INFECTIOUS DISEASE Flashcards
1
Q
natural penicillins
A
penicillin VK, G, G, G- gram positive
anthrax- gran positive anaerobes
indc : strep pharyngitis, syphillis
2
Q
nafcillin, dicloxaciillin
A
gram positive- but protects against beta lactamase producing staff
3
Q
amino-penicillins like amox, ampi
A
positive and neg coverage
4
Q
amino-penicillin with B lactamase
A
augmenting, unasyn
5
Q
anti-pseudomnal
A
bradest spectrum pen: zosyn
6
Q
cephalosporin- 1st
A
skin , soft tissue
7
Q
2nd generation cephalo
A
braoder gram neg coverage- skin, respiratory, UTI, anaerobes
8
Q
3rd generation of ceph
A
ceftriaxone, ceftazidime, cefixime- good cns penegration, gonorrhea
9
Q
4th generaiton of ceph
A
covers pseudo- cefepime
10
Q
5th generation of ceph
A
broad- including mrsa and negative- ceftaroline
11
Q
carbapenems
A
broadest of all abx- imipenem, meropenem- lowers seizures threshold
12
Q
doxy is a tetracycline
A
rmsf, lyme disease, pid
13
Q
tetra and minocycline
A
used for acne
14
Q
clinda
A
anaerobes above diaphran, covers gram- may cause c. diff
15
Q
aminoglycosides
A
GRAM NEGATIVE AEROBES ONLY!- ototoxic and nephrotox
16
Q
flouroquinolones, dna or rna syntehsis inhibitors
A
cipro- best for gram neg- vs. pseudomonas, uti, pyelonphritis, gastroenteritis
17
Q
levo
A
legionella
18
Q
flagyl
A
anaerobes and protoza- c. diff,
Protozoa: e. hystolica, giardia lambia, tricho
19
Q
bactrim
A
PCP- drug of CHOICE
not for pregnant woman
inhibits folic acid syntehsis
2nd best po coverage vs. mrsa
20
Q
nitrofurantoin
A
only for cystitis
safe in pregnancy
21
Q
penicillins
A
hyper sese reaction- 10% cross reactivity in patients allergic to cephalo
22
Q
vanco
A
redman syndrome
23
Q
macrolides
A
GI upset- caution if patient is on niacin or statins
24
Q
flouroquinolones
A
tendor reupture- QT prolongation
25
clinda
c.diff
26
tetra
deposition in teeth- teeth coloration, not given for younger children than 8, photosensitivity
27
bactrim
sulfa allergy, hemolysis if G6PD deficiency
28
metronidazole- flagyl
avoid ETOH during and 48 hours after- disulfiram like reaction
29
chloromphenical
broad spectrum- good CSF penetration, gray baby syndrome
30
amphotericine b
antifungal of choice for invasive or life threatening fungal infections.
fevers/chills during infusion nephrotox
31
nystatin
vaginal & local treatment: oral cadidiasis
32
azoles
inhibits ergosterol synthesis
33
fluconazole
DOC for noninvasive candida and cryptocooccal infection
| good for urine and csf infections
34
intraconazole
extended spectrum- DOC for histoplasmosis, blastomycosis, coccidiomycosis
35
keto and itraconzole
poor CSF penegration!!
36
candidiasis
esophagitis: fluconazole
oral thrush: nystatin
vaginal candidasis: miconazole, clotrimazole
intertrigo: satellite lesions- clotrimazole
endocarditis fungus: IV amphotericin
37
cryptococcosis
budding round yeast- pigion/bird droppings, mc cause of fungal meningitis
INDIA stain- encapsulated yeast
amphotericin B plus flucytosine- and then oral fluconaozle
38
histoplasmosis
AIDS defining illness
bird/bat droppings
missisippi and ohio river valley
ITRACONZAOLE`
39
pneumocystits jirovecci
CD4- less than 200.
bilateral diffuse interstitial infiltrates
BACTRIM is drug of choice
dapsone if sulfa allergy
40
cocciodiomycosis
southwestern US and mexico- SOIL IN ARID/desert
*erythema nodosum
arthralgia, knee, ankle
culture most definite
FLUCONAZOLE IF CNS,- most cases self limited.
