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Step 2 CK > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Which abx can treat MRSA?

A

Vancomycin

Ceftaroline

Linezolid (+tedizolid)

Daptomycin

Telavancin / dalbavancin / oritavancin

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2
Q

Which abx can be used for mild MRSA skin infections?

A

Bactrim

Doxy

Clindamycin

Linezolid

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3
Q

Side Effects of Linezolid

A

Serotonin syndrome (do not use w/ MAOI)

Thrombocytopenia

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4
Q

Side Effects of Daptomycin

A

CPK elevation (mycin hurts myosin)

does not work in lungs (surfactant deactivates)

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5
Q

Main Uses of Amoxicillin (6)

A

Otitis media

Dental infection / endocarditis ppx

Lyme if just rash, joints, CN

Listeria

Enterococcal infections

UTI in pregnant women (or nitro)

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6
Q

Which abx are penicillinase-resistant? What are they used for?

A

Oxacillin, cloxacillin, dicloxacillin, nafcillin

Uses

  • Skin infection (cellulitis)
  • Staph meningitis, endocarditis, bacteremia
  • OM / septic arthritis w/ gram pos
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7
Q

Can those w/ PCN allergy use cephalosporins?

A

YES - if just rash w/ PCN

NO - if anaphylaxis w/ PCN

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8
Q

Side effect of cefoxitin

A

Disulfarim like reaction w/ alcohol

depletes prothrombin –> inc risk of bleeding

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9
Q

Why can’t ceftriaxone be given to newborns?

A

impairs biliary metabolism (use cefotaxime instead)

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10
Q

What are carbapenems used for?

A

ANAEROBES & ESBL-PROD GRAM NEG

Ertapenem - does NOT cover pseudo (others do)

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11
Q

Side effect of Bactrim

A

Rash

Hemolysis if G6PD deficiency

BM suppression - folate antagonist

Renal damage

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12
Q

Anaerobe Coverage

A

Above diaphragm
- clindamycin

Below diaphragm

  • metro
  • any beta lactam/lactamase combo
  • carbapenems
  • moxifloxicin (good for diverticulitis)
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13
Q

Polymixin

A

Last resort for gram neg infection (because renal toxic)

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14
Q

When do you need head CT before LP?

A

Papilledema

Focal neuro findings on exam

Seizures

Confusion so cannot trust physical exam

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15
Q

Who needs to be given ppx in meningitis? What is it?

A

Close contacts - major respiratory fluid contact (kissing, in same house, sharing cigs or utensils)

NOT school or work contacts

Healthcare - only if intubate, suction or contact respiratory secretions in some way

USE RIFAMPIN, CIPRO, CEFTRIAXONE

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16
Q

What is Yersinia diarrhea associated with?

A

IRON - has high affinity for iron so seen in hemochromatosis patients, ppl w/ blood transfusion

**People with hemochromatosis also susceptible to vibrio cholera and listeria

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17
Q

What does Hep B e-antigen tell you?

A
  • correlates w/ the amount of active viral replication
  • only present w/ high amount go DNA polymerase activity
  • means person w/ highest e antigen is most likely to benefit from anti-viral therapy
18
Q

How do you treat Hep C genotype 1?

A

ledipasvir + sofosbuvir

19
Q

Side effects of interferon

A

arthralgia

myalgia

anemia

depression

20
Q

Cervicitis

A
  • cervical discharge
  • strawberry cervix

TX = ceftriazone + azithromycin

21
Q

What is the most sensitive test for syphilis in CSF?

A

FTA (fluorescent treponemal antibody)

If FTA is positive they have neurosyphilis

If VLDR and RPR from CSF are negative they may still have neurosyphilis

22
Q

Causes of False Pos VLDR/RPR in Serum

A

Infection

Older age

Injection drug use

AIDS

Malaria

Anti-phospholipid syndrome

Endocarditis

23
Q

Tx duration for proctitis

A

2-6 wks (usually chronic infection)

v. only 1 wk for cystitis

24
Q

Which 2 bacteria are associated w/ colon pathology?

A

Strep bovis

Clostridium septicum

Get colonoscopy if ID these in blood cx

25
Q

When is surgery required in endocarditis?

A

CHF w/ acute valve rupture

Fungal endocarditis - replace valve

If associated w/ existing prosthetic valve

Abscess

AV block

Recurrent emboli despite abx

26
Q

Culture-Neg Endocarditis

A

Think bartonella or coxiella

HACEK (H aphrophilus, H parainfluenza, actinobacillus, cardiobacterium, eikenella, kingella)

27
Q

What do you do if someone has asymptomatic tick bite?

A

Sngl dose doxy if …

  • confirmed Ixodes scapularis
  • Engorged
  • attached > 24 to 48 hrs
  • endemic area
28
Q

First Line HIV Tx

A

2 NRTIs + Integrase Inhibitor

NRTIs = tenofovir, zidovudine, lamivudine, abacavir, emtricitabine

Integrase inhibitors all end in -gravir

29
Q

What is the adverse effect associated with abacavir?

A

If HLA B5701 then hypersensitivity reaction (SJS-like)

30
Q

HIV Tx in Pregnanct

A

Treat immediately - do not wait for genotype

Use at least 3 drug combo during pregnancy

Zidovudine during delivery, give to baby 6 wks after birth

C-section if viral load > 1000

31
Q

What HIV drug are used for PrEP?

A

emtricitabine - tenofovir

Cont indefinitely or 1 mo after last exposure

Careful of reactivation of Hep B once stopping tenofovir

32
Q

Which disseminated fungal infection is not treated w/ amphotercin?

A

Aspergillus - use voriconazole, isavuconazole or caspofungin instead

DO FOR … Coccidio, histoplasmosis (followed by itraconazole), mucormycosis, blasto

33
Q

How do you treat severe malaria?

A

artemisinin

CNS dysfunction, hypotension, shock, parasitemia > 5%, renal injury

34
Q

Malaria PPX

A

Mefloquine or atovaquone/proguanil

35
Q

Chikungunya

Zika

Dengue

A

All transmitted by Aedes mosquito

Chik = intense joint pain

Zika = microcephaly if pregnant, GBS

Dengue = break bone fever, also low WBCs, high LFTs

36
Q

Ebola

A

NOT transmitted by mosquito, direct contact w/ body fluids

Viral syndrome w/ high volume diarrhea

Low WBC, low platelet, high LFTs

Hypovolemic shock

Encephalitis

37
Q

How do you treat babesiosis?

A

Azithromycin + atovaquone

38
Q

Leptospirosis

A

Ingestion of foods infected w/ animal URINE

Oligouria, liver problems, muscle pain (high CK)

ELISA

Tx - PCN, amoxicillin, ceftriaxone or doxy

39
Q

Treatment of Leishmania

A

SANDFLIES

Stibogluconate (steak)

40
Q

Bacillary Angiomatosis

A

Caused by bartonella

HIV-AID w/ CD4 < 100

Purple/red vascular papules that bleed easily

+ Constitutional sx
+ Liver/bone/CNS

Tx = anti-retrovirals, doxy and erythromycin

Step 2 CK (28 decks)

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