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tsomkapQ > OMED Antibiotics and Infectious Diz > Flashcards

OMED Antibiotics and Infectious Diz Flashcards

1
Q

Community acquired pneumonia-
hospital setting
non-hospital setting
beta-lactam allergy

A

hospital-ceftriaxone and azithromycin
non-hospital- azithromycin
CAP + beta lactam allergy- moxifloxacin

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2
Q

health care associated pneumonia (one main treatment and two allergy alternates)

A

vanc + Pip Tazo
if vanc allergy –> linezolid
if Pip Tazo allergy –> merzopenim

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3
Q

meningitis

A

ceftriaxone and vancomycin
+/- steroids (methylpred)
+/- ampicillin (if immunocomp)

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4
Q

UTI

A

amoxicillin overall
if beta-lac allergic–> nitrofurantoin
TMP-SMX as absolute alternative

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5
Q

cellulitis from strep

A

out patient–> amoxicillin

in-patient –> cetriaxone

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6
Q

cellulitis from staph

A

clindamycin (1st)

vancomycin (2nd)

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7
Q

2 + 1

A

DOMINANT HIV treatment: 1 NRTi + 2 NNRTi

NNRTi’s:
protease inhibitor- ritonavir
Entry inhibitor
fussion inhibitor

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8
Q

HIV: pre-exposure

A

PrEP

emtricitabine + tenofavir (both NTRi)

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9
Q

HIV: post-exposure

A

PEP

emtricitabine + tenofavir (both NTRi) +/- Raltegravir

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10
Q

HIV pregnancy

A

2 + 1 +AZT (vertical transmission prophylaxis)

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11
Q

Acute HIV flu: dx and tx

A

dx: PCR
tx: 2 + 1

ELISA will be negative

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12
Q

HIV opportunistic infection: dx and tx

A

dx:
1. Elisa (+)–>
2. Western blot (+) –>
3. HIV viral count –>
4. CD4 count —>
5. genotype

tx: 2 + 1

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13
Q

cd4 > 500

A

normal basically

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14
Q

cd4 > 350

A

no prophylaxis

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15
Q

cd4 < 200

A

PCP no sulfa allergies : TMP-SMX
PCP sulfa allergies: dapsone
PCP in G6PD pt: atovaquone

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16
Q

cd4 < 100

A

toxo: pyrimethamine + leucovorin

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17
Q

cd4 < 50

A

MAC: weekly azithromycin

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18
Q

lobar pneumonia, caseating granulomas

A

primary TB infection

19
Q

hemoptysis, night sweats, weight loss, younger people or with RFs: initial steps

A

secondary TB (reactivation): CXR and AFB smear

  1. CXR: if positive for TB, isolate pt
  2. AFB smear

if both negative–> pt does not have TB

if positive: RIPE tx

20
Q

PPD negative

A

no further work up

21
Q

PPD positive

A
  1. get CXR
  2. negative CXR –> isoniazid + B6 for 9 months
  3. positive CXR –> AFB smear
  4. AFB positive –> active TB –> RIPE tx
  5. AFB negative –> INH + B6 9 months
22
Q

PPD equal/above 10 mm: who

A

health care workers, prisoners, homelessness, travel

23
Q

PPD equal/above 15 mm: who

A

soccer mom, no rf’s

24
Q

PPD equal/above 5 mm: who

A

ppl with close contacts to others w/TB, immunocompromised, HIV, transplant, anargy

25
Q

what will cause interferon beta to have a false positive?

A

pts with BCG vaccine

26
Q

CXR is positive for TB but AFB smear is negative for TB: tx

A

latent TB: isoniazid + B6

27
Q

CXR positive for TB and AFB smear (+) for TB: tx

A

active TB: RIPE

a. rifampin (red pee)
b. isoniazid (neuropathies, give B6)
c. pyrazinamide (hyperuricemia, gout)
d. ethambutol (red/green color blindness)

28
Q

Fever + HA…+/- photophobia, phonophobia, N/V

A

brain inflammation: three things-

meningitis, abscess, encephalitis

29
Q

Fever + HA…+stiff leg + leg raise positive: causes

A

Bacterial meningitis: TB, RMSF, Lyme, Crypto, Viral

30
Q

Fever + HA + focal neurological deficit

A

abscess or cancer

31
Q

Fever + HA + AMS

A

encephalitis: a million causes. tx for all of them is the same- supportive, except for HSV

32
Q

FAILS mnemonic

A

the contraindications to lumbar puncture:

FND (focal neuro def)
AMS (altered men stat)
Immunosuppression
Lesions 
Seizures
33
Q

FAILS (+)

A

FAILS+: order is

  1. Blood cultures first
  2. IV abx + steroids
  3. CT scan
  4. LP
34
Q

FAILS (-)

A

LP –> then ABX

35
Q

FAILS (+), CT (-): now what

A

LP

36
Q

LP: lots of PMNs, dx and tx

A

bacterial meningitis

ceftriaxone, vancomycin, steroids, +/- ampicillin

37
Q

LP: no PMNs

A

consider something other than bacterial. c

38
Q

Brain abscess: tx

A

drain and abx

39
Q

LP: lymphocytes

A

encephalitis

40
Q

Encephalitis, HSV suspected

A

dx: HSV PCR
tx: if HSV positive…acyclovir

dx: if HSV PCR negative…
tx: supportive

41
Q

skin with well demarcated area that is red, hot and tender

A

cellulitis

42
Q

skin with well demarcated area that is red, hot and tender with (+) abscess: toxic tx and non-toxic tx

A

Cellulitis, staph:

toxic: pip/tazo+augmentin
nontoxic: 1st gen cephalosporin

43
Q

skin with well demarcated area that is red, hot and tender with, superficial and no abscess: toxic tx and non-toxic tx

A

Cellulitis, strep:

nontoxic: TMP-SMX (po), clindamycin
toxic: vanc, linezolid, clindamycin

44
Q

wound with exposed bone, or recurrent/refractory cellulitis, or sinus tract: dx

A

suspect osteomyelitis:

dx:
1st: xray
2nd: MRI if xray is neg.

tsomkapQ (117 decks)

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