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RCE 2021 > ID > Flashcards

ID Flashcards

1
Q

TSS Bugs

A

GAS, S aureus (tampon, nasal packing)

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2
Q

TSS Treatment

A

Beta lactam + clinda

+/- IVIg, hyperbaric O2

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3
Q

TSS Chemoprophylaxis

A

Keflex x 10 d OR Clinda

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4
Q

Nec Fasc Empiric

A

Pip tazo/vanco/clinda

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5
Q

Nec Fasc GAS

A

PCN + clinda

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6
Q

Nec fasc polymicrobial

A

Pip taco + vanco or carbapenem

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7
Q

Nec fasc clostridium

A

PCN + clinda

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8
Q

Nec fasc Vibrio

A

doxy + clinda

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9
Q

Nec fasc aeromonas

A

doxy + cipro

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10
Q

OM bugs in all

A

s aureus

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11
Q

OM bug foreign body/prosthetsis

A

CNST, cutibacterium

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12
Q

OM bug nosocomial

A

Pseud, entero, candida

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13
Q

OM bug DM

A

GNB, strep, anaerobes

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14
Q

OM bug IC

A

Candida, aspergillus, mycobacterium

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15
Q

NVOM empiric therapy

A

CTX+VANCO

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16
Q

Prosthetic joint infection empiric

A

CTX and vanco

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17
Q

Signs of early HIV

A

Genital ulcers > weight loss> vomiting>LN>fever

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18
Q

ARV Options

A 
2 NRTI + INSTI/PI/NNRTI
Bictegravir+tenofovir a+emtricitabine
Dolutegravir, lamivudine
TAF = less bone/renal
TDF = less lipid, cost less
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19
Q

PJP Prophylaxis

A

CD4<200

  1. Septra DS OD, SS OD, DS MWF
  2. Dapsone - not if G6P
  3. Atovaquone
  4. Aerosolized pentamidine
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20
Q

Sulfa allergy proph

A

No septra
Dapsone okay but not if sjs/tens
If SJS/TENS - atovaquone

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21
Q

Toxo prophylaxis

A

CD4<100

  1. Septra
  2. Dapsone + pyrimethamine (leucovorin)
  3. Atovaquone
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22
Q

MAC prophylaxis

A

CD4<50

  1. Azithro or clarithro
  2. Rifampin
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23
Q

PJP treatment

A
  1. Sulfa IV
    - Add pred if O2<70 or A-a 35+
    Alt
    Mild-Mod
  2. Primaquine + PO clinda
  3. Dapsone + TMP
  4. Atovaquone
    Mod-Sev
  5. Primaquine + IV clinda
  6. Pentamidine
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24
Q

Toxo treatment

A 
1. Sulfadiazine + pyrimethamine
Alt:
1. Atovaquone alone or with pyrimethamine or with sulfadiazine
2. Septra
3. Pyrimethamine + clinda
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25
Q

MAC treatment

A

Clarithro + ethambutol

Azithro + ethambutol

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26
Q

TB + 4-10 mm

A 
HIV
ESRD
Organ transplant
Close contact w/infectious 2 years
Fibronodular CXR
TNFalpha
Immunosuppressant
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27
Q

Latent TB Tx

A
  1. Isoniazid x 9 mos
  2. Isoniazid x 6 mos
  3. Isoniazid + rif x 3 mos
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28
Q

Active TB Tx

A 
Rifampin
Isoniazid
Pyrizidamole
Ethambutol (can stop if susceptible)
Steroids if TB meningitis or pericarditis
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29
Q

TB and LTBI

A

Treat all
Isoniazid + pyridoxine x 9 mos
No prednisone in TB pericarditis

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30
Q

NTB Mycobacterium

A

3 drugs:

  1. Macrolide
  2. Ethambutol
  3. Rifampin or AG
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31
Q

Fever returned traveller

A

<2 weeks = malaria, dengue, chikungunya, diarrhea, URTI, flu

>2 weeks = malaria, TB, hep, HIV, enteric fever (Salmonella)

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32
Q

Malaria Treatment Uncomplicated

A 
P falciparum
Chloroquine if CS
1. Atovaquone - proguanil 
2. Quinine-doxy
3. Quinine-clinda
Non falciparum
Chloroquine if CS
1. Atovaquone-proguanil
2. Quinine-doxy
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33
Q

