Infectious Diseases Flashcards
Describe the symptoms and vaginal discharge in bacterial vaginosis (Gardnerella)?
white or grey; fishy odor; non-pruritic, no vaginal erythema; pH above 4.5
Describe the symptoms and vaginal discharge of trichomonas infection.
yellow-green and pruritic; may have “strawberry cervix”; malodorous; pH above 4.5
Describe the symptoms/vaginal discharge of vaginal candidiasis.
odorless, cottage cheese-like discharge w/ significant irritation and inflammation
What vaginal infection shows clue cells on Pap smear?
gardnerella
What is the treatment for vaginal candidiasis?
vaginal clotrimazole or oral fluconazole
What is the treatment for bacterial vaginosis?
metronidazole or clindamycin; oral or vag
In 25% of cases, drug fever is accompanied by _______ and _______.
eosinophilia and rash
What Dx can be made w/ 2 or more of the following in the absence of an unknown cause: temp >38.0 or 90; RR > 20 or Pco2 12,000 or 10% band forms?
SIRS
How do you define sepsis?
SIRS in response to a confirmed infectious process
How do you define severe sepsis?
Sepsis w/ evidence of end-organ damage
How do you define septic shock?
Sepsis-induced hypotension or hypoperfusion abnormalities despite adequate fluid resuscitation.
What anti-influenza agent is most appropriate for an asthmatic pt?
oseltamivir
What kind of anit-influenza drugs are oseltamivir and zanamivir?
neuraminidase inhibitors
Name one of the preferred initial treatments for acute bacterial rhinosinusitis.
3-10 days of a narrow-spectrum antiobiotic: amoxicillin, TMP-SMX, or doxycycline
What is the preferred empiric treatment for pyelonephritis in a compliant pt w/ no nausea and vomiting? (drug and duration)
oral levofloxacine - 7-14 days
What is the preferred empiric treatment for uncomplicated UTI? (drug and duration)
TMP-SMX - 3 days
In what cases of UTI would you choose to use amoxicillin (7 days)?
culture-proven Enterococcus infection - esp. in pregnancy, when TMP-SMX and fluoroquinolones are contraindicated
What drug, other than amoxicillin, may be used to treat UTI in a pregnant woman?
1st gen cephalosporin, such as cephalexine
What is the most appropriate Tx for uncomplicated genitasl herpes outbreak?
oral valacyclovir
In a pt w/ a skin rash, what is potassium hydroxide stain of skin scrapings meant to look for?
tinea corporis or any fungus
What is the only significant disease that occurs in AIDS w/ a CD4 ct below 200, but above 100?
Pneumocystis jiroveci
What is the first diagnostic step for an AIDS pt w/ dysphagia and odynophagia?
administration of fluconazole
What is the most common cause of dysphagia and odynophagia in HIV pts w/ low T-cell cts?
Candida
AIDS pt w/ dysphagia and odynophagia: fluconazole doesn’t work. What is the next step?
upper endoscopy
At what CD4 count does Kaposi’s sarcoma begin to occur?
Trick question! No CD4 depression necessary!
What are the cutoffs of PPD induration for the various risk-categories?
<5 - immunocompromised
What is the recommended treatment for latent TB?
Isoniazid for 9 mos.
What is the antibiotic of choice for bacterial aspiration pneumonia?
clindamycin
What are the 2 options for treating a pt w/ in the internal medicine ward with CAP?
1) beta-lactam + macrolide or doxycycline
or
2) fluoroquinolone monotherapy
What is the empiric therapy for a pt w/ CAP in the ICU?
beta-lactam + macrolide or fluoroquinolone
What are the options for treating CAP in the outpatient?
advanced generation macrolide (e.g. azithromycin or clindamycin) OR a ketolide (telithromycin) OR doxycycline
