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ID Flashcards

1
Q

What is staph epi associated with

A

Catheters
Prosthetic valves
Dialysis

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2
Q

Bacteria covered by amoxicillin

A 
H. influenzae
E. coli
Listeria
Proteus
Salmonella
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3
Q

What are the B-lactams

A

PCNs
Cephs
Carbapenems
Aztreonam

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4
Q

What PCNs the best initial therapy for

A 
Otitis media
Dental infection/Endocarditis PPx
Lyme limited to rash, joints, CN VII
UTI in pregnancy
L. monocytogenes
Enterococci
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5
Q

What are Ox/clox/diclox/naf used for

A

Skin infections
Staph Endocarditis/Meningitis/Bacteremia
Sensitive osteomylitis and septic arthritis

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6
Q

Anti-pseudomonal PCNs are best initial therapy for

A

Bacteremia
Febrile neutropenia

Cholecystitis
HAVP
Ascending cholangitis
Pyelonephritis

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7
Q

What do all cephalosporins cover

A 
Grp A, B, C strep
Viridans
E. coli
Klebsiella
P. mirabilis
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8
Q

What is resistant to all cephalosporins

A

Listeria
MRSA
Entercoccus

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9
Q

Rash to PCN then use

A

Cephalosporin

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10
Q

Anaphylaxis to PCN then use

A

Non-beta lactam ABX

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11
Q

Cephalosporin covering MRSA

A

Ceftaroline

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12
Q

AE Cefotetan, Cefoxitin

A

Deplete prothrombin

Increase bleeding risk

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13
Q

AE Ceftriaxone

A

Inadequate biliary metabolism

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14
Q

What doesn’t ertapenem cover

A

Pseudomonas

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15
Q

What is Aztreonam for

A

G- bacilli including pseudomonas

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16
Q

AE quinolones

A

Bone growth abnormalities

Tendonitis (achilles)

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17
Q

What is Doxy for

A

Chlamydia
Richettsia
Lyme

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18
Q

What is TMP/SMX for

A

Uncomplicated cystitis

PCP

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19
Q

First choice mouth and GI abscess

A

Beta lactam/Beta-lactamase combinations

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20
Q

Best initial therapy staph and strep

A

Ox/Clox/Diclox/Naf
Cephazolin, Cephalexin (PCN rash)
Fluoroquinolones
Macrolides (PCN anaphylaxis)

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21
Q

What does clindamycin cover

A

Anaerobes, staph, strep

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22
Q

What doesn’t clindamycin cover

A

Mycoplasma

Legionella

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23
Q

Best Rx MRSA

A 
Vanco
Linezolid
Dapto
Tigecycline
Ceftaroline
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24
Q

AE Linezolid

A

Reversible BM toxicity

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25
Q

AE Daptomycin

A

Elevated CPK

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26
Q

Coverage for Tigecycline

A

G-
Anaerobes
MRSA

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27
Q

Minor MRSA skin infections are treated with

A

TMP/SMX
Clindamycin
Doxy
Linezolid

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28
Q

Anaerobe coverage above diaphragm

A 
Clindamycin = #1
PCN
Carbapenems
Cefoxitin
Cefotetan
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29
Q

Anaerobe coverage in ABD/GI

A

Metro

Beta lactam/Beta-lactamase combinations

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30
Q

G- bacilli coverage

A 
Quinolones
Aminoglycosides
Carbapenems
Pipercillin, Ticarcillin
Aztreonam
Cephalosporines 3rd/4th

All 80-90% effective

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31
Q

Main G- bacilli (Anaerobes)

A 
E. coli
Klebsiella
Proteus
Pseudomonas
Enterobacter
Citrobacter
Morganella
Serratia
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32
Q

