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Infectious Disease Flashcards

1
Q

Alternate for ceftriaxone?

A

ceftazidime

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2
Q

Alternate for Pip/tazo?

A

meropenem, cefepime

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3
Q

Alternate for Vancomycin?

A

linezolid

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4
Q

ABX for a young woman with a pyelo but ambulatory and can tolerate po?

A

ciprofloxacin

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5
Q

ABX for a young woman with pyelo who is toxic?

A

ceftriaxone

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6
Q

ABX for cholangitis?

A

Gram negative and anaerobic coverage, Ciprofloxacin + Metronidazole

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7
Q

ABX for community acquired PNA?

A

Ceftriaxone and azithromycin

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8
Q

Antibiotics for Diverticulitis?

A

Gram negative and anaerobic coverage, Cipro and Metronidazole

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9
Q

ABX for HCAP?

A

Vancomycin + Pip/Tazo

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10
Q

Young woman with a UTI but no sepsis?

A

nitrofurantoin, TMP-SMX

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11
Q

Organism at risk for with CD4 count <200?

A

PCP; TMP-SMX prophylaxis

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12
Q

Organism at risk for with CD4 count <100?

A

Toxoplasmosis

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13
Q

Organism at risk for with CD4 count <50?

A

MAC; prophylaxis with azithromycin weekly

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14
Q

PCP prophylaxis in person who is G6PD deficient?

A

Atovaquone

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15
Q

PCP prophylaxis in person with sulfa allergy?

A

Dapsone (don’t use in G6PD deficiency)

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16
Q

Raised palpable purple lesions in a an HIV patient?

A

Kaposi’s Sarcoma; HHV8

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17
Q

Risk factors for HIV?

A

sex workers, frequent sex, UTIs, needle drugs

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18
Q

What do you look for when the patient has flu-like sx, flu is negative, and question is about HIV?

A

PCR Viral load; this is acute infection, not enough time has passed to make antibodies, so ELISA wont work

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19
Q

White stuff you can scrape off the mouth, WITH dysphagia?

A

esophageal candidiasis, oral fluconazole

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20
Q

White stuff you can easily scrape off the mouth, NO dysphagia?

A

oral candidiasis, nystatin swish and spit

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21
Q

pts acid fast bacillus stain is positive for TB. treatment?

A

isolation + RIPE

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22
Q

how do we screen someone with a positive ppd in the past that was treated for TB?

A

chest X-rays

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23
Q

In TB, what do you do about a BCG vaccine?

A

Ignore it, or choose gamma interferon release

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24
Q

The PPD is 11mm, who is that positive for?

