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PANCE > Infectious Dz Treatment > Flashcards

Infectious Dz Treatment Flashcards

1
Q

Streptococcus sp.

A

Group A B-hemolytic streptococci:
Penicillin
Cephalosporins
Macrolides (for pt allergic to Penicillin)
Supportive care (i.e., fluids, analgesics, antipyretics)

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2
Q

Botulism

A

Antitoxin from CDC
If Respiratory failure: intubation, mechanical ventilation
If dysphagia: IV nutrition and hyperalimentation

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3
Q

Anthrax

A 
Combo therapy for inhalation of, disseminated dz, or cutaneous infxn involving head or neck;
Ciprofloxacin (1)
Other Fluoroquinolone (1)
Doxycycline (2)
Vaccine available for exposure likelihood;
Cutaneous exposure = good prognosis;
Inhalation = 85% mortality;
Tx early
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4
Q

Cholera

A

Fluid and electrolyte therapy;
Mild-moderate: 1 tsp salt or 4 tsp sugar and 1 cup H2O
Severe: IV replacement
Abx to shorten duration, reduce severity of sx, reserve for severely ill or comorbidities;
Tetracycline
Ampicillin
Chloroamphenicol
TMP-SMX
Fluoroquinolones
Prevent: clean H2O and food, proper waste disposal; vaccine for temporary uses

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5
Q

Tetanus

A

Immune globulin via IM; once recovered, full course of toxoid;
Bed rest, sedation, and mechanical ventilation for tetanic spasms
Penicillin
Active immunization recommended starting in children;
3-4 initial doses, then boosters q10 yrs; q5yrs if major injury occurs
Mortality is high

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6
Q

Salmonellosis

A

Ampicillin (1)
Chloramphenicol (1)
TMP-SMX (1)
Ceftriaxone (2)
Fluoroquinolones (2)
Tx for 2 wks; Tx of carries/close-contacts not effective
Prevent: clean H2O, food, and proper waster removal
Typhoid Fever: Ceftriaxone, fluoroquinolones (contra: pregnancy, children)
Gastroenteritis: self-limited; tx is symptomatic; Ampicillin/Ciprofloxacin
Bacteremia: same as typhoid; drain abscesses

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7
Q

Shigellosis

A 
Abx:
TMP-SMX (1)
Ciprofloxacin
Fluoroquinolone
Amoxicillin - NOT EFFECTIVE
Fluid Replacement essential
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8
Q

Diptheria

A 
Penicillin
Erythromycin
Azithromycin (2)
Clarithromycin (2
Horse serum antitoxin from CDC;
If airway obstruction, removal of membrane if necessary;
Isolate pt until 3 Neg. pharyngeal cultures;
Tx close contacts w/ Erythromycin;
Toxoid avail. as a vaccine (DTaP)
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9
Q

Pertussis

A 
Erythromycin (1)
Azithromycin (2)
Clarithromycin (2)
TMP-SMX (2)
Tx aims to stop transmission;
Supportive therapy;
Tx close contacts w/ Erythromycin;
Prevent: acellular vaccine; TDaP
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10
Q

Epstein-Barr Virus

A 
Tx is symptomatic;
Non-aspirin and anti-inflammatories;
Antivirals only decrease viral shedding;
Avoid contact sports (splenomegaly);
Steroids for thrombocytopenia, hemolytic anemia, or airway obstruction caused by lymphedema
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11
Q

Human Papillomavirus

A

Salicylic acid
Liquid Nitrogen
Podophyllum
Topical interferon (imiquimod [Aldara]);
Spontaneous remission for most skin warts;
Tx goal: reduce number and frequency of lesions;
Surgery: blunt dissection, electrocautery, CO2 laser;
Recurrence is common

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12
Q

Herpes Simplex Virus

A

Acyclovir
Valacyclovir
Trifluridine - keratitis
Supportive and suppressive therapy

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13
Q

Influenza

A

Relenza (1)
Tamiflu (1) (both within 48 hrs)
Amantadine/Rimantadine (2) (resistance increasing)
Rest, analgesics, cough suppressants

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14
Q

Varicella-zoster

A

Tx is supportive;
Prevent: good hygiene, vaccine (1-2 y/o), Zostavax (>60 y/o) reduces shingles possibility;
Zostavax contra: pregnancy, TB, allergy to gelatin/neomycin, immunocompromised

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15
Q

Rabies

A

No specific tx;
Ventilation and O2; Vaccine immunoglobulin with monoclonal antibodies, ribavirin, interferon-a, ketamine;
Prevention is key;
Cleanse, debride, and flush a bite; do not suture;
Post-exposure: immunoglobulin and human diploid cell vaccine

