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MTB > infectious Diseases p34-45 > Flashcards

infectious Diseases p34-45 Flashcards

1
Q

organism that can cause endocarditis on normal heart valves; risk factor

A

staph aureus; iv drug abuse

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2
Q

best initial tests for endocarditis

A 
blood culture (95-99% sensitive)
TEE (95% sensitive)
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3
Q

endocarditis causing organisms associated with colonic pathology

A

strep bovis,

clostridium septicum

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4
Q

best initial empiric therapy for endocarditis

A

vancomycin and gentamicin

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5
Q 
Rx of endocarditis
a)viridians strep
B) staph aureus (sensitive)
C)fungal
D)Staph epidermidis and MRSA
E) Enterococci
A 
A) ceftriaxone *4 weeks
B) oxacillin, nafcillin, or cefazolin
C) amphotericin and valve replacement
D) vancomycin
E)  ampicillin n gentamicin
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6
Q

strongest indications for surgery in patients with endocarditis

A

acute valve rupture;

CHF

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7
Q

most common cause of culture negative endocarditis

A

COXIELLA

Bartonella

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8
Q

other than coxiella, what are the causes of culture negative endocarditis

A 
HACEK group(treat with ceftriaxone),
Bartonella
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9
Q

procedures that need prophylaxis to prevent endocarditis

A

a) dental work,
B)respiratory tract surgery
C) prosthetic valve
D) cardiac transplant with valvulopathy

other indications: previous endocarditis, unrepaired cyanotic heart disease
Amoxicillin is given for prophylaxis

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10
Q

tick that transmits lyme disease

A

Ixodes scapularis

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11
Q

minimum time required for tick attachment leading to transmission of lyme

A

24 hours

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12
Q

most commonly involved joint in lyme disease

A

knee

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13
Q

most common neurological manifestation of lyme disease

A

bells palsy involving facial nerve

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14
Q

most common cardiac manifestation of lyme disease

A

transient AV block

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15
Q

do u need a confirmatory serology for lyme disease when patient presents with erythema migrans

A

no,

but is required for all other manifestations. Done using IgM, IgG, ELISA, Western blot and PCR testing

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16
Q

Rx for lyme disease

A

*rash= doxycycline
Amoxicillin or cefuroxime
*joint, seventh cranial nerve palsy= doxycycline,
amoxicillin and cefuroxime
*cardiac and neurological manifestations other than 7th CN palsy = IV ceftriaxone

17
Q

management of asymptomatic tick bite

A 
single dose of doxycycline if
A) Ixodes scapularis identified as the tick
B) tick attached longer than 24-48 hours
C) engorged tick
D) endemic area
18
Q

CD4 levels for PCP prophylaxis

A

below 200/microL

19
Q

infections that can still occur with HIV despite CD4>200

A 
shingles,
herpes simplex,
TB
oral and vaginal candidiasis
bacterial pneumonia
Kaposi sarcoma
20
Q

Best initial test for HIV

A

ELISA

21
Q

confirmatory test for HIV

A

Western blot

22
Q

why is ELISA unreliable for HIV in infants

A

because maternal HIV antibodies may be present up to 6 months after delivery

23
Q

Uses of viral load testing(PCR RNA level) in HIV

A

A) measure response to therapy
B) detect treatment failure
C) Diagnose HIV in babies

24
Q

CD4 counts when HIV treatment is initiated

A

below 500/microL

25
Q

best initial drug combination for HIV

A

Emtricitabine, tenofovir, and efavirenz

26
Q

which PI group drug is used to boost the levels of other protease inhibitors

A

ritonavir

27
Q

Nucleoside and nucleotide Reverse Transcriptase Inhibitors (NRTI)

A 
zidovudine
didanosine
lamivudine
stavudine
emtricitabine
abacavir
tenofovir
28
Q

non-nucleoside reverse transcriptase inhibitors (NNRTI)

A

efavirenz
etravirine
nevirapine
rilpivirine

29
Q

Protease inhibitors

A

all avirs

30
Q

drugs used for resistance to first line agents for HIV

A

a) entry inhibitors= enfuvirtide, maraviroc

B) integrase inhibitors = raltegravir, dolutegravir, elvitegravir with cobicistat

31
Q

post exposure prophylaxis for HIV

A

4 weeks of combination therapy

32
Q

is PEP required for bites from a HIV positive individual

A

yes

33
Q

PEP for needle stick injury with unknown status of the needle/patient

A

not given routinely

MTB (22 decks)

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