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RCE 2021 > ID > Flashcards

ID Flashcards

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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
MAC treatment
Clarithro + ethambutol | Azithro + ethambutol
26
TB + 4-10 mm
``` HIV ESRD Organ transplant Close contact w/infectious 2 years Fibronodular CXR TNFalpha Immunosuppressant ```
27
Latent TB Tx
1. Isoniazid x 9 mos 2. Isoniazid x 6 mos 3. Isoniazid + rif x 3 mos
28
Active TB Tx
``` Rifampin Isoniazid Pyrizidamole Ethambutol (can stop if susceptible) Steroids if TB meningitis or pericarditis ```
29
TB and LTBI
Treat all Isoniazid + pyridoxine x 9 mos No prednisone in TB pericarditis
30
NTB Mycobacterium
3 drugs: 1. Macrolide 2. Ethambutol 3. Rifampin or AG
31
Fever returned traveller
<2 weeks = malaria, dengue, chikungunya, diarrhea, URTI, flu | >2 weeks = malaria, TB, hep, HIV, enteric fever (Salmonella)
32
Malaria Treatment Uncomplicated
``` 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 ```
33
Malaria Tx complicated
1. IV artesunate x 48 hrs then 2. Atovaquone-proguanil 3. Doxy 4. Clinda
34
Salmonella typhi treatment
1. CTX 2. Azithro 3. Cipro
35
Lyme disease Rx
- Bite - doxy - Erythema migrans - doxy - Early neuro - doxy, CTX, PenG - CV lyme - CTX - Arthritis - doxy - Late neuro - CTX
36
Steroid screening
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
37
Candida sensitivities
Albicans - all Krusei/glabrata - not azoles Parapsilosis - not echinocandins Lusitania - not ampho B
38
Candida tx
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
Aspergillus Tx
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
Dimorphic Fungi Tx
1. Blasto - itra (mild/mod), ampho B (sev) 2. Histo - none (mild), itra (mod), ampho B (Sev) 3. Coccidio - itra if symptoms
41
Airborne
TB - tx 2 wk, 3 neg AFB Disseminated VZV - contact, lesions crusted Measles - 4 d after rash start
42
Droplet
``` SARS Mumps - 5 d after parotitis Meningococcus - 24 hr tx Invasive GAS - with contact, 24 hr tx Ebola - with contact ```
43
Bites empiric tx
1. Amox-clav 2. Cephalosporin + flagyl 3. Moxi 4. Doxy + clinda
44
Animal bites bugs
``` Pasteurella Capnocytophaga Staph Strep Anaerobes ```
45
Human bites bugs
Eikenella Staph aureus Strep anaerobes
46
Meningitis Tx
<50 = CTX, Vanco >50 = CTX, Vanco, ampicillin Dex 10 QID x 4 d
47
Meningitis CHEMOproph Abx
Within 10 d | CTX/cipro/rifampin x 1
48
Meningitis bugs
S pneumo N meningitides H flu Listeria (old)
49
IE MSSA Tx
Native: Cloxacillin/cefazolin Prosthetic: add Rifampin and gentamicin
50
IE MRSA/CNST Tx
Native: Vanco Prosthetic: add rifampin and getamicin
51
IE Viridans group strep/S gallolyticus/S bovis TX
PenG or CTX
52
IE E faecalis TX
Amp plus gent/CTX
53
IE E faecium TX
Vanco and gent
54
IE HACEK Tx
CTX
55
IE Prophylaxis no allergy
- Amoxicillin | - NPO: ampicillin, CTX, or cefazolin
56
IE prophylaxis penicillin allergy
- Keflex, clinda, azithro | - NPO: cefazolin, CTX, clinda
57
CAP Outpatient Healthy
Amoxicillin TID | Doxycycline
58
CAP Outpatient Comorbid
1. Amox-clav or cephalosporin PLUS macrolide or doxy | 2. Respiratory fluoroquinolone
59
Campylobacter diarrhea tx
Azithro
60
S enterica typhi diarrhea tx
CTX/cipro
61
Shigella diarrhea tx
Azithro, copra, CTX
62
Vibrio diarrhea tx
Doxy
63
Yersinia diarrhea tx
Septra
64
C diff episode 1
Vanco 10 d Or Fidoxamin Flagyl
65
C diff episode 1 severe but uncomplicated
Vanco 14 d | Or fidoxamin
66
C diff episode 1 severe and complicated
Vanco or fidoxamin IV Flagyl +/- PR vanco
67
C diff 1st relapse
Vanco x 14 d or fidoxami (if sev/comp)
68
C diff 2nd relapse
Vanco with taper | Consider FMT
69
Intraabdominal infection treatment
- Drain - <3 cm antibiotic alone may suffice - outpatient- CTX/Flagyl or cipro/flagyl - inpatient - piptazo, mero, ceftazidime or cipro plus flagyl
70
UTI Tx
UTI 1. Nitrofurantoin 2. Septra 3. Fosfomycin Pyelonephritis 1. Fluoroquinolone 2. IV beta lacy am
71
Prostatitis
Need to cover pseudomonas, E. coli and enterococcus Chronic - FQ Acute well - FQ Acute unwell - piptazo, cephalosporin, FQ
72
Endometritis
Need to cover GBS CLINDAMYCIN and amino glycoside
73
Intra abdominal infection treatment
Community CTX or copra and flatly Hospital - need to cover PSA Pip tazo/ceftaz/mero/cipro and flagyl
74
UTI Tx
``` 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
Prostatitis bugs and tx
``` Pseudomonas, E Coli, Enterococcus Acute 1. Well - FQ 2. Unwell - pip tazo, 3rd gen ceph, FQ Chronic 1. FQ ```
76
Endometritis bugs and tx
GBS and others | Clinda and AG
77
Chlamydia tx
1. Azithro x 1 2. Doxy x 7 days Test for cure only if poor compliance, pregnant, pre pubertal, alternative tx used
78
Gonorrhea tx
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
Syphilis primary/secondary/early latent
Benz PenG 2.4 MU x 1
80
Syphilis late latent/tertiary
Benz PenG 2.4 MU weekly x3
81
Neurosyphilis
Aqueous PenG q4hr x 14 d then IM x 1 if possible late latent
82
Mycobacterium genitalum tx
Moxifloxacin x 14 d
83
HSV 1/2 tx
Acyclovir | Valacyclovir
84
LGV Tx
GIANT CELLS | Doxy x 14 d - need to treat partner
85
Chancroid tx
1. Cipro | 2. Azithro
86
Bacterial vaginosis tx
Positive whiff, clue cells | Flagyl x 7 d
87
Trichomoniasis tx
Yellow, frothy, strawberry cervix | Flagyl x 7 d
88
Candidiasis vaginal tx
Clotrimazole, fluconazole
89
Genital warts tx
HPV 6/11 | Cryo, imiquimod
90
Purulent SSTI Tx
``` Mild - I&D alone Mod - Empiric: Keflex, Septra, doxy - MSSA = keflex - MRSA = Septra Severe - Empiric = Vanco and ancef - MSSA = ancef - MRSA = Vanco ```
91
SSTI not purulent tx
``` Mild - Keflex Moderate - Ancef Severe - Vanco and piptazo - Vanco and mero ```
92
Cellulitis prophylaxis
If 3+ episodes per year can consider: Pencillin Amoxicillin Keflex
93
S aureus abscess
Clinda or Septra plus I&D

RCE 2021 (6 decks)

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