Infectious Disease topics Flashcards by Kate Ovington

Pharmacotherapy treatment of choice for gonococci

Ceftriaxone (3rd gen cephalosporin)

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Most common pathogen for osteomylitis

Staphylococcus aureus

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Beefy red throat, minimal exudates, cervical adenopathy, fever

Group A beta-hemolytic streptococcus

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White curd-like vaginal discharge should make you think of what diagnosis?

Vaginal candida infection

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Owl eye inclusion bodies should make you think of what diagnosis?

Cytomegalovirus

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If you have a patient with positive blood cultures for candida, what is the first line drug?

Amphotericin B

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What is the treatment for pertussis?

Erythromycin x 7 days

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A leukemia patient has a CT of the liver which shows punched out lesions. What diagnosis should you be thinking of?

Hepatosplenic candida

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What disease does Rickettsia rickettsii cause?

Rocky Mountain spotted fever

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An India ink stain showing cysts should make you think of what diagnosis?

Cryptococcosis

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A COPD patient has apical cavities and calcified nodes on his CXR. You also discover he has a pet bat and a few birds. What is the most likely diagnosis?

Histoplasmosis

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An HIV patient present with a nonproductive cough and a CXR showing diffuse interstitial infiltrates. What is the most likely diagnosis?

Pneumocystis jiroveci pneumonia (PCJ). Formerly known as Pneumocystis pneumonia

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Honey and babies should make you think of what diagnosis?

Botulism

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What type of organism causes botulism?

A Gram(+) rod. Clostridium botulinum

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What is the treatment for botulism?

Antitoxin

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A patient presents to the ER with acute progressive weakness, diplopia and a very dry mouth. What organism may be causing this?

Clostridium botulinum

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Rice water stool should make you think of what diagnosis?

Cholera

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Is diphteria a Gram-positive or Gram-negative organism?

Gram-positive

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A stuck-on grey membrane in the pharynx should make you think of what diagnosis?

Diphteria

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What are four steps in treating diphteria?

Antitoxin, penicillin, remove the membrane, report the case to the CDC

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What is the clinical name for whooping cough?

Pertussis

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What type of organism causes tetanus?

A gram-positve rod, Clostridium tetani

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A patient ate out last night and today has cramping and bloody diarrhea. What is the most likely organism?

Salmonella

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Diarrhea with blood and mucus should make you think of what diagnosis?

Shigella

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What is the best test to diagnose malaria?

Peripheral blood smear

What organism causes Lyme Disease?

Borrelia burgdorferi

What is the minimum amount of time needed for a tick to transfer Lyme disease to a human?

24 hours

What is the drug of choice to treat Lyme disease in kids or pregnant women?

Amoxicillin

What is the drug of choice to treat C. dificile?

Metronidazole (Flagyl)

A patient was in the woods yesterday and now has a rash that began on his wrists and ankles. What is the most likely diagnosis?

Rocky Mountain Spotted fever

What is the drug of choice for treating Rocky Mountain spotted fever?

Doxycycline

What is the drug of choice for the treatment of syphilis?

Penicillin

Any reference to dark field microscopy should make you think of what organism?

Treponema pallidum

Is staph gram-positive or gram-negative?

Gram-positive

A patient being treated with penicillin for a syphilis infection develops fever, chills, muscle pain, and headaches. Do you stop treatment?

No. This is Jarisch-Herxheimer reaction. The patient must be closely monitored, but it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction.

What organism is believed to be the main culprit in creating peptic ulcers?

Helicobacter pylori

A painless, clean base chancre should make you think of what diagnosis?

Primary syphilis

Is pseudomonas gram-positive or gram-negative?

Gram-negative

A patient complains of a rash on his palms and soles. He has a fever and chills. In conversation, he mentions a strange painless chancre he had a few weeks ago. What is the most likely diagnosis?

Secondary syphilis. This is the most contagious stage

What is the treatment of choice for cholera?

Fluids

What is the current drug of choice for the cytomegalovirus?

Ganciclovir

Which herpes virus causes Epstein-Barr?

Herpes 4

A 16 year old girl presents with an exudative sore throat and general malaise. On physical exam, you observe some posterior chain lymphadenopathy and mild splenomegaly. What is the most likely diagnosis?

Epstein-Barr virus

What are two important pieces of patient education for anyone diagnosed with mononucleosis?

No contact sports (splenic rupture) and no kissing (highly contagious)

What is the first symptom of a rabies infection?

Pain and anesthesia at the site of the bite

How do you definitively diagnose rabies?

Pathology of the brain of the animal that performed the bite using fluorescent antibody stain

A patient is bitten by a rabies infected raccoon. On what days do you give human diploid cells?

0, 3, 7, 14, 28

A diaper rash with satellite lesions should make you think of what diagnosis?

Candida

Name three serious reactions a patient may have with the use of vancomycin?

Nephrotoxicity, ototoxicity, and Stevens-Johnson syndrome

What tests are done to screen for HIV?

