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Step 2 CK > Infectious Dz First Aid > Flashcards

Infectious Dz First Aid Flashcards

1
Q

what is the pneumonia hospitalization criteria?

A

CURB-65

Confusion
Uremia (BUN > 19)
Respiratory rate ( > 30 breath/min)
Bp (SBP 65

2-3: consider inpatient treatment
more than 4: admission

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2
Q

bug that causes resp failure in US southwestern area?

A

coccidioidomycosis

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3
Q

treatment for severe coccidioidomycosis infection?

A

IV amphotericin B

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4
Q

treatments for active TB?

A

RIPE

Rifampin
INH (add B6 to prevent peripheral neuropathy)
Pyrazinamide
Ethambutol

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5
Q

treatment for latent TB?

A

Isoniazide(INH) for 9 months

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6
Q

most common infecting organism in prosthetic valve endocarditis?

A

coagulase neg Staph

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7
Q

2 choices of antibiotics for infective endocarditis?

A

vancomycin + gentamicin

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8
Q

what is the preferred antibiotic prophylaxis for infective endocarditis?

A

amoxicillin

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9
Q

choice of antibiotics for infective endocarditis for pts with penicillin allergies?

A

cephalexin, clindamycin, azithromycin, or clarithromycin

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10
Q

how does otitis externa present diff from otitis media?

A

pain with movement of the tragus/pinna

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11
Q

what is the choice of antibiotics for osteomyelitis pts with sickle cell anemia?

A

3rd generation cephalosporin: ceftriaxone

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12
Q

diagnosis for oral candidiasis (oral thrush)?

A

clinical + KOH or gram stain shows budding yeast or pseudohyphae

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13
Q

treatment for oral thrush?

A

nystatin suspension, clotrimazole tablets, PO azoles

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14
Q

treatment for candidal esophagitis?

A

PO azole

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15
Q

treatments for acute bacterial sinusitis?

A

amoxicillin/clavulanate for 10 days

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16
Q

treatments for histoplasmosis?

A
  1. mild pulmonary dz or stable nodule: supportively for immune competent, otherwise itraconazole
  2. chronic cavitary lesion: itraconazole for more than a year
  3. severe acute pulmonary dz or disseminated dz: liposomal amphotericin B X 14 days followed by itraconazole X1 year
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17
Q

CXR characteristics of Pneumocystis Jirovecii pneumonia

A

bilateral interstitial infiltrates with ground glass appearnce

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18
Q

diagnosis for PCP?

A

cytology induced sputum or bronchoscopy specimen with silver stain and immunofluorescence –> obtain ABG to check PaO2

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19
Q

what is the best next step for pts with positive PPD?

A

X-ray to rule out active dz

20
Q

what are the clinical signs of herpes simplex virus keratitis?

A

photophobia, foreign body sensation, constricted pupil

21
Q

what are the diagnostic tools for keratoconjunctivitis secondary to herpes simplex virus infection?

A

dendrites visible on fluorescein statining

22
Q

CT is the choice of sinus imaging, but when do we do it?

A

only necessary if symptoms persist after treatment

23
Q

pts with lacerations caused by the human mouth, what bug must be covered by antibiotics?

A

Eikenella

24
Q

3 most common community acquired bacterial sinusitis?

A
  1. Strep pneumoniae
  2. Haemophilus influenzae
  3. Moraxella catarrhails
25
Q

clinical signs of otitis externa?

A

discomfort is limited to the external auditory canal

26
Q

describe the pain associated with otitis externa?

A

pain with movement of the tragus/pinna

27
Q

treatments for otitis externa?

A

clean the ear and give antibiotics (ofloxacin or ciprofloxacin), and steroid eardrops

28
Q

what group of pt is at risk for malignant otitis externa?

A

diabetic pts

29
Q

what dimorphic fungi is endemic to the southwestern US and Mexico?

A

Coccidioidomycosis

30
Q

characteristics of miliary TB on CXR?

A

reticulonodular infiltrates spread evenly throughout both lung fields

31
Q

what bacteria infection is pts with recent hx of kidney transplant should be worried about?

A

Pseudomonas aeruginosa

32
Q

definition of neutropenic fever?

A

oral temp of >38.3 C (101F) or >38C (100.4F) for more than 1 hour in a pt with less than 500 cells/mm3 absolute neutrophil count

33
Q

treatments for coccidioidomycosis?

A

ketoconazole, fluconazole, itraconazole

amphotericin B is less preferred due to toxicity

34
Q

antibiotics choices for malignant otitis externa or necrotizing otitis externa?

A

fluoroquinolone plus beta lactam for Pseudomonas and Staph aureus

35
Q

what is osteomyelitis of the temporal bone?

A

malignant otitis externa or necrotizing otitis externa

36
Q

what are the bugs and antibiotics needed for asplenic pts such as sickle cell pts?

A

Strep pneumoniae, H. influenzae, Neisseria meningitidis

use broad-spectrum antibiotic coverage with vancomycin and ceftriaxone

37
Q

what is the characteristics of imaging of PML caused by JC virus?

A

nonenhancing white matter lesion of MRI of the brain

38
Q

treatments for asymptomatic chronic pulmonary nodules or cavities by Coccidioidomycosis?

A

no treatment needed (supportive)

39
Q

for progressive cavitary or symptomatic dz of coccidioidomycosis, what are the treatments?

A

surgery plus long term azole

40
Q

for acute coccidiodomycosis and mild infection, what is the treatment option?

A

fluconazole, itraconazole

41
Q

for severe coccidiodomycosis or 1’ pulmonary infection and disseminated dz, what is the treatment option?

A

IV amphotericin B

42
Q

what is the complication of rheumatic heart dz that is a risk factor for native valve infective endocarditis?

A

mitral valve prolapse

43
Q

next best step for acute uncomplicated cystitis?

A

no culture required prior to antibiotic therapy

44
Q

3 antibiotic options for acute uncomplicated cystitis?

A
  1. TMP-SMX for 3 day
  2. Nitrofurantoin for 5 day
  3. fosfomycin single dose
45
Q

dx? clumps of bacilli on Warthin-Starry silver stain?

A

Bartonella henselae

46
Q

for neutropenic pts, if fever persists for 72 hrs after giving antibiotic therapy, what is the best next step?

A

start anti-fungal therapy

47
Q

next best step for neutropenic pts?

A

empiric antibiotic therapy with anti-pseudomonal agent (cefepime, piperacillin-tazobactam)

Step 2 CK (20 decks)

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