Step3 CCS

Question 1

Initial management of COPD exacerbation

Answer 1

elevate head of bed, continuous pulse ox, oxygen, IV access, cardiac monitor

PEFR q 1hr, CXR, ABG,ECG, CBC and BMP, albuterol nebulizers continuous

[If not getting better in 30 minutes at ipratroprium nebulizer, and IV steroids, antibiotics (levofloxicin)]

Question 2

Tx diverticulitis

Answer 2

Metronidazole and ciprofloxacin for 7 to 10 days

Question 3

Empiric Tx meningitis

> 3 months

Healthy children> 3months

Adult >50 years, alcoholics

meningitis after neurosurgical procedures

Answer 3

> 3 months- ampicillin and cefoxitin

Healthy children> 3months- Vancomycin and ceftriaxone

Adult >50 years, alcoholics- Vancomycin, ceftriaxone, and ampicillin

meningitis after neurosurgical procedures- Vancomycin and ceftazidime (covers gram negs including pseudomonas)

Question 4

Empiric therapy endocarditis

Answer 4

Vanco and gentamicin

Question 5

Tx for cryptococcal menigitis

Answer 5

Amphterricin B AND Flucytosine for 2 weeks

later can start HAART (to avoid immune reconstitution syndrome)

Fluconazole later for prophylaxis

Question 6

Antibiotics for cholecystitis

Answer 6

pip-tazo

Question 7

antibiotics before AAA repair

Answer 7

cefazolin

Question 8

tx for active TB

Answer 8

INH
pyridoxine
Rifampin
Pyrazinamide
Ethambutol

Question 9

Drugs for alzhiemer

Answer 9

Donepizil

olanzapine