A

health care workers, prison, homeless, travel

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25
The PPD is 16 mm, who is that positive for?
soccer mom in Wyoming (people who shouldn't have been tested)
26
The PPD is 6mm. who is that positive for?
immunocompromised and close contacts
27
what are the SIRS criteria?
* WBC \> 12 * HR \> 90 * Temp \> 38 or \< 36 C * RR \> 20
28
first step in pt with. sepsis + low blood pressure?
give **fluid bolus**, sepsis is severe
29
what seperates severe sepsis from septic shock?
severe sepsis is responsive to fluids, septic shock is not
30
Brain mass on CT, AIDS negative in vignette. Next step?
biopsy
31
Brain mass on CT, AIDS positive in vignette. Next step?
treat for Toxo for 4-6 weeks, then rescan
32
what are the empiric abx for bacterial meningitis?
vancomycin + ceftriaxone + steroids
33
empiric abx for bacterial meningitis if immunocompromised?
vancomycin + ceftriaxone + steroids + **ampicillin**
34
What is the FAILS mneumonic?
tells increased ICP in suspected meningits, do not do LP **do ABX first** then CT scan first * Focal neurologic deficit * altered mental status * immunocompromised * lesion (tumor/abscess/stroke) * seizures
35
fever and headache, no FAILS. next step?
LP
36
fever and a headache with +FAILS. next step?
IV ABX
37
flaccid paralysis and encephalopathy; likely diagnosis?
West Nile
38
Lyme meningitis. Treatment?
ceftriaxone
39
temporal encephalitis. likely diagnosis?
HSV
40
treatment for HSV encephalitis?
acyclovir
41
fungal skin infections that don't involve the nail. treat with?
topical antifungals
42
fungal infections that do involve the nail. treatment?
oral meds=terbinafine
43
skin infection with gas on X-ray?
gas-gangrene, clostridium perfringens
44
honey crusted lesion?
Impetigo (group A beta hemolytic strep) treat with **amoxicillin**
45
how to diagnose osteomyelitis with cellulitis?
X-ray, then MRI, then biopsy (no bone scan)
46
how to diagnose osteomyelitis without cellulitis?
X-ray, then bone scan, then biopsy
47
rapidly spreading cellulitis with far more pain than should be present?
necrotizing fasciitis; debride ASAP
48
treat lice with?
permethrin
49
treat scabies with ?
permethrin
50
bilateral lung whiteout in an AIDS patient? treatment?
PCP; treat with IV TMP-SMX and prednisone
51
fever and a cough, consolidation on x-ray, not toxic. treat with which abx?
azithromycin
52
fever and cough, consolidation on x-ray, **septic**. treat with?
ceftriaxone + azithromycin
53
fever and cough. no consolidation on x-ray. abx?
doxycycline or azithromycin
54
penumonia but foul breath and chest x-ray shows cavitation
abscess (3rd gen. cephalosporin + clindamycin)
55
pneumonia in a dialysis patient?
HCAP, Vanc + Pip/Tazo
56
penumonia in nursing home patient
HCAP, Vanc + Pip/Tazo
57
healthy man with a UTI and no sepsis
nitrofurantoin x 7 days
58
healthy woman with UTI and no sepsis?
nitrofurantoin x 3 days
59
healthy woman with pyelonephritis but can tolerate PO?
Cipro x 7 days
60
healthy woman with pyelonephritis but **cannot tolerate PO?**
ceftriaxone x 10 days
61
positive UTI on labs during "routine" or "screen", patient is asymptomatic. treatment?
do nothing
62
positive UTI on labs, patient is asymptomatic, but pregnant. treatment?
amoxicillin (nitrofurantoin if penicillin allergic)
63
3 days into pyelo and the patient hasn't improved. Next step?
perinephric abscess, get CT scan
64
white blood cell casts?
pyelonephritis
65
genital. ulcer with central umbilication
molluscum contagiosum
66
painful ulcer with lymphadenopathy on the vulva. organism and treatment?
H. ducreyi, azithromycin
67
Penicillin allergic and pregnant, treat tertiary syphilis with?
desensitization + penicillin anyway
68
penicillin allergic. treat tertiary syphilis with?
doxycycline
69
single painless ulcer with lymphadenopathy on penis?
primary syphilis; darkfield microscopy, penicillin x 1
70
targetoid lesions on palms and soles
syphilis (also erythema multiforme)
71
test an ulcer for herpes. what do you pick?
HSV PCR (not Tzanck or histology)
72
vesicles on an erythematous base
Zoster (herpes or varicella)
73
antibiotic management for ENT infections?
* Amoxicillin is 1st line * azithromycin if penicillin allergic * amoxicillin-clavulonate if refractory
74
best diagnostic test for otitis media?
pneumatic insufflation
75
catheter fails to pass through the nose of a young infant. diagnosis?
choanal atresia
76
if. you see nasal polyps, what other diagnosis whould you look for?
cystic fibrosis
77
non-purulent rhinorrhea, no cough, congestion: dx and treatment?
common cold. supportive- decongestants ok, but NO ABX
78
otitis externa is treated with
cipro steroid drops
79
pain on pulling on pinna, child swimmer, what is it and how to treat
otitis externa, pseudomonas (swimmers ear), cipro drops
80
purulent rhinorrhea, congestion, facial tenderness, and fever: diagnosis and management?
sinusitis. * Amoxicillin-clavulanate 1st ilne * levofloxacin if penicillin allergic
81
when can you get a CT scan for sinusitis?
recurrent or refractory, to look for anatomic defects
82
bacteremia and a new murmur. next step?
TEE
83
MRSA bacteremia that clears with one dose of vancomycin?
TTE
84
what is the empiric **native valve endocarditis** treatment?
vancomycin
85
whats the empiric **prosthetic valve** treatment (what does everyone get)?
* vancomycin + gentamycin; * cefepime \< 60 days, * ceftriaxone \> 365 days
86
\> 15mm endocarditis lesion gets?
surgery
87
dental procedure and prosthetic valve gets?
amoxicillin

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