Malaria Tx complicated

A
  1. IV artesunate x 48 hrs then
  2. Atovaquone-proguanil
  3. Doxy
  4. Clinda
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34
Q

Salmonella typhi treatment

A
  1. CTX
  2. Azithro
  3. Cipro
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35
Q

Lyme disease Rx

A
  • Bite - doxy
  • Erythema migrans - doxy
  • Early neuro - doxy, CTX, PenG
  • CV lyme - CTX
  • Arthritis - doxy
  • Late neuro - CTX
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36
Q

Steroid screening

A
  1. LTBI - pred >15 for >4 wks
  2. HepB - pred >7.5
  3. PCP - pred >20 for >4-8 wks
  4. Strongyloides - if any IS or lived/traveled to endemic area
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37
Q

Candida sensitivities

A

Albicans - all
Krusei/glabrata - not azoles
Parapsilosis - not echinocandins
Lusitania - not ampho B

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38
Q

Candida tx

A
  1. stable and no recent azole= fluc
  2. unstable, recent azole, neut = echinocandin
  3. CNS/eyes = ampho B +/- flucytasine
  4. Pregnancy = Ampho B
    Tx for 2 weeks from first neg blood culture
39
Q

Aspergillus Tx

A

ABPA - steroid + anti IgE +/- itra
Aspergilloma - solitary = remove, multiple = anti fungal
Chronic cavitary pulmonary = antifungal
Invasive aspergillosis = voriconazole, OI/neu/IC CT chest/galatomannan/cx

40
Q

Dimorphic Fungi Tx

A
  1. Blasto - itra (mild/mod), ampho B (sev)
  2. Histo - none (mild), itra (mod), ampho B (Sev)
  3. Coccidio - itra if symptoms
41
Q

Airborne

A

TB - tx 2 wk, 3 neg AFB
Disseminated VZV - contact, lesions crusted
Measles - 4 d after rash start

42
Q

Droplet

A 
SARS
Mumps - 5 d after parotitis 
Meningococcus - 24 hr tx
Invasive GAS - with contact, 24 hr tx
Ebola - with contact
43
Q

Bites empiric tx

A
  1. Amox-clav
  2. Cephalosporin + flagyl
  3. Moxi
  4. Doxy + clinda
44
Q

Animal bites bugs

A 
Pasteurella
Capnocytophaga
Staph
Strep
Anaerobes
45
Q

Human bites bugs

A

Eikenella
Staph aureus
Strep
anaerobes

46
Q

Meningitis Tx

A

<50 = CTX, Vanco
>50 = CTX, Vanco, ampicillin
Dex 10 QID x 4 d

47
Q

Meningitis CHEMOproph Abx

A

Within 10 d

CTX/cipro/rifampin x 1

48
Q

Meningitis bugs

A

S pneumo
N meningitides
H flu
Listeria (old)

49
Q

IE MSSA Tx

A

Native: Cloxacillin/cefazolin
Prosthetic: add Rifampin and gentamicin

50
Q

IE MRSA/CNST Tx

A

Native: Vanco
Prosthetic: add rifampin and getamicin

51
Q

IE Viridans group strep/S gallolyticus/S bovis TX

A

PenG or CTX

52
Q

IE E faecalis TX

A

Amp plus gent/CTX

53
Q

IE E faecium TX

A

Vanco and gent

54
Q

IE HACEK Tx

A

CTX

55
Q

IE Prophylaxis no allergy

A
  • Amoxicillin

- NPO: ampicillin, CTX, or cefazolin

56
Q

IE prophylaxis penicillin allergy

A
  • Keflex, clinda, azithro

- NPO: cefazolin, CTX, clinda

57
Q

CAP Outpatient Healthy

A

Amoxicillin TID

Doxycycline

58
Q

CAP Outpatient Comorbid

A
  1. Amox-clav or cephalosporin PLUS macrolide or doxy

2. Respiratory fluoroquinolone

59
Q

Campylobacter diarrhea tx

A

Azithro

60
Q

S enterica typhi diarrhea tx

A

CTX/cipro

61
Q

Shigella diarrhea tx

A

Azithro, copra, CTX

62
Q

Vibrio diarrhea tx

A

Doxy

63
Q

Yersinia diarrhea tx

A

Septra

64
Q

C diff episode 1

A

Vanco 10 d
Or
Fidoxamin
Flagyl

65
Q

C diff episode 1 severe but uncomplicated

A

Vanco 14 d

Or fidoxamin

66
Q

C diff episode 1 severe and complicated

A

Vanco or fidoxamin
IV Flagyl
+/- PR vanco

67
Q

C diff 1st relapse

A

Vanco x 14 d or fidoxami (if sev/comp)