What do all CNS infections present with

A

HA
Fever
N/V
All can give seizures

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33
Q

Most likely Dx stiff neck, photophobia, meningismus

A

Meningitis

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34
Q

Most likely Dx confusion w/ HA/Fever

A

Encephalitis

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35
Q

Most likely Dx focal neuro signs w/ HA/Fever

A

Abscess

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36
Q

MC organism in meningitis

A

S. pneumo

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37
Q

MC organism in meningitis in adolescents

A

N. meningitides

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38
Q

First step in suspected meningitis pt w/ confusion/focal deficits

A

CT before LP

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39
Q

Most accurate test meningitis

A

CSF Cx via LP

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40
Q

Most sensitive test meningitis

A

CSF protein

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41
Q

Best initial test for meningitis

A

LP

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42
Q

What says whether or not to treat in meningitis

A

CSF cell count

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43
Q

Organism in meningitis w/ AIDS

A

Cryptococcus

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44
Q

Organism in meningitis w/ hiker, target rash

A

Lyme

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45
Q

Organism in meningitis w/ hiker moving rash

A

RMSF

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46
Q

Organism in meningitis w/ pulm TB

A

TB

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47
Q

Organism in meningitis w/ adolescent, petechial rash

A

Neisseria

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48
Q

Rx cryptococcal meningitis

A

Amphoteracin B until Ag decreases

Fluconazole for life if T cells don’t rise

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49
Q

Rx Lyme meningitis

A

Ceftriaxone

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50
Q

Rx RMSF meningitis

A

Doxy

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51
Q

Rx TB meningitis

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

Plus steroids

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52
Q

Defining CSF feature bacterial meningitis

A

Cell count in 1000s w/ neutrophils

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53
Q

Defining CSF feature TB meningitis

A

Tons of protein

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54
Q

Neonatal meningitis etiology

A

S. galactiae

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55
Q

Neurosurg meningitis etiology

A

S. aureus

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56
Q

When is Head CT better than LP for initial test

A

Possibility of space-occupying lesion causing herniation

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57
Q

What sx mean do head CT before LP in meningitis

A

Papilledema
Seizures
Focal neuro deficits
Confusion

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58
Q

Meningitis management when there is contraindication to LP

A

ABX immediately

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59
Q

When do you do bacterial Ag detection test

A

When ABX is given before LP so Cx may be falsely -ve

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60
Q

Dx test for TB meningitis

A

Acid fast stain and Cx on 3 high volume LPs

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61
Q

Dx test for Lyme and Rickettsia meningitis

A

Serology
ELISA
Western blot
PCR

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62
Q

Dx test for Cryptococcal meningitis

A

India ink

Crypt Ag

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63
Q

Dx test for Viral meningitis

A

Dx of exclusion

No Rx

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64
Q

Best initial Rx bacterial meningitis

A

Ceftriaxone
Vanco
Steroids

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65
Q

When to add ampicillin to bacterial meningitis regimen

A

Immunocompromised for Listeria

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66
Q

Risk factors for Listeria meningitis

A 
Elderly
Neonates
Immunicompromised
- Alcoholism
- Steroids
- HIV/AIDS
- Pregnancy
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67
Q

Most important step in N. meningitidis management

A

Respiratory Isolation

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68
Q

Close contact ABX for N. meningitidis

A

Rifampin
Cipro
Ceftriaxone

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69
Q

What is “close contact”

A

Dorms
Barracks
No spleen
Steroids

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70
Q

Most common neuro defect in untreated bacterial meningitis

A

CN VIII deficit (deafness)

