Lecture 3: ABXs Flashcards

1
Q

MC bacterial cause of Pharyngitis

A

MC bacterial cause of Pharyngitis = GAS

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2
Q

Pt presents w/ sudden onset of sore throat, fever, tonsillar inflam and exudates and anterior cervical adenopathy but no cough.

Dx?
1st line Tx? and for how long ?

A

Dx = Bacterial Pharyngitis (GAS)

Tx = PCN V for 10 days

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3
Q

Pharyngitis Tx

  • ABX tx for kids
  • Tx if PCN allergic
A

Pharyngitis Tx

  • ABX tx for kids = Amoxicillin
  • Tx if PCN allergic = Macrolide (mycins) –> clinda, Azithro
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4
Q

What is the MC bacterial cause of UTIs

A

MC bacterial cause of UTIs = E. coli

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5
Q

UTI Dx

  1. Common dx test
  2. Definitive Dx
A

UTI Dx

  1. common dx test = UA
  2. Defintive Dx test = Urine culture (CLEAN CATCH)
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6
Q

Pt presents w/ c/o burning while peeing, increased freq and urgency. On you UA you note + nitrites and leuk esterases

Dx?
1st line Tx?

A

Dx = UTI

1st line Tx = Nitrofurantin

  1. Fluroquinolones
  2. Bactrim
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7
Q

What is typicall Txs for UTIs in pregnant women

A

Preg women w/UTI –> Amox or Augmentin

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8
Q

How to Dx Otitis Media

A

H&P

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9
Q

What is the MC bacterial cause of Otitis Media

what is AOM (bacterial) usually preceded by?

A

Strep pneumo = MC bacterial cause of Otitis Media
- others = H. influ, M. catarralis

  • AOM usually preceded by viral URI
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10
Q

16 mo old pt presents w/ fever, ear pain and tugging or R ear, hearing loss in R ear and stuffiness. On exam you see a bulging TM w/effusion.

Dx & 1st line Tx

A

Dx = Otitis Media

1st line = Amoxicillin

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11
Q

What is the tx of AOM if pt had recent ABX therapy (2 options)

A

Tx of AOM if pt had recent ABX therapy

  1. Augmentin
  2. Oral Cephalosporin
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12
Q

Bacterial Meningitis:

MC cause in < 1 mo

A

Bacterial Meningitis:

MC cause in < 1 mo = GBS

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13
Q

Bacterial Meningitis:

MC cause in 1 mo - 18 y/o

A

Bacterial Meningitis:

MC cause in 1 mo - 18 y/o = Neisseria Meningiditis

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14
Q

Bacterial Meningitis:

MC cause in 18 - 50 y/o

A

Bacterial Meningitis:

MC cause in 18 - 50 y/o = Strep Pneumo

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15
Q

Bacterial Meningitis:

Causes in > 50
Main cause in immunocompromised

A

Bacterial Meningitis:

Causes in > 50 = Listeria, S. pneumo
Main cause in immunocompromised = Listeria

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16
Q

What ABX must add on for pts > 50 or immunocompromised (cover listeria)

A

pts > 50 or immunocompromised (cover listeria)

- Ampicillin

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17
Q

26 y/o pt presents w/ fevers and chills, HA, neck stiffness, photsensitivity and N/V. On exam she is (+) for Kernig’s and Brudzinki’s

Dx?
Tx (for this age group)

A

Dx = Bacterial Meningitis

Tx for age group
- Cefotaxime or Ceftriaxone + Vanco

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18
Q

What is the Tx for Bacterial Meningitis in < 1 mo old

3 drugs

A

Tx for Bacterial Meningitis in < 1 mo old

- Ampillicin + Cefotaxime + Gentamycin

19
Q

Dx Bacterial Meningitis

  1. What should you do before LP
  2. What is the definitive way to Dx
A

Dx Bacterial Meningitis

  1. CT before LP
  2. definitive way to Dx = CSF examination
20
Q

Dx Bacterial Meningitis: LP

  1. how does sample look
  2. opening pressure level?
  3. protein levels?
  4. glucose levels?
A

Dx Bacterial Meningitis: LP

  1. how does sample look = turbid
  2. opening pressure level = HIGH
  3. protein levels =HIGH
  4. glucose levels = low
21
Q

Dx Bacterial Meningitis: LP

  1. how does sample look
  2. opening pressure level?
  3. protein levels?
  4. glucose levels?
A

