onlinemeded- infection

Question 1

which abscesses- staph or strep

Answer 1

staph

Question 2

abx of choice for non-toxic vs toxic strep

Answer 2

non tox: cefalexin

tox: zosyn, augmentin

Question 3

abx for non-toxic vs toxic staph

Answer 3

non-toxic: bactrim, clinda

toxic: vanc, linezolid, clinda

Question 4

“blue gray” skin infection, think…

Answer 4

necrotizing fascitis

Question 5

treatment for nec fasc

Answer 5

debride

3rd gen ceph
+ clinda
+ ampicillin

Question 6

situations that arent safe to do LP

Answer 6

FND
AMS
Lesion
Seizure
Immunosuppressed

Question 7

which meningitis has increased opening pressure

Answer 7

cryptococcus

Question 8

treatment for bacterial meningitis

Answer 8

ceftriaxone
vanco
steroids
+/- ampicillin

Question 9

work up if cant do LP

Answer 9

1. give abx
2. CT
3. if mass on CT, test for HIV and toxo
4. if neg for HIV and toxo, do brain biopsy (abscess or cancer)

Question 10

hemorrhagic tap, think…

Answer 10

HSV

Question 11

major criteria for infective endocarditis

Answer 11

bactermic (staph, strep, HACEK)

new regurg murmur

echo: vegetation

Question 12

minor criteria for infective endocarditis

Answer 12

Fever >38

Vascular

Rheum

Risk factors

Question 13

risk factors for infective endocarditis

Answer 13

IV drugs
prosthetics
history

Question 14

vascular complications of infective endocarditis

Answer 14

dif size septic emboli

• -> PE
• -> embolic stroke
• -> acute limb ischemia
• -> splinter hemorrhages
• -> janeway lesions (painless)

Question 15

rheum complications of infective endocarditis

Answer 15

roth spots

osler nodes ( ouch ouch)

glomerulonephritis

Question 16

IE: staph, strep, HACEK- which acute, which subacute

Answer 16

acute: staph, strep
subacute: HACEK

Question 17

presentation of acute vs subacute IE

Answer 17

acute: CHF, persistent bactermia, no rheum
==> abx until blood clx neg

subacute: cyclical fever, pos rheum
==> no abx until blood clx pos

Question 18

how long of abx for IE?

Answer 18

4-6 weeks

Question 19

when to do surgery for IE?

Answer 19

• CHF
• vegetation (>15 mm or >10mm +emboli)
• abscess
• fungus

Question 20

abx of choice for native vs prosthetic vs subacute IE

Answer 20

native: vanc
subacute: vanc + ceftriaxone

prosthetic:
<60 days: vanc + gent + cefepime
>365: vanc + ceftriaxone

Question 21

if no vanc, which abx for IE?

Answer 21

daptomycin

Question 22

ppx abx for IE when someone has bad valve

Answer 22

amoxicillin

Question 23

common bacteria in HCAP

Answer 23

MRSA

pseudomonas

Question 24

treatment for HCAP

Answer 24

vanc, zosyn