infectious disease Flashcards
why cipro not recommended for pna?
poor lung penetration
which med permanently stains children teeth?
doxycycline
CAP in children <5 - most common organism?
strep pneumo
CAP in children <5 w/lobar findings on CXR - tx?
high dose amoxicillin
what age start giving flu vaccine?
> = 6 months
PNA in COPD - which organisms?
- strep pneumo
- h flu
- moraxella catarrhalis
- pseudomonas
- viral
PNA in immunocompromise?
- strep pneumo
- h flu
- pneumocystis
- atypicals
most common organisms in otitis externa
- staph aureus
- pseudomonas
how soon do you have to start post-exposure ppx for HIV?
within 72 hours
how long is course for post-exposure ppx for HIV?
4 weeks
how many drugs do you give for post-exposure ppx?
- 2 NRTIs (nucleotide reverse transcriptase inhibitors)
- 1 integrase strand transfer inhibitor OR protease inhibitor OR NNRTI
what antibiotic covers strep viridans?
amoxicillin
what antibiotics covers enterococcus?
ampicillin
procedures that warrant abx ppx for IE in ts w/high risk include:
- dental procedures
- respiratory tract procedures involving incision/bx
- surgical placement of prosthetic cardiac material
classification for hospitalization for pneumonia?
CURB-65
components of CURB-65
C - confusion U - BUN >20 R - RR>30 B - SBP <90 65 - age >65
how treat meningovascular syphilis?
IV penicillin
fungal etiologies that can cause meningitis + stroke?
- cryptococcus
- coccidiomycois
- histoplasmosis
hemorrhagic infarction of temporal lobe w/RBC in CSF dx?
HSV encephalitis
CNS lymphoma in HIV pts is linked to which infectious disease?
EBV
CNS lymphoma associated w/CD4 count less than what?
50
UTI abx contraindicated in pregnancy?
- tetracyclines
- fluoroquinolones
- bactrim
UTI abx that are OK in pregnancy?
- cephalexin
- fosfomycin
- augmentin
gentamicin poses what risk to developing fetus?
ireversible deafness
which vaccines are live?
MMR, zoster, varicella
when are live vaccines contraindicated in HIV?
CD4 < 200
anterior uveitis - aka?
iritis
symptoms of anterior uveitis?
pain, redness, variable vision loss, consricted/irregular pupil.
infectious keratitis - symptoms?
severe photophobia, difficulty opening eye, corneal opacity/infiltrate
conjunctivitis - how is tx different for contact lens wearers vs non-contact wearers?
topical fluoroquinolones for contact wearers (to cover pseudomonas)
keratitis - what is it?
inflammation of the cornea (clear tissue covering the pupil and iris and bordered by the bulbar conjunctivae)
endopthalmitis - what is it?
bacterial infection o the deep eye (vitreous)
uveitis - what is it?
inflammation of the middle eye (choroid, vitreous, iris, ciliary body)
uveitis - what causes it?
usually auto-immune diseases (JRA, reiter syndrome) or systemic infection
most common causes of bloody diarrhea in US??
- Salmonella
- Shigella
- E coli
- Cmpylobacter
- Yersinia
in kids - when treat bloody diarrhea w/abx?
- immunocomporomised
- sepsis
- age < 3mo
erlichiosis - signs/symptoms?
- fever, malaise, HA
- nausea, vomiting
- arthralgias
- leukopenia, thrombocytopenia
- high transaminases
typhoid - symptoms?
- fever
- abdominal pain
- cutaneous “rose spots”
- hepatosplenomegaly
- intestinal bleeding
- intestinal perforation
pertussis - treatment?
macrolides (azithromycin) - prevents transmission but does not shorten duration of illness
which organism causes croup?
paraflu
which organism associated with Guillain Barre?
Cmapylobacter
treatment for latent TB?
9 mo of isoniazid
pt w/ + screening TB test, + cough, fever, night sweats –> what next?
additional evaluation
– sputum samples for AFB and MB culture
pt previously treated for latent TB, now w/fever + cough –> what next?
CXR
ramsay hunt syndrome?
- reactivated VZV
- ear pain
- external auditory vesicles
- same sided facial paralysis
how treat malignant otitis externa?
- IV cipro until ESR/CRP normalize
- PO cipro x 6-8 weeks
malaria is caused by which organism?
plasmodium falciparum
fever in returning travler within <10days?
- typhoid
- dengue
- chikungunya
- flu
- legionella
fever in returning traveler within 1-3 weeks?
- malaria
- typhoid
- leptospirosis
- schistosomiasis
- rickettsial dz
fever in returning traveler in > 3 weeks
- TB
- leishmaniasis
- enteric parasitic infection
typhoid fever - clinical symptoms?
- stepwise fever
- relative bradycardia
- rose spots
infectious epididymo-orchitis - treatment?
1 dose IM ceftriaxone + 10d doxy
postpartum endometritis - what abx?
clinda + gent
chorioamnionitis - what abx?
ampicillin + gent
MRSA - what abx cover?
- clinda
- bactrim
- doxy
- linezolid
cellulitis - abx for MSSA and B-hemolytic strep?
- clinda
- amox + bactrim
- amox + doxy
- linezolid
cellulitis - abx course?
- 5-7 days in mild cases
- 14 days in sevre
sub-acute headache in HIV - what are the potential causes?
- cryptococcal meningitis
- tuberculous meningitis
- toxoplasmosis
- CNS lymphoma
how treat cryptococcal meningitis?
- IV amphotericin B (14d) PLUS - oral flucytosine (14d) THEN - fluconazole for 8-10 weeks (can start HAART @ END of acute treatment)
when positive HIV ELISA - what order next?
- HIV western blot
- CD4 count
- HIV VL
