Infectious Dz First Aid Flashcards
what is the pneumonia hospitalization criteria?
CURB-65
Confusion
Uremia (BUN > 19)
Respiratory rate ( > 30 breath/min)
Bp (SBP 65
2-3: consider inpatient treatment
more than 4: admission
bug that causes resp failure in US southwestern area?
coccidioidomycosis
treatment for severe coccidioidomycosis infection?
IV amphotericin B
treatments for active TB?
RIPE
Rifampin
INH (add B6 to prevent peripheral neuropathy)
Pyrazinamide
Ethambutol
treatment for latent TB?
Isoniazide(INH) for 9 months
most common infecting organism in prosthetic valve endocarditis?
coagulase neg Staph
2 choices of antibiotics for infective endocarditis?
vancomycin + gentamicin
what is the preferred antibiotic prophylaxis for infective endocarditis?
amoxicillin
choice of antibiotics for infective endocarditis for pts with penicillin allergies?
cephalexin, clindamycin, azithromycin, or clarithromycin
how does otitis externa present diff from otitis media?
pain with movement of the tragus/pinna
what is the choice of antibiotics for osteomyelitis pts with sickle cell anemia?
3rd generation cephalosporin: ceftriaxone
diagnosis for oral candidiasis (oral thrush)?
clinical + KOH or gram stain shows budding yeast or pseudohyphae
treatment for oral thrush?
nystatin suspension, clotrimazole tablets, PO azoles
treatment for candidal esophagitis?
PO azole
treatments for acute bacterial sinusitis?
amoxicillin/clavulanate for 10 days
treatments for histoplasmosis?
- mild pulmonary dz or stable nodule: supportively for immune competent, otherwise itraconazole
- chronic cavitary lesion: itraconazole for more than a year
- severe acute pulmonary dz or disseminated dz: liposomal amphotericin B X 14 days followed by itraconazole X1 year
CXR characteristics of Pneumocystis Jirovecii pneumonia
bilateral interstitial infiltrates with ground glass appearnce
diagnosis for PCP?
cytology induced sputum or bronchoscopy specimen with silver stain and immunofluorescence –> obtain ABG to check PaO2
what is the best next step for pts with positive PPD?
X-ray to rule out active dz
what are the clinical signs of herpes simplex virus keratitis?
photophobia, foreign body sensation, constricted pupil
what are the diagnostic tools for keratoconjunctivitis secondary to herpes simplex virus infection?
dendrites visible on fluorescein statining
CT is the choice of sinus imaging, but when do we do it?
only necessary if symptoms persist after treatment
pts with lacerations caused by the human mouth, what bug must be covered by antibiotics?
Eikenella
3 most common community acquired bacterial sinusitis?
- Strep pneumoniae
- Haemophilus influenzae
- Moraxella catarrhails
clinical signs of otitis externa?
discomfort is limited to the external auditory canal
describe the pain associated with otitis externa?
pain with movement of the tragus/pinna
treatments for otitis externa?
clean the ear and give antibiotics (ofloxacin or ciprofloxacin), and steroid eardrops
what group of pt is at risk for malignant otitis externa?
diabetic pts
what dimorphic fungi is endemic to the southwestern US and Mexico?
Coccidioidomycosis
characteristics of miliary TB on CXR?
reticulonodular infiltrates spread evenly throughout both lung fields
what bacteria infection is pts with recent hx of kidney transplant should be worried about?
Pseudomonas aeruginosa
definition of neutropenic fever?
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
treatments for coccidioidomycosis?
ketoconazole, fluconazole, itraconazole
amphotericin B is less preferred due to toxicity
antibiotics choices for malignant otitis externa or necrotizing otitis externa?
fluoroquinolone plus beta lactam for Pseudomonas and Staph aureus
what is osteomyelitis of the temporal bone?
malignant otitis externa or necrotizing otitis externa
what are the bugs and antibiotics needed for asplenic pts such as sickle cell pts?
Strep pneumoniae, H. influenzae, Neisseria meningitidis
use broad-spectrum antibiotic coverage with vancomycin and ceftriaxone
what is the characteristics of imaging of PML caused by JC virus?
nonenhancing white matter lesion of MRI of the brain
treatments for asymptomatic chronic pulmonary nodules or cavities by Coccidioidomycosis?
no treatment needed (supportive)
for progressive cavitary or symptomatic dz of coccidioidomycosis, what are the treatments?
surgery plus long term azole
for acute coccidiodomycosis and mild infection, what is the treatment option?
fluconazole, itraconazole
for severe coccidiodomycosis or 1’ pulmonary infection and disseminated dz, what is the treatment option?
IV amphotericin B
what is the complication of rheumatic heart dz that is a risk factor for native valve infective endocarditis?
mitral valve prolapse
next best step for acute uncomplicated cystitis?
no culture required prior to antibiotic therapy
3 antibiotic options for acute uncomplicated cystitis?
- TMP-SMX for 3 day
- Nitrofurantoin for 5 day
- fosfomycin single dose
dx? clumps of bacilli on Warthin-Starry silver stain?
Bartonella henselae
for neutropenic pts, if fever persists for 72 hrs after giving antibiotic therapy, what is the best next step?
start anti-fungal therapy
next best step for neutropenic pts?
empiric antibiotic therapy with anti-pseudomonal agent (cefepime, piperacillin-tazobactam)
