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2020 > ID > Flashcards

ID Flashcards

1
Q

SPICE (HAM) organisms and treatment

A

Serratia, Providencia, Indole-positive Proteus, Citrobacter, Enterobacter, Hafnia, Acinetobacter, Morganella

Rx: Carbapenem, TMP-SMX, Fluoroquinolone (FQ), Aminoglycoside (AG)

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2
Q

ESBL organisms and treatment

A

E. coli, Klebsiella Rx: Carbapenem, TMP-SMX, FQ, AG (if sensitive)

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3
Q

CPE Rx

A

Colistin, AG, Tigecycline, Call ID (TMP-SMX or FQ if lucky)

INFECTION CONTROL

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4
Q

MRSA Rx

A

Vancomycin, Doxycycline, TMP-SMX, Clindamycin, Linezolid, Daptomycin, Ceftobiprole

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5
Q

Pseudomonas Rx

A

Pip/Tazo, Ceftazidime, Cefepime, Carbapenems (not Ertapenem), Ciprofloxacin, AG, Aztreonam, Colistin

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6
Q

Enterococcus Rx

A

Vanco (not VRE), Linezolid, Daptomycin (amp/piperacillin if lucky)

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7
Q

Gram positive cocci

A

in clusters – S. aureus or CNST (Coag Neg Staph)

in pairs/chains – Streptococcus or Enterococcus

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8
Q

Gram positive bacilli

A
  • spore forming – Bacillus or Clostridium
  • non-spore forming – e.g. Corynebacterium, Listeria
  • Branching – Actinomyces, Nocardia
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9
Q

Gram negative cocci

A

Neisseria meningitides/gonorrheae, Moraxella

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10
Q

Gram negative bacilli

A
  • Lactose fermenters – Klebsiella, E. coli, Enterobacter

* Non-lactose fermenters – Pseudomonas, Stenotrophomonas

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11
Q

Length of treatment for bacterial meningitis with following organisms:
S. pneumoniae
N. meningitidis
Listeria monocytogenes

A

S. pneumoniae–> 10-14 days
N. meningitidis–> 7 days
Listeria 21 days–> monocytogenes

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12
Q

CAP treatment healthy outpt

A

– Amox 1g TID(strong,moderate)
– Doxy 100mg BID(conditional,low)
– Azithro 500mg and then 250mg (or Clarithro)

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13
Q

CAP treatment outpt with co-mordbidites (ex. etoh, DM)

A 
Amoxclav
OR 
Cephalosporin(Cefpodoxime,cefuroxime) +macrolide
OR
Doxy (conditional, low)
OR
Resp FQ (strong,moderate)
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14
Q

TB, who should be tested?

A
  • Contacts of active case of pulmonary TB
  • Immigrants from countries with high TB incidence
  • Travelers to countries with high TB incidence
  • Aboriginal communities
  • Injection drug users
  • Homeless
  • Health care workers
  • Residents of long-term care facilities or correctional facilities
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15
Q

Empiric treatment for Necrotizing Fasciitis

A

Vanco + clinda + PipTazo

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16
Q

Organisms associated with water: salt, fresh, fish tank, hot tub

A

Vibrio vulnificus (salt water)
Aeromonas spp. (fresh water)
M. marinum (fish tank exposure)
M. fortuitum (hot tub exposure)

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17
Q

Organism associated with rose garden

A

Sporothrix schenckii

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18
Q

Organism associated with bites

A 
Eikenella corrodens (humans)
Pasteurella spp., B. henselae, Capnocytophaga (animals)
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19
Q

Oral hairy leukoplakia (EBV): patient population and findings

A

HIV+ patient with white plaque on lateral aspect of tongue; does not scrape off

20
Q

Features of Cryptococcus neoformans

A

Umbilicated lesions, HIV (CD4 < 50), sub-acute meningitis, ↑ opening pressure

21
Q

How do you treat Lyme disease?