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71
Q

MCC encephalitis

A

Herpes simplex

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72
Q

Best initial test for encephalitis

A

Head CT

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73
Q

Most accurate test for herpes encephalitis

A

PCR

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74
Q

Best initial test genital herpes

A

Tzanck

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75
Q

Most accurate test genital herpes

A

Viral Cx

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76
Q

Best initial therapy for herpes encephalitis

A

Acyclovir

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77
Q

Acyclovir resistant herpes encephalitis Rx

A

Foscarnet

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78
Q

Steps to therapy of ring-enhancing brain abscess in HIV+

A

Pyramithamine + Sulfadiazine for toxo
No response = lymphoma
Bx

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79
Q

Steps to therapy of ring-enhancing brain abscess in HIV-

A

Brain Bx

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80
Q

Presentation of otitis media

A

Redness
Immobility
Bulging
Decreased light reflex

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81
Q

Most sensitive physical finding for otitis media

A

Immobility

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82
Q

Most accurate Dx test for otitis media

A

Tympanocentesis

- Esp. recurrences or non-responsive to ABX

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83
Q

Best initial therapy for otitis media

A

Amoxicillin

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84
Q

Alternate therapy for otitis media if amox fails

A

Amox/clavulanate
Azithro, clarithro
Cefuroxime, Loracarbef
Levo, Gemi, Moxi - NOT in children

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85
Q

Organisms in sinusitis

A

S. pneumo - 40%
H. influenzae - 30%
M. cattharalis - 20%

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86
Q

Most accurate test for sinusitis Dx

A

Bx

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87
Q

When to do sinusitis Bx

A

Recurring

No response to different empiric

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88
Q

First line therapy for sinusitis

A

Amox/Clav
Doxy
TMP/SMX

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89
Q

Best initial therapy for otitis and sinusitis

A

Amoxicillin

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90
Q

Presentation of Pharyngitis

A

Pain on swallowing
Enlarged LNs
Exudate
Fever

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91
Q

Important negatives in pharyngitis

A

Cough

Hoarseness

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92
Q

MC organism in pharyngitis

A

Strep (Group A beta hemolytic)

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93
Q

Best initial test for strep pharyngitis

A

Rapid strep test

This is equivalent to +ve pharyngeal Cx

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94
Q

What can untreated strep pharyngitis lead to

A

Rheumatic fever and Glomerulonephritis

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95
Q

Small pharyngeal vesicles or ulcers

A

HSV or herpangina

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96
Q

Membranous exudates on pharynx

A

Diptheria
Vincent angina
EBV

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97
Q

Best initial therapy for strep pharyngitis

A

PCN or Amox

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98
Q

Rx strep pharyngitis for PCN allergy

A

Cephalexin if rash

Clinda or Macrolide if anaphylaxis

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99
Q

Criteria for Influenzae vaccination

A 
> 50
Chronic lung/heart disease
Preg 2nd/3rd trimester
Nursing home
Health-care worker
Immunosuppressed
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100
Q

Presentation of influenzae

A 
Arthralgias/Myalgias
Cough
Fever
HA/sore throat
N/V/D
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101
Q

Most important next step within 48hrs of influenza presentation

A

Nasopharyngeal swab to detect Ag

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102
Q

Rx within 48hrs of Sx

A

Oseltamivir

Zanamivir

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103
Q

Rx more than 48hrs of Sx

A

Sx treatment only

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104
Q

1 cause of blood/WBCs in stool

A

Campylibacter

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105
Q

Causes of infectious diarrhea with blood/WBCs in stool

A 
Salmonella
Campylobacter
E. coli 0157:H7
Shigella
V. parahemolyticus
V. vulnificus
Yersinia
C. diff
Entamoeba hystolytica
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106
Q

Causes of HUS

A

E. coli 0157:H7

Shigella

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107
Q

Associations with yersinia

A

Hemochromatosis

Blood transfusions

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108
Q

Association with campylobacter

A

GBS

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109
Q

Association with V. parahemolyticus

A

Shellfish

Cruise ships

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110
Q

Association with V. vulnificus

A

Shellfish
Liver disease
Skin lesions

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111
Q

Features of HUS

A

Hemolysis
↑ Cr
↓ Platelets

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112
Q

Causes of infectious diarrhea without blood/WBCs in stool

A 
Viral
Giardia
Cryptosporidiosis
B. cereus
Staph
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113
Q

Association with giardia

A

Camping/hiking
Unfiltered fresh water
Looks like fat malabsorption

114
Q

Association with cryptosporidiosis

A

AIDS CD4

115
Q

Association with B. cereus and staph

A

Vomitting

116
Q

Best Dx test for giardia

A

1 stool ELISA Ag

117
Q

Features of scromboid

A

Most rapid onset
Wheezing, flushing, rash
Found in fish
Treat with antihistamines

