7/22/16

Question 1

abx for uncomplicated UTI

Answer 1

nitrofurantoin for 3 days

Question 2

abx for pyelonephritis until culture results are known

Answer 2

amp and gent

Question 3

abx for acute prostatitis until culture results are known

Answer 3

TMP/SMX or fluoroquinolones (-floxacin)

Question 4

what two organisms if found in blood culture in a pt with bacterial endocarditis should be followed by colonoscopy?

Answer 4

clostridium septicum and strep bovis

Question 5

in who should you suspect strep viridans endocarditis and what is the tx?

Answer 5

pts with previously damaged heart valves; ceftriaxone

Question 6

abx for culture negative endocarditis

Answer 6

ceftriaxone

Question 7

most common neurological manifestations of Lyme disease

Answer 7

bilateral facial nerve (CN7) or Bell palsy (can also cause encephalitis or meningitis)

Question 8

most common cardiac manifestation of Lyme disease

Answer 8

transient AV heart block

Question 9

tx of cardiac or neurologic manifestations of Lyme disease other than facial nerve (CN7) palsy

Answer 9

ceftriaxone (doxycycline in earlier stages)

Question 10

abx for neonatal meningitis

Answer 10

amp and gent

Question 11

abx for adult meningitis

Answer 11

ceftriaxone and vancomycin

Question 12

gram positive cocci in pairs vs gram negative cocci in pairs

Answer 12

gram positive diplococci: strep pneumo

gram negative diplococci: neisseria

Question 13

gram negative coccobacilli (small rods)

Answer 13

haemophilus

Question 14

plump gram negative rod with thick capsule (mucoid appearance)

Answer 14

klebsiella

Question 15

gram positive rods that form spores

Answer 15

clostridium, bacillus

Question 16

fluoroquinolones that provide atypical pneumonia coverage

Answer 16

levofloxacin and moxifloxacin

Question 17

abx for community-acquired pneumonia

Answer 17

macrolide (azithromycin, clarithromycin), doxycycline, third-generation cephalosporin (ceftriaxone, ceftazidime) with a macrolide or doxycycline

Question 18

how to identify and tx H. influenzae pneumonia

Answer 18

gram negative coccobacilli on sputum gram stain; amoxicillin or second- (cefuroxime, cefoxitin, cefotetan) or third-generation (ceftriaxone, cefazidime) cephalosporin

Question 19

what organisms cause pneumonia in cystic fibrosis pts?

Answer 19

staph aureus and pseudomonas

Question 20

currant jelly sputum pneumonia

Answer 20

klebsiella

Question 21

abx for pseudomonas

Answer 21

ticarcillin, piperacillin plus beta lactamase inhibitor (clavulanic acid or tazobactam)

Question 22

pneumonia with positive cold agglutinin antibody titers

Answer 22

mycoplasma

Question 23

tx for pneumocystis jiroveci pneumonia (PCP)

Answer 23

TMP/SMX

Question 24

tx for CMV pneumonia

Answer 24

valganciclovir

Question 25

pneumonia after exposure to a parrot or exotic bird

Answer 25

chlamydophila psittaci

Question 26

fungus ball/hemoptysis after TB or cavitary lung disease

Answer 26

aspergillus

Question 27

fever, muscle pain, eosinophilia, and periorbital edema after eating raw meat

Answer 27

trichinella spiralis

Question 28

cellulitis after dog/cat bites (organism and ppx)

Answer 28

pasteurella multocida; amox-clav to anyone who gets a bite

Question 29

tiny white spots on buccal mucosa 3 days after fever, cough, runny nose and conjunctivitis in an unimmunized pt

Answer 29

rubeola (measles)

Question 30

medications that improve long-term survival in pts with left systolic dysfunction (ejection fraction less than 40%)

Answer 30

ACE-i/ARBs, beta blockers, aldosterone antagonists (combination of hydralazine and nitrates in African-American pts)

Question 31

what are two problems encountered by female pts with primary hypothyroidism?

Answer 31

menstrual irregularities (due to decreased FSH and LH) and hyperprolactinemia (TRH-incuced stimulation of lactotrophs)

Question 32

when does the first-line tocolytic change? what are they (name and type of medication)?

Answer 32

less than 32 weeks: indomethacin (COX inhibitor) | 32-34 weeks: nifedipine (calcium channel blocker)

Question 33

a mom develops FLUSHING, headache, tachycardia, palpitations after receiving a tocolytic. what medication (name and type) was she given?)

Answer 33

nifedipine (calcium channel blocker) causes peripheral vasodilation which leads to these side effects

Question 34

what are the side effects of indomethacin when it is used as a tocolytic? compare maternal vs fetal

Answer 34

maternal: gastritis, platelet dysfunction fetal: oligohydramnios, closure of ductus arteriosus

Question 35

what kind of drug is terbutaline and what is a dangerous side effect?

Answer 35

beta agonist used as second-line tocolytic; pulmonary edema

Question 36

dx and tx for pts who have yellowish streaks on their palms, milky and opalescent blood samples, and who presents with pancreatitis after partying

Answer 36

hypertriglyceridemia; fenofibrate

Question 37

combination OCPs increase the risk for ________ and decrease the risk for ________

Answer 37

increase: breast and cervical cancer (slightly), HTN, venous thrombosis decrease: endometrial and ovarian cancer

Question 38

what is the initial tx for torsades de pointes?

Answer 38

magnesium sulfate