A

Doxy x14 days OR if CNS or CVS involvement–>CTX x14 days

22
Q

Empiric treatment for ventriculitis

A

Vanco + Ceftazidime OR meropenem x14days

23
Q

Sensitivity pattern for C. albicans (azole, echino, Ampo B)

A

sensitive to all

*consult optho, Tx x14 days, consider TTE if not clearing

24
Q

Sensitivity pattern for C. galbrata, krusei (azole, echino, Ampo B)

A

Resistant to azoles, sensitive to echino and ampho

*consult optho, Tx x14 days, consider TTE if not clearing

25
Q

Four pathogens that you must initiate airborne precautions

A
  • TB (confirmed/suspected pulmonary TB, pleural/laryngeal TB)
  • Disseminated VZV
  • Primary or disseminated varicella
  • Measles
26
Q

Seven pathogens that you must initiate droplet (mask) precautions

A
  • SARS coronavirus
  • Mumps
  • Meningococcus
  • Ebola Virus Disease
  • Invasive GAS (TSS/NF/pneumonia/meningitis)
  • Diphtheria (pharyngeal)
  • Seasonal influenza
27
Q

Pathogens that you must initiate contact (gloves, gown) precautions

A
  • Disseminated or primary and extensive HSV
  • C. difficile
  • AROs (including MRSA, VRE, ESBL, CRE)
  • Norovirus
  • Scabies
28
Q

Feature of Cryoglobulinemia? What virus and hematolgic conditions is it associated with?

A

Arthralgia, purpura, peripheral neuropathy, GN

  • HCV
  • MGUS, MM, Waldenstroms
29
Q

When to start HARRT for pts with HIV and TB: CD4<50, CD4>50, TB meningitis

A

CD4<50–> within 2 weeks
CD4>50–> within 8 weeks
TB meningitis–> defer for 8 weeks give risk of IRS

30
Q

How do you treat Typhoid?

A

IV CTX, cipro or Azithro

31
Q

How do you treat Vibrio cholerae?

A

Doxycycline

32
Q

How do you treat Yersina enterocolitica?

A

TMP-SMX (alternative Cefotaxime or ciprofloxacin)

33
Q

How do you treat mild/moderate malaria (falciparum and non. fal)?

A

CS: Chloroquine
CR: Atovaquone-proguanil OR Quinine + doxycycline

  • If P. vivax or P. ovale, add primaquine (check G6PD level first) to treat hypnozoite stage
34
Q

How do you treat severe malaria?

A

IV artesunate X 48h then PO
• Atovaquone-proguanil OR
• Doxycycline OR
• Clindamycin

35
Q

Treatment of Strongyloides?

A

Ivermectin 200 mcg/kg PO day 1, 14

36
Q

Are you pretty?

A

What kind of a question is that, I’m the pretty girl ever to walk the Earth.

37
Q

What medications must you avoid in Dengue?

A

NSAIDs

38
Q

Side effects of active TB treatment

A

RMP - drug interaction, rash1, hepatitis3
INH - rash3, hepatitis2, neuropathy
PZA - hepatitis1, rash2, arthralgia
EMB - eye toxicity, rash4

39
Q

When do you do a TOC in treatment of G & C?

A

TOC NOT indicated if treatment completed and symptoms resolve!

Otherwise, TOC with culture done 1 week post-treatment in patients with:
• Persistent symptoms
• Pharyngeal infection
• Treatment other than cephalosporin
• Known partner with drug-resistant infection

  • Positive Gram stain > 72 hours after treatment
  • Positive culture > 72 hours after treatment
  • Positive NAAT 2-3 weeks after treatment
40
Q

Treatment for LGV (Chlamydia)?

A

Doxycycline 100mg PO BID X 21d; Rx partner(s)!

41
Q

Treatment of genital warts?

A

Nothing! Cryotherapy.

42
Q

Treatment of Bacterial vaginosis and Trichomonas vaginalis?

A

Metronidazole 2g PO X 1 dose OR 500mg PO X 7 days;

If Trichomonas, treat partner!

43
Q

Treatment length for aspergillus? (Aspergilloma, Chronic Cavitary Pulmonary Aspergilosis (CCPA), Invasive aspergillosis)

A

Aspergilloma and Chronic Cavitary Pulmonary Aspergilosis (CCPA) = 6 mos

Invasive aspergillosis= Usually Voriconazole x 6 weeks

44
Q

Treatment of Blastomycosis, Histoplasmosis, Coccidiodomycosis

A

Itraconazole (mild to moderate), Amphotericin B (severe)

45
Q

Which antibiotics should you avoid if concern for pyleonephritis?

A

– Nitrofurantoin or Fosfomycin

46
Q

How do you treat GAS?

A

PCN and clinda

*also the treatment for clostridium

2020 (13 decks)

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