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From Flashcardlet > MKSAP: ID > Flashcards

MKSAP: ID Flashcards

0
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0
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5 Ssx of bacterial vaginosis?

A
  1. Homogenous white discharge
  2. Absence of vaginal erythema
  3. Presence of clue cells
  4. Vaginal pH > 4.5
  5. Vaginal discharge with malodorous “fishy” odor
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1
Q

Pt with recurrent GI and resp infections, what disease should you think about? Dx?

A
  • think: common variable immunodeficiency (AKA acquired hypogammaglobulinemia)
  • dx: measure serum IgG levels
  • *recurrent GI infections especially with giardiasis!
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2
Q

Three most common causes of vaginal discharge?

A
  1. Candidal infection
  2. Trichomonias
  3. Bacterial vaginosis
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3
Q

2 Tx options for candida vaginitis?

A
  1. Intravaginal clotrimazole cream

2. Single oral dose of fluconazole

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4
Q

Which two common infections cause cervicitis rather than vaginitis?

A
  1. Chlaymidia

2. Gonorrhea

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5
Q

What is drug fever and which commonly cause it?

A
  • a prolonged fever caused by a medication, with no other obvious signs of inflammation
  • antibiotics can cause this, esp beta-lactams
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6
Q

Definition of systemic inflammatory response syndrome (SIRS)?

A
  • presence of 2 or more of (in absence of a known cause):
    a) temp > 100F or < 96.8F
    b) heart rate > 90/min
    c) resp rate > 20/min, or PCO2 < 32
    d) leukocyte count > 12,000 or < 4,000 or > 10% bands
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7
Q

Definition of sepsis?

A

-SIRS in response to confirmed infectious process

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8
Q

Definition of severe sepsis?

A

-sepsis with organ dysfunction, hypoperfusion, or hypotension

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9
Q

Septic shock definition?

A
  • sepsis-induced hypotension or hypoperfusion abnormalities despite adequate fluid resuscitation
  • this dx cannot be made until fluid resuscitation has been administered and the response has been evaluated!!
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10
Q

What tx has shown to have the most impact on survival in a pt with severe sepsis?

A

-aggressive fluid resuscitation within 6 hrs!

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11
Q

Prophylaxtic tx for an immunocomp, nonvaccinated pt exposed to the flu?

A
  1. Zanamivir or oseltamivir

2. Inactivated flu vaccine

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12
Q

What kind of drugs are oseltamivir and zanamivir? What are they used for?

A
  • neuraminidase inhibitors
  • both active against influenza A and B
  • zanamivir can cause bronchospasm –> CONTRAINDICATED IN ASTHMA!!
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13
Q

What influenza medication is contraindicated in asthmatic pts? Why?

A
  • zanamivir

- may induce bronchospasm!

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14
Q

Name 2 neuraminidase inhibitors that can be used for influenza?

A
  1. Oseltamivir

2. Zanamivir

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15
Q

Rhinitis medicamentosa? Tx?

A
  • persistent rhinitis sx in a pt with chronic nasal decongestant spray use
  • due to the rebound phenomenon
  • tx: withdraw the decongestant and give nasal corticosteroid spray
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16
Q

4 Ssx of bacterial rhinosinusitis?

A
  1. Duration of the sx –> greater than 1 week + worsening sx after an initial improvement
  2. Maxillary tenderness
  3. Purulent drainage
  4. Poor response to decongestants
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17
Q

Tx for acute bacterial rhinosinusitis?

A
  • 3 - 10 day course of narrow-spectrum antibiotics, such as:
    1) amoxicillin
    2) TMP-SMZ
    3) doxycycline
18
Q

Tx of acute pyelonephritis in a pt who is: compliant, can eat and drink, and not pregnant?

A

-oral levofloxacin

19
Q

What is the Tx for an uncomplicated UTI in a compliant, young, healthy, nonpregnant female?

