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Infectious > MTB 1 > Flashcards

MTB 1 Flashcards

1
Q

What does PCN cover

A 
Viridans group strep
Strep pyogenes
Oral anaerobes
Syphilis 
Leptospira
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2
Q

What does Amoxicillin and Amp cover

A 
PCN drugs + HELPS
H.influenzae
E.Coli
Listeria 
Proteus
Salmonella
Lyme Dz
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3
Q

AE of Methicillin

A

Renal Failure from AIN

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4
Q

Pt w rash to PCN - TX?

A

Cephalosporins

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5
Q

Pt w anaphylaxis to PCN - TX?

A

Non-beta-lactam
Vanco
Linezolid
Daptomycin

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6
Q

AE of Cefotetan and cefoxitin

A

Increased risk of bleeding

Disulfiramlike Rxn w Alcohol

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7
Q

Cephalosporins that cover Pseudomonas

A

Ceftazidime

Cefepime

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8
Q

Why do avoid ceftriaxone in neonates

A

impaired biliary metabolism

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9
Q

AEs of Doxycycline

A

Tooth discoloration - children
Fanconi syndrome - Type II RTA proximal
Photosensitivity
Esophagitis/ulcer

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10
Q

TMP-SMX AEs

A

Rash
Hemolysis
Bone marrow suppression
Folate antagonist

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11
Q

MCC meningitis w recent neurosurgery

A

Staph

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12
Q

Meningitis in camper/hiker w centripetal rash and tick

A

RMSF

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13
Q

What is a centripetal rash

A

Involves wrists, ankles, moves from arms/legs to trunk

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14
Q

Meningitis - best initial test

A

LP

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15
Q

Meningitis - Most accurate test

A

LP

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16
Q

Meningitis - LP in Bacterial

A

Glucose = Low
Protein =High
Cell count = 1000s, Neutrophils

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17
Q

Meningitis - LP in Cryptococcus, Lyme, Rickettsia

A

Glucose = Possibly Low
Protein = Normal, Possibly High
Cell count = 10s-100s, Lymphocytes
No stain/culture

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18
Q

Meningitis - LP in TB

A

Glucose = May be low
Protein = VERY High
Cell count = 10-100s Lymphocytes

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19
Q

Meningitis - LP in Viral

A

Glucose = Normal
Protein = Normal
Cell count = 10-100s Lymphocytes

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20
Q

Meningitis TX w head CT if:

A
  1. Papilledema
  2. Seizures
  3. Focal neuro changes
  4. Confusion
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21
Q

Meningitis pt with CI to LP - next best step?

A

ABX

22
Q

Testing for Lyme and Rickettsia

A

Serology w ELISA, Western blot, PCR

23
Q

Best initial TX for bacterial meningitis

A

Ceftriaxone
Vanco
Steroids

24
Q

Why steroids in bacterial meningitis

A

Lower mortality in Strep Pneumo pts

25
Q

TX for Meningitis + 1000s neutrophils on CSF

A

Ceftriaxone
Vanco
Steroids

26
Q

When do we add Ampicilin in meningitis

A

Immunocompromised for Listeria

  • Elderly
  • Neonates
  • Steroid use
  • HIV
  • Pregnant
27
Q

TX for Listeria

A

Sensitive to PCN

Resistant to ALL cephalosporins

28
Q

TX for TB meningitis

A

Extend TX + steroids

29
Q

Neisseria meningitis TX

A 
Respiratory isolation
Rifampin/cIpro to close contacts
- Household contacts
- Kissing
- Cig sharing
- Utensils
- HCW w exposure to resp secretions
30
Q

Pt w fever, HA, stiff neck, photophobia, weakness of arm and leg - left. Next best step?

A

Ceftiraxone, Vanco, Steroids

  1. LP
  2. ABX
  3. CT head
31
Q

MC neuro deficit of untreated bacterial meningitis

A

8th CN deficit

Deafness

32
Q

What is seen on CT for brain abscess

A

Ring/contrast enhancing lesion

33
Q

IF Ring/contrast enhancing lesion on CT AND HIV + , next step

A

TX for Toxo for 2 weeks w Pyrimethazine and sulfsalazine
Repeat CT 2 wks - if same, BX

DDX: Toxo or Lymphoma

34
Q

IF Ring/contrast enhancing lesion on CT AND HIV - , next step

A

BX

DDX: Cancer, Infxn

35
Q

Most accurate test Herpes Encephalitis

A

PCR of CSF

36
Q

Best initial therapy for Herpes Encephalitis

A

Acyclovir

37
Q

Best initial therapy for Herpes Encephalitis Resistant to Acyclovir

A

Foscarnet

38
Q

Malignant Otitis Externa seen in ? Etiology?

A

Elderly pts
Diabetics
Pseudomonal Infxn on External Auditory Canal (EAC)

39
Q

MOE presentation and TX

A 
Severe Ear pain
Discharge
Low grade fever
Granulation tissue in EAC 
TX: Cipro
40
Q

Best initial therapy for otitis media

A

Amoxicillin

41
Q

Most Accurate diagnositic test for OM

A

Tympanocentesis

- done with multiple recurrences

42
Q

If OM pt not responding to Amoxicillin

A

Amox/Clauv
Azithromycin, Clarithromycin
Cefuroxime, Loracarbef
FQ

43
Q

Most Accurate Dx test for sinusitis

A

Sinus BX or Aspirate

44
Q

When is sinus BX done in sinusitis

A

Recurrent

No response to empiric tx

45
Q

First line agents for otitis and sinusitis

A

Amoxcillin
Doxycycline
TMP-SMX

46
Q

Tx for rhizopus and mucormycosis

A

Surgical Debridement

Ampho B

47
Q

Presentation of Strep pharyngitis

A 
Pain w swallowing
LA -neck
Exudate - whitish, scrapes off
Fever
NO cough, NO hoarseness
48
Q

Laryngitis presentation

A

Hoaresness

Cough

49
Q

Best initial test pharyngitis

A

Rapid Strep test

50
Q

Pharyngitis + vesicles or ulcers

A

HSV

Herpangia

51
Q

Pharyngitis + membranous exudate

A

diphtheria
EBV
Vincent angina

52
Q

TX for Pharyngitis

A
  1. Amoxcillin or PCN
  2. Cephalexin - PCN allergic w rash
    Clindamycin or macrolide - PCN allergic w anaphylaxis

Infectious (4 decks)

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