MTB 4 Flashcards
HIV PPX < 200 Pts w rash w TMP SMZ
Dapsone
Atorvaquone
HIV PPX < 200 Pts w rash w TMP SMZ and G6PD
Pentamidine - Aerolized
Atovaquone
Pt on TB TX and develops optic neuritis - next best step
STop Ethambutol
TB drugs CI in Pregnancy
Pyrazinamide
Streptomycin
What bug with fisherman?
Vibrio vulnificans
Presentation of C.Dif
Profuse
Watery
Diarrhea
TX for C.Dif
- Metronidazole
- Recurs - Metronidazole 10 d
- PO Vanco Taper down hi to low dose
- Fidoxmycin
- Fecal transplant
DX test for Giardia and Cryptosporidia
Stool for ova and parasites
ELISA - Giardia
Modified AFB stain - Cryptosporidia
Most important contributory factor to perinephric abscess
Stones
Best initial test for HIV
ELISA
Confirmatory test for HIV
Western Blot
HIV test for infants
PCR
Viral culture
How long are maternal HIV abs present in infants
Up to 6 months
When is viral load testing used in HIV
Viral load = PCR RNA
- Response to therapy
- Detect TX failure
- DX for HIV in babies
HIV pts w CD4 < 100 + living in endemic areas of Histoplasmosis
PPX Itraconazole
First manifestation of failing TX
Rising PCR-RNA load
When do we start TX for HIV
CD4 < 500 in asymptomatic pt OR Very high Viral load (> 55,000-100,000) OR Opportunistic infxn occurs
What is TX for HIV
3 Drugs from at least 2 classes
Emtricitabine, Tenofovir, Efavirenz = Atripla
Combos of HAART
2 NRTIs + 1 NNRTI or 1 PI
2 Nucleosides + 1 PI
2 Nucleosides + Efavirenz
HIV drug CI in Pregnancy
Efavirenz = NNRTI
When do we do postexposure PPX for needle stick injury and HIV
Serious exposure to blood containing body fluids
What is PEP for needle stick
3 drug combo for 4 weeks
AZT, lamivudine, nelfinavir
How does acute HIV Infxn present
Fever, sore throat, cervical LA, oral ulcers, diffuse maculopapular rash
AE of zidovudine
Anemia
Leukopenia
GI
AE of Didanosine and Stavudine
Pancreatitis
Peripheral Neuropathy
AE of Abacavir
HSN - usually first 6 wks
Steven Johnson rxn
AE of PIs
Hyperlipidemia
Hyperglycemia
AE of Indinavir
Nephrolithiasis
AE of Tenofovir
Renal Insufficiency
How is HSN to Abacavir predicted
HLA B5701
AE of Zalcitabine
Pancreatitis
Peripheral Neuropathy
Lactic Acidosis
Drugs that Cause Pancreatitis
Pentamidine Didanosine Stavudine Zalcitabine Azathiorpine Sulfas - thiazides, TMP-SMX
How to ID NNRTI
“vir” in middle
Pregnant HIV woman on HAART - management
Continue regimen
Switch Efavirenz to PI
Pregnant HIV pt with CD4 > 350 and not on HAART - management
TX with combo HAART
Pregnant HIV pt with high CD4 and low viral load - management
HAART in 2nd and 3rd trimester to prevent perinatal trasmission
Stop after delivery if not needed for pt
TX for babies born to HIV + mothers
Zidovudine during delivery for 6 wks after
C section in HIV + pts
If CD4 < 350
Viral load is high > 1,000