118
Q

Rx infectious diarrhea

A

Mild - oral fluid replacement

Severe - Fluid replacement and oral ABX (quinolones)

119
Q

What is “severe” diarrhea

A 
Hypotension
Tachy
Fever
ABD pain
Bloody diarrhea
Metab acidosis
120
Q

Rx giardia diarrhea

A

Metro

Tinidazile

121
Q

Rx cryptosporidiosis diarrhea

A

Treat underlying AIDS

Nitazoxanide

122
Q

Rx Viral diarrhea

A

Fluid support

123
Q

Rx B. cereus diarrhea

A

Fluid support

124
Q

Rx protocol for C. diff

A

Metro
Get’s better → Gets again → Metro again
Doesn’t get better → Vanco

125
Q

Who is at worst risk for Hep E

A

Pregnant

126
Q

Route of transmission Hep B, C, D

A

Sex
Blood
Perinatal

127
Q

Route of transmission of Hep A, E

A

Food and water

128
Q

Dx tests for hepatitis

A

Increased direct bili
Increased ALT/AST ratio
Increased ALP

129
Q

Rare complication of acute hepatitis

A

Aplastic anemia

130
Q

MCC liver transplant

A

Hep C (not for long)

131
Q

Most likely correlated with increased mortality in Hep

A

Elevated PT

132
Q

Best Dx test Hep A, C, D, E

A

IgM - acute

IgG - resolution

133
Q

How is disease activity in Hep C assessed

A

PCR for RNA level

134
Q

First serum abnormality in Hep B

A

sAg

135
Q

Which serum value is associated with viral replication in Hep B

A

eAg

ie. can transmit

136
Q

Which serum value is associated with resolution of active Hep B infection

A

No sAg

137
Q

Best indication for need for Rx w/antivirals for chronic Hep B

A

eAg

138
Q

Best indication that pregnant mother will transmit Hep B to child

A

eAg

139
Q

Serology in Hep B vaccinated

A

sAb

140
Q

Serology in Hep B window

A

cAb (IgM then IgG)

141
Q

Serology in old/resolved Hep B

A

cAb

sAb

142
Q

Serology in Acute or chronic Hep B

A

sAg
eAg (+/- in chronic)
cAb (IgM or IgG)

143
Q

Rate of conversion of Acute to Chronic Hep B

A

In 10% of pts

144
Q

Rx acute Hep C

A

IFN
Ribavirin
Boceprevir or Telaprevir

145
Q

What is chronic Hep B

A

sAg present for > 6mos

146
Q

Rx eAg w/ elevated DNA pol

A 
One of:
Entecavir
Adefovir
Lamivudine
Telbivudine
IFN
Tenofovir
147
Q

AE IFN

A

Arthralgia/myalgia
Leukopenia and thrombocytopenia
Depression and flu-like Sx

148
Q

Goal of chronic hep Rx

A

Reduce DNA pol to undetectable

Conver eAg to eAb

149
Q

Why do liver Bx in hep B or C

A

Presence of fibrosis is strong indication to start therapy

Fibrosis progresses to cirrhosis in acute viral replication

150
Q

AE ribavirin

A

Red cell anemia

151
Q

Goal of therapy in chronic Hep C

A

Undetectable VL

152
Q

Difference between cystitis and urethritis

A

Cystitis doesn’t have discharge

Both have frequency, urgency, burning

153
Q

Best initial test for urethritis

A

Swab for Gram stain

154
Q

Most accurate test for urethritis

A

Urethral Cx, DNA probe or nucleic acid amplification for gonorrhea and chlamydia

155
Q

Best drug combo for urethritis

A

Cefixime (gonorrhea)

Azithromycin (chlamydia)

156
Q

Alternative drug combo for urethritis

A

Ceftriaxone (gonorrhea)

Doxy (chlamydia)

