like symptoms. Suspect this in a high risk person w/flu.
Dx: ELISA will be negative! Must do PCR to check for viral load!
Tx: ARV 2+1
HIV prophylaxis in pregnant women for vertical transmission?
AZT = Zidovudine
CD4 <200 = at risk for….
Prophylaxis?
PCP Pneumonia!
Bactrim(TMP-SMX)>Dapsone>Atorvaqovne
CD4 <100 at risk for….
Prophylaxis?
TOXO!
Bactrim(TMP-SMX)>Pyrimethamine
CD4 <50 at risk for…
Prophylaxis?
MAC!
Azithromycin
Pt w/Fever, HA, NV, Photophobia and stiff neck Dx?
Meningitis
Pt w/Fever, HA, NV, Photophobia and focal neurological deficits, Dx?
Abscess or cancer
Pt w/Fever, HA, NV, Photophobia and confusion, Dx?
Encephalitis
Pt w/fever and HA, when can you not do a lumbar puncture?
FAILS: FND, AMS, Immunosuppressive, Lesion, Seizures
Pt w/fever HA and FAILS+ what test do you do?
Go ahead and give ABX(vanc,ceftriax,steroids +/- amp) and do CT scan
Patient w/suspected brain inflammation that is FAILS+ but has a normal CT, next step?
Lumbar punction
Pt suspected brain inflammation, FAILS+, ABx started, CT shows somthing…next step?
Treat for toxo = Pyrimethamine + sulfadiazine + leuvocovorin
After you treat a patient for toxo of the brain what do you do?
Rescan brain w/CT! If shit still there do Bx to rule out infection vs cancer
Brain inflammation: pt w/lymphocytes on lumbar puncture tx?
Assume HSV & tx w/acyclovir + do HSV PCR if - just supportive care.
Tx of typical bacterial meningitis
Vanco + ceftriax + steroids +/- ampicillin(only if immuno comp)
Sx for RMSF encephalitis + tx?
Rath that moves from arms –> trunk +tick bites +camping
Tx: ceftriaxone
Sx for Lyme encephalitis + tx?
Targetoid rash w/arthalgias, arrhythmias. + travel to CT, +/- tick
Tx: ceftriaxone(same as RMSF)
Sx for cryptococcal encephalitis + tx?
AIDs pt w/fever + HA.»_space;20 cm H2O opening + Crypto Ag»_space;Indian ink
Tx: amphotericin
Sx for TB encephalitis + tx?
Night sweats, weight loss, hemoptysis, meningitis, homeless, prison, endemic areas
Tx: RIPE
2 most common organisms that cause cellulitis?
Staph(likes to burrow and cause abscesses) & GAS
Sx of cellulitis + Dx + tx?
Hot, red, tender area of skin + known entry point. DO NOT CULTURE!
Tx: mark boundries so you can note if recedes after d1 of abx & give clindamycin or Bactrim for staph or 1st gen cephalosporin for GAS
If toxic: vanc, Linz, clinda
+ bone pain +probe to bone + refractory cellulitis
Dx?
Tx?
F/u?
Dx: 1. Xray(+@2wks) 2. MRI 3. Bone Scan, 4. BIOPSY = best
Tx: DEBRIDMENT + 4-6wks Vanc + Pip/tazo
F/U: ESR, CRP once drop your okay
Organism that causes OM in normal patient…
Staph
Organism that causes OM in patient with SS…
Salmonella
Organism that causes OM in patient with diabetic foot/sneaker+nail…
Pseudomonas
Organism that causes OM in patient with cirrhosis…
Vibrio vulnificus
Organism that causes OM in patient with gardening…
Sport tricks
Contaminated wound that now has crepitis..
Dx?tx?
Xray = gas === gas gangrene
Tx: Debridment + Clindamycin+PCN
Cellulitis + toxic + rapidly spreading + PAIN>PT, Blue green discoloration + crepitis
Dx? Tx?
Xray = gas ======Necrotizing Fascitis
Tx: debridment + 3rd gen ceph + clinda + amp
Fever Cough + no consolidation on CXR
Dx?
Tx?
Bronchitis
Tx: outpatient w/Macrolide(azith), or doxy or moxiflox
Fever, Cough + bilateral infiltrates on CXR
Mycoplasma pneumonia
Tx w/ macrolide(azith)
Tx of CAP
1st: Ceftriax + Azithromycin
2nd: Moxifloxacin
Tx of HCAP
1st: Vanco + pip/tazo
Tx of pneumonia w/bilateral fluffy infiltrates…..Dx?
PCP!
Tx: bactrim +/-steroids
Tx of influenza pneumonia
Oseltamivir
Most common cause of pneumonia?
S. Pneumoniae
Pneumonia w/GI + CNS sx bug?
Legionella
Pneumonia w/EtOH use bug?
Klebsiella
Pneumonia w/COPD/Smoker bug?
Haemophilus influence
Post viral pneumonia bug?
S. Aureus
Tinea Cruis
JOCK ITCH/BOOB RASH! = tx w/ antifungals
