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internal medicine-emma holiday > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Meningitis… most common bugs? tx?

A

Strep pneumo, H. influenza, N. meningitidis

ceftriaxone and vanc

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2
Q

Meningitis bug associated with young and old? tx?

A

Lysteria

Ampicillin

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3
Q

Meningitis in people s/p brain surgery? Tx?

A

Staph

Vanco

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4
Q

Meningitis best first step?

A

Start empiric treatment.

Add steroids if you think it is bacterial

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5
Q

Diagnostic test for Meningitis?

A

Exam elevated ICP/CT, then LP

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6
Q

Diagnostic LP for meningitis?

A

+ Gram Stain, >1000 wbc

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7
Q

LP supportative for bacterial meningitis?

A

High protein and low glucose

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8
Q

Tx of roommate of the kid in the dorms who has bacterial meningitis and petechial rash?

A

Rifampin

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9
Q

Suspect pneumonia, best 1st step?

A

CXR

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10
Q

PNA most common bugs? Tx?

A

Pneumococcus

Macrolide, Fluroquinalone, 3rd Cephlasporin

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11
Q

PNA most common bug healthy young people? Assc w/? Tx?

A

Mycoplasma
Cold agglutinins
Macrolide, Fluroquinalone, Doxy

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12
Q

PNA hospitalized w/in 3 months or in the hospital >5-7 days? Tx?

A

Pseudomonas, kelbsiella, E. Coli, MRSA

Piperacillin/tazobactam or imipenem + Vanc

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13
Q

PNA old smokers w/ COPD? Tx?

A

H. influenzae

2nd-3rd Ceph

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14
Q

PNA alcoholics w/ currant jelly sputum? Tx?

A

Kelbsiella

3rd Ceph

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15
Q

PNA old men w/ HA, confusion, diarrhea, and abdominal pain? Dx?

A

Legionella
Urine antigen
Macrolide, fluroquinalone, doxy

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16
Q

PNA just had the flu?

Tx?

A

MRSA

Vanc

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17
Q

PNA just delivered a baby cow and have vomiting and diarrhea? Tx?

A

Q-fever. Coxiella burnetti

Doxy

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18
Q

PNA just skinned a rabbit? Tx?

A

Franciella tularensis

Streptamycin, gentamycin

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19
Q

Symptomatic TB best test?

A

CXR

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20
Q

Screening TB?

A

> 15mm
10mm if prison, HC, nursing home, DM, EtOH, chronically ill
5 mm AIDs, immune suppressed

21
Q

Screening TB w/ + PPD?

A

CXR

22
Q

Screening TB w/ +PPD, +CXR?

A

Acid fast stain of sputum

23
Q

Screening TB w/ +PPD, +CXR, +Acid fast stain?

A

Treat w/ 4 drug RIPE for 6 months (12 for meningitis and 9 if pregnant)

24
Q

Rifampin side effects?

A

Body fluids turn orange/red, induces CYP450

25
Q

INH side effects?

A

Peripheral neuropathy and sideroblastic anemia (prevent by giving B6. Hepatitis w/ mild bump in LFTs)

26
Q

Pyrazinamide side effects?

A

Benign hyperuricemia

27
Q

Ethambutol side effects?

A

Optic neuritis, other color vision abnormalities

28
Q

Acute endocarditis most common bug?

A

Staph aureus seeds native valves from bacteremia

29
Q

Subacute native valve endocarditis, most common valve? Predisposition?

A

Mitral Valve

MVP

30
Q

Subacute native valve endocarditis, most common bug?

A

Viridens group strep

31
Q

IVDU endocarditis, most common valve?

A

Tricuspid valve

Murmur worse w/ inspiration

32
Q

IVDU endocarditis, most common bug?

A

Staph Aureus

33
Q

Endocardtitis diagnosis?

A

Blood cx, TTE then TEE. Major and minor criteria

34
Q

Endocarditis complications?

A

CHF #1 cause of death, septic emboli to lungs or brain

35
Q

Endocarditis strep viridens tx? Staph tx?

A

4-6 weeks PCN

Naf + gent or vanc

36
Q

When do you do prophylaxis for endocarditis?

A

Prosthetic valve, hx of EC, or uncorrected congenital lesion

37
Q

What is the next step if you find strep bovis bacteremia?

A

Colonscopy

38
Q

What is acute retroviral syndrome?

A

2-3 s/p HIV exposure but 3 weeks before seroconversion

39
Q

Symptoms of acute retroviral syndrome?

A

Fever, fatigue, lymphadenopathy, headache, pharyngitis, N/V/D +/- aseptic meningitis

40
Q

When to suspect HIV in a young person?

A

New/bilateral Bell’s palsy
Unexplained thrombocytopenia
unexplained weight loss >10%
Thrush, zoster, or kaposi sarcoma

41
Q

In a HIV patient when do you start HAART?

A

CD 4 < 350

Viral Load > 55000 (pregnant start > 1000)

42
Q

Zidovudine side effects?

A

GI, leukopenia, macrocytic anemia

43
Q

Didanosine side effects?

A

Pancreatitis, peripheral neuropathy

44
Q

Abacavir side effects?

A

HS rash, fever, n/v, muscle aches, SOB in 1st 6 week

45
Q

When do you stop abacavir?

A

SOB in 1st 6 weeks

46
Q

Indinavir side effects?

A

Nephrolithiasis

Hyperbilirubinemia

47
Q

Efavirenz side effects?

A

Sleepy, confused, psycho

48
Q

HIV post exposure prophylaxis?

A

AZT, lamivudine, nelfinavir for 4 wks

internal medicine-emma holiday (9 decks)

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