Infectious Pathology Flashcards
Drug class most commonly associated with hypersensitivtiy reactions
PCNs
Should cephalosporins be used in a patient with ANAPHYLACTIC reaction to PCNs?
No
Aztreonam definition
IV beta lactam antibiotic that is primarily gram negative aerobes only including pseudomonas and enterobacteriae, used most often in patients with PCN allergies, renal insufficiency, those who cannot tolerate aminoglycosides
Polymyxin definition
Most often used topical for infections of eye, ear, and skin, may be part of triple therapy ointment with neomycin and bacitracin
Vancomycin spectrum and adverse effects
Gram positive only including MRSA (IV) and C diff colitis (oral route), adverse effects include red man syndrome (flushing and pruritis due to histamine release), ototoxicity, and nephrotoxicity
Drug of choice for lymphogranuloma venereum
Doxycycline (doxy is drug of choice for all chlamydia)
Drug of choice for mycoplasma pneumoniae
Azithromycin or doxycycline
Drug of choice for cholera
Doxycycline
Drug of choice for cat scratch fever
Azithromycin first line, doxycycline
Adverse reactions to macrolides
GI upset, ototoxicity, prolonged QT interval
Clindamycin adverse effect
C diff colitis
Drug of choice for rocky mountain spotted fever during pregnancy
Chloramphenicol (yeah I know, despite the whole gray baby thing…)
Drug that can be used to treat MRSA and VRE
Linezolid
C diff treatment
Metronidazole
Things that metronidazole treats
C diff, BV, giardia, trich, h pylori, added to PID sometimes
Quinupristin/dalfopristin function
MRSA, VRSA, VRE coverage, given IV
Tetanus management
Metronidazole plus IM Tetanus immune globulin, benzos to reduce spasms and respiroatry support if needed
Tetanus prophylaxis if previously vaccinated vs never vaccinated
Previously vaccinated: Tdap (preferred) or Td booster every 10 years or major or dirty wounds occuring >5 years since last booster
Never vacicnated: tetanus immune globulin plus initiation of tetanus toxoid vaccine, 2nd dose 4-8 weeks laer and a 3rd 6-12 months later
Tdap booster schedule
At 11-12 years of age, given 10 year intervals after that or sooner if major injury and booster was 5 years ago or longer, recommended once during every pregnancy
Clostridium perfringens management
Surgical debridement plus antibiotics IV penicillin plus clindamycin
Management of foodborne botulism vs wound botulism
Antitoxin first line therapy in foodborne with no antibiotics or if infantile, if wound based then antitoxin plus penicillin
Diphtheria management
Antitoxin plus either erythromycin or PCN
Gonococcal arthritis first line treatment vs urethritis and cervicitis
IV ceftriaxone, ceftriaxone 250 im plus either doxy or azithro
Lymphogranuloma venereum vs chancroid presentation
Lymphogranuloma is PAINLESS at site of inoculation followed by painful inguinal lymphadenopathy (buboes), chancroid is caused by hemophilus ducreyi and is painful genital ulcer followed by painful inguinal lymphadenopathy (buboes)
Severe invasive or life threatening candida infection treatment (ex - endocarditis)
Iv amphotericin B
Most common cause of fungal meningitis
Cryptococcosis, from bird or pigeon droppings and most common in immunocompromised HIV patients with CD4 <100
Histoplasmosis vs coccidiomycosis
Found in soil containing bird and bat feces in mississippi and ohio river valleys, aids defining illness and most patients are asymptomatic otherwise
Found in southwestern US from inhalation of spores, causes mild flu illness or valley fever
MAC definition
Spread from water to soil and seen in immunocompromised patients or those with underlying pulmonary disease, treated with clarithromycin plus ethambutol plus rifampin (REC)
Pinworm Enterobiasis treatment
Mebendazole, pyrantel preferred in pregnancy
Ascariasis diagnosis and treatment
Stool ova and parasite, mebendazole or pyrantel preferred in pregnancy
Trichonosis diagnosis and treatmnet
Eosinophilia, elevated creatinine kinase, managed with mebendazole
Hookworm (Necator americanus) diagnosis and treatment
Eosinophilia, iron deficiency anemia, mebendazle or pyrantel preferred in pregnancy
Malaria first line treatment
Chloroquine, hydroxychloroquine is alternative
Malaria treatment in chloroquine resistant regions
Artemisnin or atovaquone proguanil
Babesiosis management
Atovaquone plus azithromycin
Toxoplasmosis definiton
Infection by toxoplasma gondii, most common cns infection in patients with AIDS not on medication, obtained from soil or cat litter, see enchpalitis especially when CD4 <100, diagnosed clinically but neuroimaging may show nonspecific multiple ring ehancing lesions (also seen in CNS lymphoma), managed with sulfadiazine, bactrim is first line prophylaxis
Chancroid treatment
azithromycin
2ndary and 3iary syphilis presentation
2nday may occur few weeks to 6 months after initial symptoms, maculopapular diffuse bilateral rash involving palsm and soles common, condyloma lata involving mucus membranes or other moist areas present, and some systemic symtpoms
3iary may occur 1-20 years later after latent infection and is either gummatous granulomas, neurosyphilis (tabes dorsalis leading to ataxia, areflexia, burning pain, weakness), argyll robertson pupil
Diagnosis of syphilis
Non treponemal test screening, RPR or VDRL, if positive must be confirmed by FTA-ABS
Late or severe management of lyme disease
IV ceftriaxone
Lyme disease diagnosis
Clinical first line, serologic testing elisa followed by western blot if elisa posotive
Acanthamoeba keratitis definition
Seen in contact lens wearers, presents with ocular pain, photophobia, conjunctival injection, partial or complete ring infiltrate of corneal stroma (physical exam findings)
Test of choice for HSV1 and gold standard test
PCR, HSV1 serology
The most common cause of encephailitis in the US
HSV-1 encephalitis
Test of choice for epstein barr virus, peripheral smear finding
Heterophile antibody (monospot), peripheral smear may show atypical lymphocytes
Most common congenital viral infection and what is the treatment of it in any situation
CMV, ganciclovir
Varicella diagnosis and treatment
Usually clinical but PCR can be performed
Symptomatic treatment in 12 or younger, acyclovir in 13 or older or immunocompromised because of varicella pneumonia leading to mortality and morbidity in adutls
Post exposure prophylaxis treatment of varicella
Varicella zoster imune globulin
Herpes zoster diagnosis and treatment
Clinical but PCR can be performed
Acyclovir
Post exposure prophylaxis of herpes zoste
Varicella zoster immune globulin for people exposed to shinles who are immunocompromised
Hutchinson’s sign
Vesicles on side or tip of nose which ahve high correlation with occular involvmeent of herpes zoster infection due to nasociliary branch of CN V, herpes zoster ophthalmicus
Herpes zoster oticus definition
Ramsay hunt syndrome, reactivation of varicella zoster in facial nerve CN VII, see ipsalateral facial paralysis plus ear pain plus vesicles in auditory canal or auricle, treated with valacyclovir plus prednisone
AIDS is a cd4 count below
200
