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Infectious Disease > Typhoid CPG > Flashcards

Typhoid CPG Flashcards

1
Q

yous suspect typhoid fever if patient presents with how many days of fever?

A

more than or equal to 5

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2
Q

fever should be documented to be how many degrees celcius?

A

more than 38

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3
Q 
the following are symptoms associated with typhoid fever except?
headache
diarrhea
body malaise
abdominal pain/distention
GI bleeding
change in sensorium
epistaxis
A

epistaxis

the rest mentioned above are associated with typhoid

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4
Q

typhoid fever that warrants hospital admission?

A
  1. complicated typhoid
  2. typhoid in pregnancy
  3. social circumstances not favoring home care
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5
Q

the following are direct detection method to confirm the diagnosis of typhoid fever

a. culture and isolation
b. PCR
c. tubex test

A

C.

PCR and culture and isolation are direct methods

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6
Q

true or false widal test is still recommended for the diagnosis of typhoid espcecially in our country?

A

False. local CPG does not recommend using widal test for diagnosis of fever

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7
Q

the following are recommended medications for treatment of uncomplicated typhoid fever

a. amoxicillin
b. amoxicillin+clavulanic acid
c. ceftriaxone
d. levofloxacin

A

A. amoxicillin
for uncomplicated typhoid fever the following antibiotics are recommended
a. amoxicillin, chloramphenicol, cotri, cefixime, azithromycin, ciprofloxacin, ofloxacin

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8
Q

recommended dose for amoxicillin for uncomplicated typhoid fever?

A

500 mg 2 caps q 6 x 14 days

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9
Q

recommended dose for chloramphenicol for uncomplicated typhoid

A

500 mg 2 caps q 6 x 14 days

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10
Q

recommended dose for cotri for uncomplicated typhoid

A

800/160 1 tab q12 x 14 days

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11
Q

recommended dose for azithromycin for uncomplicated typhoid

A

500 mg 1-2 tabs q24h x 7 days

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12
Q

recommended dose for cefixime for uncomplicated typhoid

A

200 mg q 12 x 7 days

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13
Q

recommended dose for ciprofloxacin for uncomplicated typhoid

A

500 mg q12 x 7 days

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14
Q

recommended dose for ofloxacin for uncomplicated typhoid

A

400 mg 1 tab a 12 x 7 days

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15
Q

mnemonic for drugs used to treat uncomplicated typhoid for 14 days C-A-T

A

chloramphenicol-amoxicillin- tmp-smx

the rest are given x 7 days

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16
Q

patient was treated for uncomplicated typhoid fever and developped SJS what drug most likely caused this?

A

TMP-SMX

17
Q

patient treated for uncomplicated typhoid came to you with cbc results showing signs of bone marrow suppression. you suspect what drug?

A

chloramphenicol

18
Q

these drugs used to treat uncomplicated typhoid are associated with prolonged QT interval?

A

Azith, cipro, oflox (A-C-O)

19
Q

the treatment duration for azithromycin when used to treat complicated typhoid fever is how many days?

A

7 days

20
Q

recommened dose for ceftriaxone for treatment of complicated typhoid fever?

A

2 - 3 grams iv q 24 x 14 days

21
Q

recommened dose for azihromycin for treatment of complicated typhoid fever?

A

1 gram q 24 x 7 days

22
Q

recommened dose for ciprofloxacin for treatment of complicated typhoid fever?

A

400 mg q12 x 14 days

23
Q

recommened dose for ofloxacin for treatment of complicated typhoid fever?

A

400 mg q12 x 14 days

24
Q

when should iv antibiotics be stepped down to oral antibiotics?

A

48 hours afebrile, able to tolerate PO medication

25
Q

first line treatment for pregnant patients with typhoid fever?

A

ampicillin 1-2 grams iv q 6 x 10-14 days

ceftriaxone 2-3 grams iv q24 x 7 days

26
Q

multidrug resistant typhoid fever is resistant to the following medications except?

a. cotrimoxazole
b. amoxicillin
c. ampicillin
d. TMP-SMX

A

b. Amoxicillinn

MDR resistant to Chloram-Ampicillin-TMP-SMX

27
Q

when to suspect if patinet has MDRTF

A
  1. failure to respond after 5-7 days
  2. household contact with MDR strain
  3. documented epidemic of MDR strain
28
Q

emperic treatment for MDR strain

A

cefixime 200 mg q12
ciprofloxacin 500 mg 12
ofloxacin 400 mg q12
azithromycin 500 1-2 tabs q 24

all treatment given fro 7 days PO

29
Q

how do you define a chronic carrier?

A

positive stool or rectal swab a year after recovery

30
Q

treatment for chronic carriers?

A 
TMP - SMX 800/160 1 tab q 12 x 6-12 weeks
Amox 100  mg/kg/day x 6-12 weeks
ampicillin 100 mg/kg/day x 6-12 weeks
norfloxacin 400 1 tab q12 x 4 weeks
ciprofloxacin 750 1 tab q12 x 4 weeks
31
Q

typhoid vaccines indicated for?

A
  1. travel to endemic area
  2. person with intimate contact to carrier
  3. lab workers routinely exposed
32
Q

endemic areas?

A

sub-saharan africa, cetral asia, indian subcontinent, latin america, middle east, south and southeast asia

33
Q

vi polysaccharide vaccine

A

1 dose booster 1 dose every 2 years

34
Q

live attenuated ty21a vaccine

A

1 capsule 4 doses, booster every 5 years

days 0,2,4,6

Infectious Disease (5 decks)

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