68
Q

C diff 2nd relapse

A

Vanco with taper

Consider FMT

69
Q

Intraabdominal infection treatment

A
  • Drain
  • <3 cm antibiotic alone may suffice
  • outpatient- CTX/Flagyl or cipro/flagyl
  • inpatient - piptazo, mero, ceftazidime or cipro plus flagyl
70
Q

UTI Tx

A

UTI

  1. Nitrofurantoin
  2. Septra
  3. Fosfomycin

Pyelonephritis

  1. Fluoroquinolone
  2. IV beta lacy am
71
Q

Prostatitis

A

Need to cover pseudomonas, E. coli and enterococcus

Chronic - FQ
Acute well - FQ
Acute unwell - piptazo, cephalosporin, FQ

72
Q

Endometritis

A

Need to cover GBS

CLINDAMYCIN and amino glycoside

73
Q

Intra abdominal infection treatment

A

Community
CTX or copra and flatly

Hospital - need to cover PSA
Pip tazo/ceftaz/mero/cipro and flagyl

74
Q

UTI Tx

A 
Uncomplicated
1. Nitrofurantoin - not in pyelo
2. Septra -  not in pregnancy
3. Fosfomycin - not in pyelo
Alt: FQ or beta lactam

Pyelo

  1. FQ
  2. IV beta lactam
75
Q

Prostatitis bugs and tx

A 
Pseudomonas, E Coli, Enterococcus
Acute
1. Well - FQ
2. Unwell - pip tazo, 3rd gen ceph, FQ
Chronic
1. FQ
76
Q

Endometritis bugs and tx

A

GBS and others

Clinda and AG

77
Q

Chlamydia tx

A
  1. Azithro x 1
  2. Doxy x 7 days
    Test for cure only if poor compliance, pregnant, pre pubertal, alternative tx used
78
Q

Gonorrhea tx

A
  1. CTX or cefixime x 1
  2. Also need to give azithro x 1
    DGI - CTX x 7 d and azithro
    Must test for cure
79
Q

Syphilis primary/secondary/early latent

A

Benz PenG 2.4 MU x 1

80
Q

Syphilis late latent/tertiary

A

Benz PenG 2.4 MU weekly x3

81
Q

Neurosyphilis

A

Aqueous PenG q4hr x 14 d then IM x 1 if possible late latent

82
Q

Mycobacterium genitalum tx

A

Moxifloxacin x 14 d

83
Q

HSV 1/2 tx

A

Acyclovir

Valacyclovir

84
Q

LGV Tx

A

GIANT CELLS

Doxy x 14 d - need to treat partner

85
Q

Chancroid tx

A
  1. Cipro

2. Azithro

86
Q

Bacterial vaginosis tx

A

Positive whiff, clue cells

Flagyl x 7 d

87
Q

Trichomoniasis tx

A

Yellow, frothy, strawberry cervix

Flagyl x 7 d

88
Q

Candidiasis vaginal tx

A

Clotrimazole, fluconazole

89
Q

Genital warts tx

A

HPV 6/11

Cryo, imiquimod

90
Q

Purulent SSTI Tx

A 
Mild
- I&D alone
Mod
- Empiric: Keflex, Septra, doxy
- MSSA = keflex
- MRSA = Septra
Severe
- Empiric = Vanco and ancef
- MSSA = ancef
- MRSA = Vanco
91
Q

SSTI not purulent tx

A 
Mild
- Keflex
Moderate
- Ancef
Severe
- Vanco and piptazo
- Vanco and mero
92
Q

Cellulitis prophylaxis

A

If 3+ episodes per year can consider:
Pencillin
Amoxicillin
Keflex

93
Q

S aureus abscess

A

Clinda or Septra plus I&D

RCE 2021 (6 decks)

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