41
TX for menignitis
ceftriaxone and vancomycin in adults
| ampcillin and cefotaxime in infants`
42
chancroid
haemophilus DUCREYI= painful GENITAL ulcers- bubo- painful inguinal lymphadenopathy
AZITHRO!
43
h.flu
COPD is a risk factor
AMOXICILLIN
IV ceftriaxone for epiglogtitits
44
tularemia
rabbits- streptomycin is doc
45
hot tub folliculitis
pseudomans aeruginosa- contaminated spa, swimming pool or hot tub
resolves spontaneously, but if needed- cipro
46
NECROTIZING Fasciitis
MC GABHS! - penis/scrotum- impaired immunity
BLUE/HEMORRHAGIC bullae- BLISTERS AT SITE
GANGRE, then becomes septic shock
extreme pain out of proportion to physical exam
BRAOD spectrum abx: unaysyn, piperacillin, imipenam
47
Diptheria
GRAM POSITIVE ROD!
friable gray/white membrane on pharynx that bleeds if scraped- tonsillopharygintis or laryngitis, bull neck!!- enlarged cervical lymphadenopathy
DIPTHREIA antitoxin, erythromycin or penicillin X 2 weeks!
48
TETANUS
clostridium tetani- gram positive ROD!- blocks acetylcholinesterase!- unblocked acetylcholine so nerves keep on contracting muscles!
puncture or crush wounds
SEVERE MUSCLE SPASM!
neck/jaw stiff, trismus: lock jaw!!- dysphagia, irritable, drooling, can affect respiratory muscles- increased DEEP TENDON REFLEX!
TX: metronidazole plus IM tetanus immune gloubulines
49
gas gangrene
clostridium perfringes- anaerobic conditions!
shock, watery exudates, crepitus/gas in the tissue
AIR IN SOFT TISSUES
IV PENICILLIN! + IV clinda, debridement
50
botulism
gram positive, spore forming rods-
weakness, flaccid paralysis, resp arrest
canned/smoked foods
ingestion of honey or dust
DILATED , fixed pupils- dry mouth, dysphagia, dysarthria, DESCENDING DECREASED MUSCLE STRENGTH!!
floppy baby syndrome
TX: ANTITOXINS IN ALL CASES!`
51
syphillis = CHANCRE
chancre- painless ulcer
secondary: maculopapular rash- palms/soles common
condyloma lata: highly contagious
TERIATRY: gumma! tabes dorsalis (demyelination of posterior columns- ataxia, weakness)
argyll-robertons pupil: small, irregular pupil - constricts to near accomdation but not reactive to light
aortitis
52
congenital syphillis
HUTCHINSON TEETH!, saddle nose deformity
53
DX of syphillis
darkfield microscopy- direct visualization of spirochete fon chancre or condyloma lata
SCREEN: RPR- confirmed by treponema testing- FTA
confirmation: FTA-ABS!flourescent treponema antibody absorption
PEN G: TX !
54
lyme disease
borrealia burgodrferi= = tick/deer
erythema migrans- central clearing, arthritis, CN VII facial nerve palsy with lyme disease, AV block
ELISA followed by western blot!
TX: DOXY!, amoxicillin if preg, or children
55
rocky mountain spotted fever
blancing macular rash- WRIST/ANKLES- then palms and soles- spreads centrally-
check for antibody for IGM and IGG - may develop throbocytopenia or hypnatremia
DOXY! even in children!!
chloramphenicol- 2nd line- choice in PREGNANCY!
56
amebiasis
e.histolytica- bloody diarrhea, gi colitis- amebic liver abscess
FLAGYL!!!