Dx Bacterial Meningitis: LP

  1. how does sample look = turbid
  2. opening pressure level = HIGH
  3. protein levels =HIGH
  4. glucose levels = low
22
Q

Are postOp fevers likely infectious the day of infxn

A

NO postOp fevers NOT likely infectious the day of infxn

- usually few days after infxn

23
Q

PosOp wound infections

  • what are the most common causes (group)
  • how to dx it
A

PosOp wound infections

  • most common causes = Gram + bacteria (staph a, strep, enterococci)
  • dx = wound gram stain + culture
24
Q
  1. 1st gen ceph
  2. Clindamycin
  3. Augmentin
  4. Dicloxacillin

why are these good choices for Tx of PosOp wound infections

A
  1. 1st gen ceph
  2. Clindamycin
  3. Augmentin
  4. Dicloxacillin

good choices for Tx of PosOp wound infections b/c have gram + coverage

25
Q

Vaginal infection ABX Tx

  1. For Chlamydia
  2. For Gonorrhea
  3. For Candida
  4. BV or Trichomonas
A

Vaginal infection ABX Tx

  1. For Chlamydia –> 1g Azithro
  2. For Gonorrhea –> Ceftriax (IM) + Azithro
  3. For Candida –> Fluconazole
  4. BV or Trichomonas –>Metronidazole
26
Q

Genital lesions Dx

Dx test for Syphilis

How to Dx HSV

A

Genital lesions Dx

Syphilis = RPR

HSV = cultures

27
Q

Genital lesions

- Tx for Syphilis

A

Genital lesions

- Tx for Syphilis = PCN G (IM)

28
Q

Genital lesions

- Tx for Chancroid (2 options)

A

Genital lesions

- Tx for Chancroid = Ceftriaxone or Azithromycin

29
Q

Genital lesions

- Tx for LGV or Granuloma inguinale

A

Genital lesions

- Tx for LGV or Granuloma inguinale = Doxy or Azithromycin

30
Q

Infectious Diarrhea

- Tx for C.diff (2 options)

A

Infectious Diarrhea

- Tx for C.diff = PO Vanco or Metronidazole

31
Q

Infectious Diarrhea

- Tx for Camplobacter, Salmonella, or Shigella

A

Infectious Diarrhea

- Tx for Camplobacter, Salmonella, or Shigella = Quinolone

32
Q

Infectious Diarrhea

- Tx for Giardia

A

Infectious Diarrhea

- Tx for Giardia = Metronidazole

33
Q

Sinusitis

  1. MC cause of Acute
  2. MC cause of Chronic
  3. MC fungal cause
A

Sinusitis

  1. MC cause of Acute = S. Pneumo
  2. MC cause of Chronic = Staph aureus
  3. MC fungal cause = Aspergillus
34
Q

Dx Sinusitis

1. What is the ToC for diagnosing it?
Dx usually clinical

A

Dx Sinusitis

1. What is the ToC for diagnosing it = CT
Dx usually clinical

35
Q

Pt presents w/ Ha, malaise, nasal d/c and
sinus pain and pressure that is worse w/bending down and leaning forward. Sxs for past 3 weeks. On exam you see opaqueness w/transillumination.

Dx + 1st line Tx?

A

Dx = ACUTE Sinusitis

1st line Tx = Augmentin

36
Q

Bronchitis

  • MC cause viral or bacterial
  • if > 14 days of cough what is likely cause
A

Bronchitis
- MC cause = viral (adeno esp)

> 14 days of cough –> pertussis (Bordella)

37
Q

Bronchitis

- is mainstay of treatment supportive or ABX

A

Bronchitis

- mainstay of tx = supportive

38
Q

Supportive Tx of bronchitis

A

NSAIDs, expectorant or cough suppressant

inhaled bronchodilators

39
Q

When should you consider ABX tx for bronchitis

A

consider ABX tx for bronchitis if pt not better after 1 wk of supportive Tx

40
Q

2 ABX Tx options for bronchitis

A

2 ABX Tx options for bronchitis

  1. Macrolides
  2. Azithromycin
41
Q

2 ABX Tx options for bronchitis

A

2 ABX Tx options for bronchitis

  1. Macrolides
  2. Azithromycin
42
Q

Pt presents w/ productive cough for the past week. He recently had a cold but that has since resolved.

Dx?

A

Bronchitis

43
Q

2 ABX Tx options for bronchitis

A

2 ABX Tx options for bronchitis

  1. Macrolides
  2. Doxy