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Internal Medicine > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Differential for cellulitis (3)

A
  1. Nec-Fasc
  2. Allergic reaction
  3. Stasis dermatitis
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2
Q

What will happen when you start treating cellulitis?

A

Cutaneous inflammation will worsen during the initial 24hrs

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3
Q

How to differentiate between strep and staph cellulitis?

A

Staph: Purulent, abscess, draining wounds, penetrating trauma
Strep: Erisipelas, absence of drainage, raised indurated border, peau d’orange skin

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4
Q

What additional coverage against cellulitis should be included in pts with:

  1. Diabetes
  2. Neutropenia
  3. IV drug use
A
  1. Anaerobes, gram(-) bacilli
  2. Pseudomonas
  3. MRSA, pseudomonas
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5
Q

Lesions on anterior shin, bluish-black or ragged ulcers - diagnosis> Associated with?

A

Pyoderma gangrenosum

Assoc. with IBD

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6
Q

Cellulitis with leukomoid reaction and HIGH rising hematocrit - bug involved?

A

Clostridium sordelli

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7
Q

What % of blood and wound cultures are positive with cellulitis?

A

Less than 5%

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8
Q

Most common initial treatment for cellulitis in the hospital?

A

Clindamycin

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9
Q

What is Dalbavancin?

A

Outpatient parenteral antibiotic, similar to Linezolid. Can administer once a week only

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10
Q

SE of Daptomycin (3)?

A

CPK elevation (check renal fxn), rhabdo (at high doses), Eosinophilic pneumonia (rare)

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11
Q

SE of Vanc (2)?

A

Nephrotoxicity, Red-Man syndrome (with rapid infusion)

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12
Q

SE of Clindamycin?

A

Pseudomembranous colitis

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13
Q

SE of Doxycycline(3)?

A

Liver toxicity, Photosensitivity, Tooth discolouration (in kids)

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14
Q

SE of Cipro (3)?

A

CNS & GI disturbances, Teratogenic, Achilles tendon rupture

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15
Q

DOC against gram (-) and pseudomonas (2)?

A

Ciprofloxacin, Pip-Tazo (Piperacillin-Tazobactam)

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16
Q

SE of Meropenem (3)?

A

Nausea, HA, diarrhea

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17
Q

Main use of Clindamycin (2)?

Which group of bugs is resistant?

A

Anaerobes, Malaria (with chloroquine)

Resistant: Gram (-) aerobes: (pseudomonas, H.flu, Moraxella)

18
Q

What are the 6 P’s of Compartment Syndrome?

A

Pulseless, Pain, Pallor, Parasthesias, Poikilothermia, Paralysis

19
Q

Which 2 bugs should also be covered in IV drug users?

A

Pseudomonas & MRSA

20
Q

Most common bug causing osteomyelitis? In diabetics? IV drug users?

A

S. aureus
Diabetics: Salmonella (actually S. aureus…)
IV drug users: Pseudomonas

21
Q

Acute LLQ pain - differential?

Which procedure is often contraindicated, and why?

A 
Diverticulitis, UC, Chrons, perf'd ulcer
No colonoscopy (due to risk of perforation)
22
Q

DOC for suspected diverticulitis?

A

Cipro (gram (-)) and metronidazole (anaerobes)

23
Q

Leading cause of encephalitis?

A

HSV

24
Q

How would HSV encephalitis present?

What tests to order?

A

Acute onset of bizarre behavior, speech disorders and hallucinations
Order HSV-PCR, HSV culture and MRI (will show temporal lobe issues bilaterally)

25
Q

Acute febrile illness with meningeal signs in the summer months?

A

West Nile Encephalitis

26
Q

If West Nile virus is suspected, what to look for on PE?

A

Ascending paralysis (GBarre), maculopapular rash & fever

27
Q

Treatment for West Nile?

A

Supportive

28
Q

Most common cause of bacterial meningitis in adults?

A

Age 2-50: S.pneumo & N.meningitidis

Age >50: Above AND Listeria monocytogenes

29
Q

What exam to include on PE if bacterial meningitis is suspected?

A

Fundoscopic exam (check for papilledema indicating high ICP)

30
Q

CSF findings in viral meningitis

A

OP: 45) & protein (<200)

31
Q

CSF findings in bacterial meningitis

A

OP 200-500; #Leukoc: 1000-5000; Neutrophils; Low glucose (<40), High protein (100-500mg/dL)

32
Q

CSF findings in fungal (TB) meningitis

A

OP 180-300; Lymphocytes; Low-normal glucose; Normal to high protein

33
Q

Smoker with pneumonia, diarrhea & high LDH - what bug to think of ?

A

Legionella

34
Q

First-line treatment for strep-pneumo meningitis?

A

Vanc & 3rd Gen Ceph

35
Q

First-line treatment for neisseria meningitis?

A

3rd Gen Ceph

36
Q

First-line treatment for listeria meningitis?

A

Amp or PenG

37
Q

First-line treatment for meningitis in pt aged 1mo - 50years?

Alternative?

A

Vanc & 3rd Gen Ceph

Alt: Moxifloxacin

38
Q

First-line treatment for meningitis in pts aged >50 years?

A

Vanc & 3rd Gen Ceph AND Ampicillin

39
Q

First-line treatment for meningitis in immunocomp. pts?

A

Vanc & Amp & Cefepime or Meropenem

40
Q

Reason to not give Dexamethasone with meningitis treatment?

What to do..?

A

It can reduce Vanc’s ability to reach CSF

Ensure vanc trough 15-20 to overcome

Internal Medicine (12 decks)

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