Infectious Disease

Question 1

Treatment of choice for primary syphilis?

Answer 1

Benzathine penicillin G

Question 2

What are the indications for urgent valve replacement in endocarditis, rather than waiting for antibiotic response?

Answer 2

heart failure; abscess or fistula formation; severe left-sided valvular regurgitation; refractory infection despite appropriate antibiotic therapy; or recurrent embolic events, especially with residual vegetation larger than 1.0 cm

Question 3

Preferred tx for uncomplicated cystitis?

Answer 3

3-day course of trimethoprim-sulfamethoxazol. can do Nitrofurantoin for 5 days if sulfa allergy

Question 4

What test to diagnose endocarditis in pt with high pretest probability?

Answer 4

transesophageal echo, rather than thoracic

Question 5

eval of hospitalized pts w/CAP?

Answer 5

Blood cultures, Legionella and Streptococcus pneumoniae urine antigen assays, and endotracheal aspirate for Gram stain and culture

Question 6

How to determine dispo for pt with pneumonia?

Answer 6

CURB-65 (Confusion, blood Urea nitrogen >19.6 mg/dL, Respiration rate ≥30/min, systolic Blood pressure <90 mm Hg or diastolic <60 mm Hg, and age ≥65 years)

Question 7

otitis media tx?

Answer 7

amoxicillin in adults (azythromycin in peeps allergic to penicillin)

Question 8

otitis externa tx?

Answer 8

neomycin, polymyxin B, or hydrocortisone. mild- dilute acetic acid solution

Question 9

3rd line tx after blood pressure is found to be poorly responsive to fluid resuscitation (1000 mL saline fluid challenge) and vasopressor therapy in pts in septic shock?

Answer 9

IV hydrocortisone