Antibiotics

Question 1

How treat GAS pharyngitis?

Answer 1

Penicillin / amoxicillin

Question 2

Why treat GAS pharyngitis?

Answer 2

Reduce risk rheumatic fever

Question 3

4 Parts to Centor Criteria for treating streptococcal pharyngitis:

Answer 3

1. Fever
2. Tender anterior cervical LN
3. Tonsillar exudates
4. NO cough

2-3 = rapid strep ANTIGEN test   abx if +
4 = oral penicillin/amoxicillin

Question 4

Which H-flu causes epiglottitis?

Answer 4

H-flu type b (covered by vaccine)

Question 5

Why constipation affect cystitis?

Answer 5

Impacted stool = rectal dissension = compress bladder
Prevents complete voiding = urinary stasis =
Cystitis (often E. coli)

Question 6

IgA vs. post-strep GN

Answer 6

IgA - normal complement levels

- hematuria w/in 5 days of URI (synpharyngitic)

Question 7

How treat acute mediastinitis - complication of cardiac surgery - intraoperative wound contamination?

Answer 7

Surgical debridement and abx

Question 8

How treat lactational mastitis?

Answer 8

Continue breastfeeding + abx
- skin flora (staph a) enters ducts

Use: dicloxacillin or cephalexin (covers methicillin-resistant)

Question 9

How treat 24yo pregger w/ E. coli who is symptomatic?

assume cystitis and not pyelo

Answer 9

Nitrofurantoin - 7 days or

Amoxicillin / amox-clav for 3-7 days to

Fosfomycin - single dose

Question 10

How treat acute pyelonephritis in pregger?

Answer 10

IV abx - meropenem / beta-lactams

10-14 day oral after afebrile for 24 hours

Question 11

How treat BAD PID?

Answer 11

Hospitalization
- IV cefotetan/cefoxitin + doxy

• IV clinda + gentamicin

Question 12

Complications of bacterial meningitis in 4yo?

Answer 12

4 yo think Strep pneumonia

• hearing loss
• MR
• cerebral palsy
• epilepsy

Question 13

Meckel diverticulum?

Answer 13

Painless hematochezia

Question 14

How treat botulism?

Answer 14

Botulism immune globulin

Question 15

Loud S1 + mid-diastolic rumble at apex (murmur)
- sore throat + febrile illness 1 year ago
Best abx?

Answer 15

Penicillin - for rheumatic fever
- for 5 years or until 21 yo (whichever is longer)

(and longer if valvular/heart disease)

Question 16

Describe toxicondendron plant contact dermatitis.

Answer 16

Type IV HS T-cell mediated rxn (like TB skin test)
- delayed inflammatory response (12 hours after exposure)

Poison ivy, oak, nickel

Question 17

Blisters w/ positive Nikolsky sign + ??

Answer 17

Staph scalded skin syndrome

• also impetigo
• blister fluid = sterile b/c toxin

Question 18

HSV herpetic whitlow vs. Impetigo

Answer 18

HSV - vermillion border (limited to orolabial region)

Sa / Strep p = face, pustules that rupture into honey-colored crusted exudates

Question 19

Rash + fever - rash starts on face spreads down

Answer 19

Some kind of Measles
1.) if CCCK, think Measles - infectious respiratory particles
(airborne precautions)

2.) if LN, think german measles - rubella

Question 20

What use droplet precautions?

Answer 20

Droplets are bigger - so surgical mask

- RSV, Influenza

Question 21

White blood cell casts…what look for?

Answer 21

Hx of drugs (penicillins, TMP-SMX, cephalosporins, NSAIDs)

Acute Interstitial Nephritis

Question 22

What is another name for hyper IgE syndrome?

Answer 22

Job syndrome

Question 23

What is another name for hyper IgM syndrome?

Answer 23

CD40 ligand deficiency

Question 24

What age do we see common variable immunodeficiency?

Answer 24

Adolescents or young adults

- all low Ig’s but normal B-cells