157
Q

Presentation of cervicitis

A

Discharge
Strawberry cervix

Testing and treatment identical to urethritis

158
Q

PID presentation

A

Lower ABD tenderness
Cervical motion tenderness
Leukocytosis
Fever

159
Q

First thing to do in pt w/ cervical motion tenderness

A

Check for ectopic pregnancy

160
Q

Dx test in PID

A

Cervical swab for Cx
DNA probe
Nucleic acid amplification

161
Q

Most accurate test for PID

A

Laparoscopy (only if Dx unclear)

162
Q

Features of disseminated gonorrhea

A

Tenosynovitis
Polyarticular
Petechial lesions

163
Q

Inpatient PID Rx

A

Cefoxitin or Cefotetan w/ Doxy

164
Q

Outpatient PID Rx

A

Ceftriaxone and Doxy (+/- metro)

165
Q

Inpatient PID PCN anaphylaxis Rx

A

Clinda and Genta and Doxy

166
Q

Outpatient PID PCN anaphylaxis Rx

A

Levo and Metro

167
Q

Common feature of all ulcerative genital lesions

A

Inguinal lymphadenopathy

168
Q

Most likely STD with painless ulcer

A

Syphilis

169
Q

Most likely STD with single painful ulcer

A

Chancroid

170
Q

Most likely STD with tender LNs and pus

A

Lymphogranuloma venereum

171
Q

Most likely STD with vesciles before multiple painful ulcers

A

Herpes simplex

172
Q

Best initial test Syphilis (most sensitive)

A

Dark field microscopy for spirochetes

173
Q

Secondary Dx test in syphilis

A

VDRL/RPR

174
Q

Confirmatory (best) test for Syphilis

A

FTA/MHA-TP

175
Q

Dx test for chancroid

A

Stain and Cx

176
Q

Dx test for Lymphogranuloma venereum

A

Complement fixation titers in blood

Nucleic acid amplification on swab

177
Q

Best initial test for herpes simplex

A

Tzanck

178
Q

Most accurate test for herpes simplex

A

Viral Cx

179
Q

Next step in pt with painful genital vesicles

A

Immediate Rx oral acyclovir

No need for Dx test

180
Q

Important points about granulareum inguinale

A

Bx
Sulfa drugs
Donovan body

181
Q

Appearance of primary syphilis

A

Heaped-up indurated edges

Painless adenopathy

182
Q

Secondary syphilis features

A

Rash on palms and soles
Alopecia areata
Mucous patches
Condyloma lata

183
Q

Pityriasis rosacea features

A

Herald patch
Not palms and soles
VDRL/RPR negative

184
Q

Most common manifestations of tertiary syphilis

A

Neuro

  • Meningovascular
  • Tabes dorsalis
  • Paresis
  • Argyl-Robertson pupil
185
Q

Rare manifestations of tertiary syphilis

A

Aortitis

Gummas

186
Q

Things that cause false positive VDRL/RPR

A 
Infection
Older
IVDU
AIDS
Malaria
APL
Endocarditis
187
Q

Rx primary and secondary syphilis

A

IM PCN

Oral doxy if allergic

188
Q

Rx tertiary syphilis

A

IV PCN

Desensitize if allergic

189
Q

Rx Jarish-Herxheimer rxn

A

Aspirin

Antipyretics

190
Q

Rx neurosyphilis in pregnancy

A

PCN

Desensitize if allergic

191
Q

What causes condyloma acuminata

A

Papillomavirus

192
Q

Dx condyloma acuminata

A

Visual

193
Q

Rx condyloma acuminata

A

Remove

  • Cryotherapy (liquid nitrogen)
  • Surgery
  • Melt (podophyllin or trichloroacetic acid)
  • Imiquimod (sloughs off)
194
Q

Important points about Pediculosis (crabs)

A

On hair-bearing areas
Itchy
Visible
Rx Permethrin

195
Q

Important points about Scabies

A

Found in web spaces, elbows, genitals, nipples
Burrows visible
Scrape and magnify
Rx Permethrin
Rx widespread (crusted)/or keratotic w/ ivermectin

