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I&I > Treatments > Flashcards

Treatments Flashcards

1
Q

Simple CAP

A

Amoxicillin 500mg-1gTDS (alt. Clarithromycin)

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2
Q

Severe CAP

A

IV Co-amoxiclav+ IV erythromycin/clarithromycin (if micro undefined 10 days Tx but if you culture Legionella, staph or gm -ve bac then extend to 14-21 days)Ch

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3
Q

Chlamydia

A

one dose oral Azithromycin 1g// or Doxycycline 100mg bd 7 days alt. erythromycin
Avoid sex till finish Tx or 7 days after Azithro

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4
Q

Gonnorhoea

A

Ceftriaxone 250mg IM (OR single cipro oral dose)- can also give single dose azithromycin alongside to cover chlamydia

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5
Q

Vulvovaginal Candidiasis

A

Topical and oral Azole (not oral if preg)

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6
Q

Appendicitis

A

IV cefuroxime+ metronidazole. Remove appendix.

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7
Q

Ascending cholangitis (Charcot’s triad- fever with rigors, Abdo pain+ Jaundice). U/S shows dilated intrahepatic ducts+ gallstones in CBD,

A

Cefuroxime and Metronidazole IV. If anaphylaxis to penicillin in past then Ciprofloxacin. ERCP. If septic too- add gentamicin

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8
Q

Pyogenic Liver abscess

Disprop increase ALP. U/S- large gas containing mass on liver U/S

A

Radiologically guided drain abscess. Tx Cefuroxime+ Metronidazole (Cont 4wks-3m)

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9
Q

Spontaneous bacterial peritonitis

A

Ascitic tap on admx to see of SBP. (Clot screen 1st)- WCC>250cm3- consistent so Tx even if no org (Cefuroxime) - if ESBL prod E.coli then add Meropenem IV

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10
Q

Acute pancreatitis (Blood amylase Increased)- - central dull abdo pain relived by sitting forwards. Tachy. Flank discol

A

Usually sterile process but infec of inflammed pancreas can occcur- so if >30% necrosis- meropenem+ fluconazole

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11
Q

Abx prophylaxis for surgery

A

Cefuroxime+ Metronidazole IV 1 dose (within 30 min of inducing anaesthesia). - unless blood loss> 1500ml, haemodialysis or surgery prolonged (then add dose)

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12
Q

What do you do if a patient is MRSA +ve coming in for an op?

A

Operate on them at the end of the theatre list+ add teicoplanin to standard prophylaxis

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13
Q

Bacterial Vaginosis

A

Oral metronidazole/ clindamycin (if breastfeeding- intravag metronidazole gel)

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14
Q

Pelvic Inflammatory Disease

A

IV ceftriaxone, Doxycycline, Metronidazole Combo

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15
Q

Herpes Simplex

A

Saline baths; Analgesia; Topical anaesthetics when peeing- lidocaine; Aciclovir or famiciclovir, or valaciclovir- shortens and reduces severity )oral) -if recurrence can use chronic supressive Tx or episodic Tx

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16
Q

Secondary Syphillis (VDRL blood test)

A

Penicillin IM (1 if 2 years)

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17
Q

Genital warts

A

No specific Tx (use condoms)- Can try imiquimod, cryotherapy, laser therapy

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18
Q

Molluscum contagiosum

A

Usually resolves. May do cutterage/ cryotherapy

19
Q

Falciparum Malaria (No dormant liver stage- so no recurrence except within that year)

A

Oral quinine+ Doxycycline (+/-cefuroxime/ metronidazole if added bac infec/ septicaemia). If severe–> ICU- IV quinine

20
Q

Vivax +Ovale Malaria- more benign but have dormant types so recur if not killed by Tx

A

Primaquine (14 days) kills hypnozoites

21
Q

Malariae malaria (benign + no hypnozoites) - but if not Tx- can recrudesce from blood + recurrent fevers ~50 yrs. Fevers every 3 days

A

Chloroquine

22
Q

Typhoid- Gm-ve rods.