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16
Q

HIV and AIDS

A

Prevention;
Antiretrovirals and chemoprophylaxis (2nd prevention);
Postexposure:
Prophylaxis (PEP) within 72 hrs;
Antiretroviral therapy (incl. pregnancy) (based on CD4 count, viral load, pt status)

17
Q

Cytomegalovirus

A 
Ganciclovir
Valganciclovir
Foscarnet
Cidofovir
Prevention:
Limit blood transfusions;
remove leukocytes from transfusions;
restrict organ donor pool to seronegative donors
18
Q

Candidiasis (Cutaneous)

A

Topical antifungal creams

19
Q

Candidiasis (Mouth and Esophagus)

A

Fluconazole
Itraconazole
Amphotericin B (if recalcitrant)

20
Q

Candidiasis (Vulvovaginal)

A

Topical azoles

Fluconazole

21
Q

Candidiasis (Fungemia)

A

Amphotericin (IV)
Flucytosine (if + blood culture, retinal lesions, infxn of dermis, brain, meninges, myocardium)
Fluconazole (2)
Can be life threatening

22
Q

Candidiasis (Hepatosplenic)

A 
Amphotericin B (1)
Fluconazole (2)
23
Q

Candidiasis (Endocarditis)

A 
Amphotericin B (1)
Fluconazole (typically lifelong after recovery)
Infected valves need surgical replacement
24
Q

Histoplasmosis

A 
Itraconazole (1)
Amphotericin B (intolerance to (1) or pt w/ meningitis/severe dz)
Itraconazole (lifelong for immunocompromised)
25
Q

Cryptococcus sp.

A

HIV+:
Fluconazole (lifelong)
Amphotericin B (in severe) followed by Fluconazole
Flucytosine (may be added if severe)
HIV-:
Amphotericin B (immunocompromised; mortality higher)

26
Q

Pneumocystis jiroveci pneumonia

A 
TMP-SMX (1) (SE: fever, rash, malaise, neutropenia, hepatitis, nephritis, thrombocytopenia, hyperbilirubinemia)
Dapsone (2a)
Pentamidine (2b)
Atovaquone (3)
Prophylaxis post-tx
27
Q

Amebiasis

A

Asymptomatic:
Diloxanide furoate
Iodoquinol
Paromomycin
Mild-Moderate:
Tinidazole/Metronidazole + above
Severe:
Fluids, electrolytes, opioids (ctrls bowel motility)
Hepatic abscess:
Tinidazole/Metronidazole + above + Chloroquine
Follow-up:
3 stool exams (2-3 day intervals after 2-4 wks)
Prevent:
clean water and H2O, good sanitation and hygiene

28
Q

Hookworms

A 
Mebendazole (1)
Pyrantel (2) (> 5 y/o)
Albendazole (2)
Note: avoid all if pregnant
Supportive:
   High-protein intake, vitamis, ferrous sulfate
29
Q

Pinworms

A 
Albendazole
Mebendazole
Pyrantel (> 5 y/o)
Prevent:
   Wash hands; wash linens; tx close contacts
30
Q

Malaria

A

Chloroquine (1)
Mefloquine (2) (in areas of (1) resistance)
Severe:
Quinine, Quinidine, Chloroquine + Doxycycline, Clindamycin, or Tetracycline
Alternatives:
Atovaquone, Proguanil, Mefloquine, Hydroxychloroquine, Atovaquone/Doxycycline
Prevention is key

31
Q

Syphilis

A

Benzathine penicillin G (1)
Neurosyphilis:
Aqueous penicillin followed by (1)
Jarisch-Herxheimer rxn: fever, toxic state; destruction of spirochetes; antipyretics during initial 24 hrs of tx

Report syphilis cases to public health dept and sexual partners
Careful follow-ups

32
Q

Gonorrhea

A

Ceftriaxone (1)
Oral Cefixime (1)
+ Doxycycline or Azithromycin

Tx all partners; report cases
RESISTS: Penicillin, Tetracyclines, and Fluoroquinolones

33
Q

Chlamydia

A

Azithromycin
Doxycycline
Erythromycin (1 - pregnancy)

Tx all partners

34
Q

Trichomonas

A

Metronidazole

Tx all partners

35
Q

Lyme Disease

A 
Doxycyline (1)
Amoxicillin (2)
Cefuroxime (2)
Ceftriaxone (2)
Cefotaxime (2)

Sx tx with analgesics (NSAIDs)
Prevention is key; Prophylactic abx NOT recommended

36
Q

Rocky Mountain Spotted Fever

A

Doxycycline
Chloramphenicol
Note: both helps recovery

Poor outcomes in older pts; death caused by pneumonitis, respiratory or cardiac failure;

Sequelae: seizures, encephalopathy, peripheral neuropathy, paraparesis, bowel/bladder incontinence, cerebellar dysfunction, vestibular dysfunction, hearing loss, motor deficits
Prevention is key

PANCE (5 decks)

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