ELISA and if positive, diagnosis is confirmed with a Western Blot Test

What is the drug of choice for the treatment of Lyme Disease?

Doxycycline

What does trismus mean?

Lock jaw, often secondary to tetanus

How do you treat amebiasis?

Metronidazole (Flagyl)

How do you treat pneumocystis jiroveci pneumonia (PCJ) formerly known as pneumocystis pneumonia (PCP)?

Bactrim

What is the treatment for a tetanus infection?

Penicillin, immune globulin and supportive care (especially respiratory support)

How do hookworm larvae enter the body?

They penetrate the skin, usually through the soles of the feet

How do you treat hookworm?

Azoles

What type of mosquitoes carry malaria?

Anopheles

How do you treat white oral plaques that can be scraped off?

This is most likely candida. Topical nystatin or oral fluconazole 1mg are first line choices

What is the drug of choice for toxoplasmosis?

Bactrim

What organism causes toxoplasmosis?

Toxoplasma gondii

What drug do you use to treat pinworm?

You treat everyone in the house with albendazole. Two weeks later you treat them again

The scotch tape test is used to diagnose what disease?

Pinworm

Is neisseria gram-positive or gram-negative?

Gram-negative

Syphilis is caused by what organism?

Treponema pallidum

A gram-positive organism in chains should make you think of what diagnosis?

Strep

A gram-negative diplococci should make you think of what diagnosis?

Neisseria

What is the most common prophylactic antibiotic used preoperatively?

Cefazolin = Ancef Keflex = Cefalexin The answer is Cefazolin

What oral antibiotic can be used for pseudomonas?

Ciprofloxacin

What is the suffix used for most fluoroquinolones?

Oxacin

Why aren't fluoroquinolones used more frequently?

They have lots of side effects

A patient presents with a ruptured Achilles tendon. He states that he was recently in the hospital for a "blood infection and on a ton of antibiotics." What antibiotic class may he have been on?

Fluoroquinolones

Why can't you give fluoroquinolones to kids?

They can cause cartilage development problems

What class of antibiotics should you start with for community-acquired pneumonia?

Macrolides

List two macrolides

Erythromycin, azithromycin, clarithromycin

What antibiotic class is the class of choice for chlamydia?

Macrolides

What class of antibiotics is sometimes prescribed specifically for its effects on increasing GI motility?

Macrolides

Which medication is worse to give to a pediatric patient, tetracycline or an aminoglycoside?

Tetracycline

Pizza pie retinopathy should make you think of what diagnosis?

Cytomegalovirus (CMV)

A patient presents complaining of a metallic taste in her mouth and dark brown urine. What antibiotic might she be on?

Metronidazole (Flagyl)

What antibiotic is most likely to cause C. diff?

Clindamycin

What is the current drug of choice for treating MRSA?

Vancomycin

You place a patient on rifampin. What side effect should you warn her about?

Orange-red discoloration of body fluids

What might happen is you infuse vancomycin too fast?

Red Man Syndrome

Name one oral medication that can be used for MRSA

Linezolid (Zyvox) and Bactrim

What organism is most commonly responsible for community-acquired penumonia?

Strep pneumonia

What organism is the most common cause of an uncomplicated urinary tract infection?

E. coli

Gummas or granulomatous nodules should make you think of what diagnosis?

Tertiary syphilis

Bloody stool with cysts and trophozoites should make you think of what diagnosis?

Amebiasis

Community-acquired carditis is most often caused by one of the HACEK organisms, List the HACEK organisms

Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella

What are the three medications often combined as a first line treatment for H. pylori?

Omeprazole, clarithromycin, and amoxicillin (PPI and 2 abx)

What is the prophylactic antibiotic most commonly given before a dental procedure if one is necessary?

Amoxicillin 2gm PO 1 hour before procedure

A pregnant woman and cat litter should make you think of what diagnosis?

Toxoplasmosis

What is the drug of choice to treat urethritis caused by neisseria?

Ceftriaxone (Rocephin)

Is Klebsiella gram-positive or gram-negative?

Gram-negative

A gram-positive organism in clusters should make you think of what diagnosis?

Staph

What is the best test for diagnosising Rocky Mountain Spotted Fever?

Indirect immunofluorescent antibodies

A gram-negative coccobaccili found in the sputum of a patient with pneumonia should make you think of what diagnosis?

H. flu

What medication is used as prophylaxis for meningococcal meningitis?

Rifampin

What is the next step in treatment for a patient who has failed outpatient doxycycline for Lyme disease and is allergic to penicillin?

Ceftriaxone 1gm IV q24hrs

Your patient is positive for Dientamoeba fragilis and Balantidium coli but they are allergic to metronidazole. What do you prescribe?

Tetracycline hydrochloride

What pathogen is isolated on Skirrow's medium? It is gram-neg, catalase and oxidase positive.

Campylobacter jejuni

List 2 abx most commonly associated pseudomembraneous colitis and c diff.

Fluoroquinolones, clindamycin, broad spectrum penicillins, broad spectrum cephalosporins