A

Ceftriaxone

23
Q

Schistosomiasis (Bilharzia)- fresh water esp. lake malawi Cercaria- become worms + lay eggs in bowel/rectum–> liver (+ shed in stools). Serology at 6+ 12wk post exposure. Risk= transverse myelitis

A

Can Tx without test if v. worried- but no point in first 3 wks. Praziquantel- single dose

24
Q

Malaria prophylaxis

A

Mefloquine (vivid dreams/ neuropsych effects)- 1 a wk- start 3 wks before. Malarone (during and 1-2d before)/ Doxycycline- nausea + photosensitivity- daily- 1-2 before

25
Q

HIV Testing

A

HIV ab+ ag. Window is 6 wks- 3months

26
Q

Classes of ART

A

NRTI (Phosp inhibit HIV RT so can’t replicate in CD4 cells); NNRTIs- act on another part of RT don’t need phosp. PI- proteins produced by translation can’t be spliced

27
Q

Predom meningococcal septicaemia

A

Don’t attempt LP- IV cefotaxime or ceftriaxone

28
Q

If predom meningitis

A

If no signs increased ICP - LP unless will delay IV cefotaxime/ ceftriaxone by >30 mins (consider streroids)
If increased LP signs- Defer LP, give the abx+ steroids

29
Q

Notifying public health

A

Meningococcal or Hib meningitis (rifampicin)

30
Q

Organisms on stain. Strep p; Staph; N. meningitidis; H. influenzae. L. monocytogenes

A 
Strep p. Gm+ve cocci in pairs
Staph- Gm+ve cocci in clusters
Gm -ve diplococci- N.meningitidis
H. influenzae- Gm -ve bacilli
Gm+ve bacilli- L.monocytogenes
31
Q

Duration meningitis Tx

A

7day in meningococcal septicaemia+ meningitis if N. men or H. influenzae
10-14d- Strep pneumoniae
21d- Aerobic gm-ve bacilli/ L.monocytogenes.

32
Q

Cellulitis

A

Afebrile+ healthy look- Oral Flucloxacillin outpatient
(if allergic- clindamycin)
If febrile+ ill look but no other co-morb- short stay/outpatient IV Ceftriaxone–> Fluclox PO
Toxic app/ 1 co-morb/limb threatening infec- IV fluclox–>Fluclox PO

33
Q

Necrotizing fasciitis (Clostridium perfringens; Strep pyogenes)

A

Meropenem+ clindamycin immed+ fluids–> urgent surgical debridement

34
Q

Animal bites (risk with dog-pastuerella)

A

Augmentin; Irrigate+ clean wound; Give tetanus jab if need

35
Q

Venflon ass. infections. Commonest HAI- Use aseptic technique+ change every 3d

A

Flucloxacillin (if MRSA in wound- vancomycin, teicoplanin, linezolid)

36
Q

UTI (lower, uncomplicated, cystitis)

A

Trimethoprim/ Nitrofurantoin for 3d

37
Q

Upper UTI

A

Meropenem or whatever hosp policy is- 7-14d IV if complicated+ bacteraemia

38
Q

Bacteruria in preg

A

7 day Amoxicillin if asymp. Trimethoprim 7d if symp

39
Q

UTI in males

A

Quinolone (or trimethoprim,)- 2 wks

40
Q

Catheter UTI

A

Don’t give abx if asymp bacteruria

41
Q

Sepsis 6

A
  1. Give 100% O2 via non-rebreathable bag
  2. Take blood cultures
  3. Give IV abx (co-amoxiclav+ gentamicin)
  4. Start IV fluid rescuscitation
  5. Check lactate
  6. Monitor urine output
42
Q

Endocarditis

A

Benzyl+ gentamicin if natural valve

Vancomycin IV and gent if prosthetic

43
Q

Patient remains hypotensive despite adequate fluid

A

Insert CVP, IV adrenaline, IV noradrenaline (1st choice as vasopressor as increases BP by increasing CO whereas IV adrenaline does it by increasing TPVR)

44
Q

Aspergillosis (invasive)- halo sign of consolidation on CXR (mass surrounded by ground glass)

A

Bronchoalveolar lavage+ serum ag. IV voriconazole.

I&I (1 decks)

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