A

-TMP-SMZ

21
Q

Oral antiviral agent used to tx uncomplicated genital herpes simplex virus?

A

-oral valacyclovir

22
Q

What is the most sensitive test to do in an HIV infection during the acute (early) stage?

A

-HIV viral load

23
Q

Progressive multifocal leukoencephalopathy: what is it? What is it caused by? What dies it lead to? Tx?

A
  • opportunistic infection
  • caused by polyomavirus JC
  • leads to demyelination of the CNS –> causes progressive neurologic deficits
  • tx: HAART tx
24
Q

What is the best solution to use to clean a catheter insertion site?

A

-chlorhexidine

25
Q

What IV catheter site is associated with a lower risk of infection?

A

-subclavian

26
Q

Best way to stop the spread of c. Diff from an infected pt?

A
  • put the pt in contact isolation

- ALCOHOL RUBS are NOT effective for killing c. Diff!

27
Q

What contact precautions should a suspected or confirmed TB patient be tx with?

A

-airborne isolation + personal respirators for the hospital staff

28
Q

What is the best way to decrease the risk of UTIs from catheters?

A
  • remove the catheter

- no other method (prophylactic antibiotics, disinfecting wash, etc) has been useful

29
Q

What helps prevent ventilator-associated pneumonia?

A

-keeping mechanically ventilated pts at 45* angle

30
Q

3 Cut-offs for induration from TB test? Who is in each group?

A
  1. > 5 mm –> highest risk, immunosuppresed, TB contacts, chest xray shows TB
  2. > 10 mm –> mid risk, immigrants, IV drug users, prisoners, health care workers, pts with chronic disease/malignancy
  3. > 15 mm –> lowest risk, “normal” people
31
Q

What PPD cutt-off range are adolescents who are exposed to adults in high-risk category in?

A

-> 10

32
Q

What is the initial antiTB tx regime?

A
  • 4 antiTB drugs (Rifampin, Isoniazide, Pyraznamide, Ethambutol)
  • the fourth drug may be stopped when the sensitivity results are back
33
Q

Latent TB tx?

A

-isoniazid for 9 mnths

34
Q

How does a prior vaccination with bCG affect the interpretation of a PPD?

A
  • it does NOT change it!

- test is read as if the person does not have the vaccine!

35
Q

How does prednisone effect a PPD test?

A
  • can cause a false-negative result!

- so test pt with PPD BEFORE starting prednisone!

36
Q

What is the best antibiotic tx for aspirate pneumonia? What are the common bugs involved?

A
  • use: clindamycin

- bugs: anaerobes

37
Q

Reccomended tx for a pt with CAP who is being hospitalized?

A

Either:

1) IV beta-lactam plus IV or oral macrolide or doxy
2) IV fluoroquinolones

38
Q

What bug is likely to be the cause if there are extrapulmonary manifestations too?

A

-legionella

39
Q

What extrapulmonary manifestations are common with legionella pneumonia?

A
  1. Hyponatremia
  2. Azotemia
  3. Elevated live enzymes
  4. Elevated creatine kinase
40
Q

Which heart valve is the most susceptible to an abscess formation?

A

-the aortic valve and its adjacent ring

41
Q

What should be done first in a pt with a contiguous foot ulcer and possible bone involvement?

A

-bone bx with cultures before starting antibiotics!

42
Q

What imaging is preferred for the dx of osteomyelitis?

A

-MRI (best) or CT

43
Q

Tx for orthopedic implant-associated osteomyelitis?

A
  • surgical debridement and removal of infected implant

- plus IV antibiotic

44
Q

What post surgery sx means the pt is more likely to have a periprosthetic infection?

A
  • periosthetic pain

- those who are pain-free aftery surgery are less likely to become infected

45
Q

What could happen if an infected orthopedic implant is not removed?

A

-a biofilm can form & the bug will escape the hosts defenses!

From Flashcardlet (79 decks)

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