196
Q

MCC UTI

A

E. coli

197
Q

Best initial therapy for pyelo

A

Quinolones

198
Q

When do you image in UTI

A

Men
Reccurent/failure to respond
ie. Foreign body/obstruction (complicated)

199
Q

Best initial test for cystitis

A

U/A w/ >10 WBCs

200
Q

Most accurate test for cystitis

A

Urine Cx

201
Q

When do you look for bacteria in urine

A

Pregnancy

202
Q

Rx uncomplicated cystitis

A

Nitrofurantoin or Fosfomycin
TMP/SMX x3 days if uncomplicated, 7 if it is complicated
Cipro in resistant areas
Cefixime

203
Q

Rx male cystitis

A

TMP/SMX 10-14 days

204
Q

Rx Pregnant cystitis

A

Nitrofurantoin/Amox/Macrodantin for 10-14 days

205
Q

What is pyelonephritis

A

Dysuria with:

  • Flank/CVA tenderness
  • Fever
  • ABD pain from inflamed kidney
206
Q

First like Rx pyelonephritis

A

Ceftriaxone

207
Q

What works for pyelo

A

G- bacilli drugs

  • Ertapenem
  • Ampi + Genta (emperic)
  • Cipro oral for outpatient
208
Q

Most accurate Dx test for pyelo

A

Bx

209
Q

What is acute prostatitis

A

Dysuria w/:

  • Perineal pain
  • Tender prostate
210
Q

Increase yield for urine cx in acute prostatitis

A

Prostate massage

211
Q

Long term therapy for chronic prostatitis

A

TMP/SMX 6-8wks

212
Q

Rx acute prostatitis

A 
Same as pyelo
G- bacilli drugs
- Ertapenem
- Ampi + Genta (emperic)
- Cipro oral for outpatient
213
Q

How to know if there’s a pyelonephric abscess

A

Pyelo doesn’t resolve

Persistent fever after 5-7 days of therapy

214
Q

Most important step in pyelonephric abscess

A

Drainage then Cx

215
Q

When to suspect endocarditis

A

Fever + Murmur

216
Q

MCC death in untreated endocarditis

A

Infectious glomerulonephritis

217
Q

Best initial test for endocarditis

A

Blood Cx

218
Q

Other options to Dx endocarditis

A

TTE

TEE

219
Q

Next step after finding strep bovis endocarditis

A

Colonoscopy

220
Q

Diagnosing Cx neg endocarditis

A 
Oscillating vegetation on echo
3 minor criteria
- Fever
- Risk factor
- Embolic phenomena
221
Q

Best empiric Rx endocarditis

A

Vanco and Genta

222
Q

How long are endocarditis Rx regimens

A

4 weeks

223
Q

How do you treat resistant endocarditis

A

Add aminoglycoside and extend to 6 weeks

224
Q

Rx viridans endocarditis

A

Ceftriaxone or PCN

225
Q

Rx S. aureus endocarditis

A

Ox/Naf or cefazoline

226
Q

Rx Staph epi or resistant staph endocarditis

A

Vanco

227
Q

Rx enterococci endocarditis

A

Ampi and genta

228
Q

When is surgery the answer for endocarditis

A 
CHF!!
Prosthetic valves
Fungal
Abscess
AV block
Recurrent emboli while on ABX
229
Q

What is added to regimen with prosthetic valve endocarditis with staph

A

Rifampin

230
Q

MCC culture neg endocarditis

A

Coxiella

Also bartonella

231
Q

Other Cx neg endocarditis organisms

A

HACEK

232
Q

Rx for HACEK endocarditis

A

Ceftriaxone

233
Q

Who gets endocarditis prophylaxis

A

Significant cardiac defect
AND
Risk of bacteremia (bloody surgery)

234
Q

What is given for endocarditis PPx

A

Amox 1hr prior
Allergy - Clinda, azithro or clarithro
GI procedure - Amp or Vanco