57
malaria
falciparum most dangerous type!! cyclical fever, hemolytical anemia, thromboycopenia, giemsa stain
CHLORoquine- 1st line- quinidine
58
babesia
attacks red blood cells- hemolytic aemia and jaundice
maltese cross
ATOVAQUONE plus azithro
59
enterobiasis- pinworm
sctoch tape test- perianal itch, albendazole
60
MAC
less than 50 HIV
pulmonary infection- bronchiectasis, disseminated, lymphadenitis in children-
clarithromycin and ethambutol
61
HSV esophagitis
small, deep ulcers on EGD
62
cytomegalovirus- HHV 5
```
- immunocompromised people
congenital CMV: hearing loss, petechia
TORCH : toxoplasmosis (ring enhancing lesions from cat)
syphillis, rubella, CMV, HSV
retinitis- if cd4 less than 50
esophagitis: LARGE superficial ulcers on upper endoscopy
owl's eye appearnce- biopsy
GANCICLOVIR TOC
```
63
vARICELLA - hhv 3
chicken pox- vesciles on erythematous base- dew drops on a rose petal- diff stages- begins on face, trunk and then extremities
SHINGLES: one dermatome
opthalmicus: hutchinson's sign- ocular involvement
trigeminal NERVE!- 1st division- dendritic lesions
ramsay-hunt syndrome- CN VII - facial palsy- otalgia- HEREPES OTICUS is ramsay
64
EBV- HHV 4
posterior cervical lyphadenopathy, splenomegaly- rash if given ampicillin- heterophile monospot- atypical lymphocytes
supportive therapy, avoid trauma/contact sports
65
opportunitistic infections in HIV
```
500-200- TB, kaposi sarcoma, thrush, zoter, lymphoma
200- pcp
150- histo
100- TOXO- bactrim
crypto: fluconazole
MAC- azithryo or clarithyro
CMV retinitis- ganciclovir
```
66
HAART regimens for HIV
NNRTI plus 2 NRTI
PI +2 NRTI
insti +2 NRTI
67
NRTI (DINE, VIR, BINE)
(zidovudine, bine, abacavir, lamivudine, didanosine, stavudine, tenoforvir)
inbhitis viral rep- interferes with hiv viral rna dependent -
TRUVADA is one of them! (2 combined)
peripheral neuropathy, pancreatitis- SIDE EFFECTS!
68
NNRTI- (VIRINE)
viren! -efavirenz, delaviridne, etravirine, nevirapine-
69
PI : protease inbhitor: navir
lipodystrophy, hyperlipidemia- main side effect along with N/v/ d
indinavir- renal stones
70
INSTI: gravir
hyperlipidemia- prevents insertion of DNA copy of viral genome
71
varizella- chicken pox
rash in diff stages at same time- face first then etremities- erythematous base dew drops on a rose petal
72
rubeola (MEASLES)
COUGH, coryza, conjunctivits- BRICK RED RASH!!!- begins at hairline and then face and extremities after- koplik spots on buccal mucosa
73
RUBELLA (GERMAN measles)
URI prodrome, PINK-light red- spotted rash on FACE then extremities- lasts 3 days
ARTHRALGIA AND PHOTOSENSITIVITY: part of TORCH!
74
ROSEOLA
ONLY ONE THAT STARTS ON TRUNK/exTREMITIES AND THEN GOES TO FACE!-
3 DAYS OF HIGH FEVER!- HIGH HIGH FEVERS!
blanchable pink rash!!
75
erythema infectiosum- PARVOVIRUS!
SLAPPED CHEEK appearnce with circumoral pallor- LACY reticular rash on the BODY!
parvovirus!
76
kawasakai
strawberry tongue- desquamation of palms and soles- mi and coronary artery invovelment
77
SCARLET fever
strawberry tongue, SAND PAPER RASH!- circumoral pallor with facial flush- small red spots on the soft palate- forchheimer spots.
78
bartonella h.
cat scratch fever- painful lymphadenopathy
79
rabies
at the bite site = fasciculations and paresthesia
80
lymphogranuloma venerum
CLAmydia- painful lymph nodes but painless lesions on penis!
81
enterobiasis
is pinworm!- scotch tape test