235
Q

Cause of Lyme disease

A

Borrelia burgdorferi

236
Q

Most common manifestation of Lyme

A

Rash and fever

237
Q

MC joint complication of Lyme

A

Knee

238
Q

MC heart complication of Lyme

A

AV block

239
Q

MC neuro complication of lyme

A

CN VII palsy (can be B/L)

240
Q

Vector for Lyme

A

Ixodes scapularis (deer tick)

241
Q

Prevalence of presentation in untreated Lyme

A

90% rash
60% joint
10-15% neuro
4-10% heart

242
Q

Dx Lyme

A

Nothing if lesion is typical

Straight to Rx

243
Q

Dx lyme for other manifestations w/o rash

A

Serology

IgM, IgG, ELISA, Western blot, PCR

244
Q

Rx Lyme w/ just rash or w/ joint/CN VII

A

Doxy

Amox or Cefuroxime

245
Q

Rx cardiac or other neuro in Lyme

A

IV ceftriaxone

246
Q

Rx ASx tick bite

A

NOTHING

247
Q

:Lyme PPx

A

1 dose doxy within 72hrs

248
Q

Who gets lyme PPx

A

Ixodes scapularis clearly identified
Tick attached > 24-48hrs
Engorged tick
Endemic area

249
Q

How long does CD4 depletion take before Sx

A

5-10yrs

250
Q

Viral load is inversely proportional to

A

Rate at which T cells drop

251
Q

ONLY routine PPx in AIDS

A

CD4

252
Q

PPx in AIDS regardless of T cell count

A

PPD >5mm = INH 9 mos

Flu and Pneumococcal vaccines

253
Q

Does kissing transmit HIV

A

NO

254
Q

Infections CD4 200-500

A 
Candidiasis
Zoster
Kaposi
TB
HSV
PN
255
Q

Infections CD4

A

PCP

256
Q

Infections CD4

A

Toxo

257
Q

Infections CD4

A

MAC
CMV
- Ganciclovir
- Foscarnet

258
Q

First manifestation of HIV Rx failure

A

Rising VL

259
Q

Best initial test for HIV

A

ELISA

Confirmed with Western blot

260
Q

Dx HIV infected infants

A

PCR or viral Cx

261
Q

When to start HIV Rx

A

CD4 100,000

Opportunistic infection

262
Q

Best initial Rx HIV

A

Emtricitabine + Tenofovir + Efavirenz

263
Q

HIV regimen skeleton

A

2 NRTI + 1 PI or efavirenz

264
Q

Meds for multi-class drug resistance

A 
Entry inhibitors
- Enfuvirtide
- Maraviroc
Integrase inhibitor
-Raltegravir
265
Q

What does Ritonavir boost

A

Darunavir

Atazanavir

266
Q

Postexposure PPx (including bites)

A

4 weeks combination therapy

267
Q

What predics abacavir hypersensitivity

A

HLA B5701

268
Q

AE Zidovudine

A

Anemia

269
Q

AE Stavudine and Didanosine

A

Peripheral neuropathy

Pancreatitis

270
Q

AE Abacavir

A

Hypersensitivity

Steven-Johnson

271
Q

AE Protease inhibitors

A

Hyperlipidemia

Hyperglycemia

272
Q

AE Indinavir

A

Nephrolithiasis

273
Q

AE Tenofovir

A

Renal insufficiency

274
Q

Perinatal PPx HIV+ already on antiretrovirals

A

Continue regimen

275
Q

Perinatal PPx HIV+ not on antiretrovirals

A

Give antiretrovirals as if they weren’t pregnant

276
Q

Perinatal PPx HIV+ High CD4, Low VL

A

Antiretrovirals for entire pregnancy

Stop after delivery

277
Q

Perinatal PPx HIV+ Low CD4, High VL

A

Antiretrovirals for entire pregnancy

Continue after delivery

278
Q

Only retroviral contraindicated in pregnancy

A

Efavirenz

279
Q

When to do C-section in HIV mother

A

CD4 1000

280
Q

What intrapartum antiretroviral is given to every HIV+ pregnant pt

A

Zidovudine

Step 2 CK (21 decks)

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