Infection Flashcards
(32 cards)
meningitis most common pathogen and empirical treatment? (for different age groups)
- 0-2 months (Group B streptococcus, E.Coli) : benzylpenicillin + cefotaxime
- >2months (N. Meningitidis, HiB, S pneumoniae) : ceftriaxone or cefotaxime, vancomycin if Gram positive
meningitis prophylaxis?
children, pregnant : Ceftriaxone
other adults : ciprofoxacin or rifampin
(rifampin contraindicated in severe liver disease, alcoholism)
a child with itching scalp, patchy loss of hair, scaling.
Dx and Tx?
Dx : Tinea capitis
Tx : PO antifungals (griseofulvin or terbinafine)
spontaneous baterial peritonitis
Dx, most common pathogen and Tx ?
ascitic fluid PMN > 250uL,
confirmed by culture
most commonly E.coli and other gut bacterial
initial Tx cefotaxime 2g IV 8 hourly
measles
how many days of school exclusion?
4 days from the onset of the rash
Tetanus vaccine schedule
- DTPa 5 doses : 2, 4, 6 and 18 months, and 4 yrs old.
- dTPa (reduced antigen) booster :
- at 11-13 yrs
- > 50 yrs old if last dose was more than 10 yrs ago
- >65 yrs old if last dose was more than 10 yrs ago
an adult never been vaccinated against tetanus in the past. what to give?
- dT 3 doses with 4 weeks intervals (1st dose should be dTPa. all three can be dTPa)
- booster (dT or dTPa at 10 and 20 yrs after the primary doses)
18 months
high fever for 3 days
fever suddley subsides and maculopapular rash on trunk
no rash on face or limb
Dx?
roseola infantum
caused by HHV-6 or 7
severe endometritis?
what pathogens to cover?
which Abx?
what if she has a history of anaphylaxis to penicillin?
gonorrhea, chlamydia
ceftriaxone, azithromycin + metronidazole.
gentamicin, azithromycin + metronidazole
adult community acquired pneumonia.
empirical Abx?
Is it mild, moderate,severe?
- Confusion : new onset
- O pO2 <60mm or O2 sat <90
- RR >30
- BP sys <90 or diast < 60
none: mild, 1 : moderate, 2 or more: severe
mild :
- amoxicillin 1g PO 8 hourly,
- review in 48 hours.
- (if cannot review in 48 hours, consider using doxycycline instead)
- imporved –> 5 days,
- slow improvement, 7 days.
moderate : admission
- benzylpenicillin + doxycycline OR clarithromycin
Severe : ICU
- benzylpenicillin +gentamicine + clarithromycin
the most common cause of gastroenteritis in adults and older children in australia?
in young children?
adults and older children : norovirus
youger children : rotavirus
thumb sign on lateral neck xray
Dx
m/c pathogen
Tx
- epiglotittis
- Past : H influenzae type B (not anymore due to the vaccine)
- Current : Group A beta hemolytic streptoccocus
- don’t delay airway protection because od Xray
cellulitis Abx?
IV flucoloxacillin
difloxacillin
hepatic hydatid cyst
which pathogen?
hosts?
how to eradicate?
human treatment?
- pathogen : echinococcus
- main host : dogs. intermediate host : sheep. accodental host : humans
- eradication? :vaccination of lambs, deworming of dogs
- Percutaneous drainage with albendazole therapy
exposure to measles.
Management?
1) Hx of vaccination (+)
2) vaccination history unsure
3) pregnant, immunecompromised, not sure of vaccination
1) Hx of vaccination (+) : reassure
2) vaccination history unsure : MMR vaccine now and 4 weeks later
3) pregnant, immunecompromised, not sure of vaccination : natural human immunoglobulin (NHIG)
three strategies to reduce perinatal HIV transmission?
- use of zidobudine for the mom and baby
- elective C-sec
- no breastfeeding
prophylactic antibiotics for HIV patients with low CD4 count?
what species to cover?
need to cover,
- < 200: toxoplasmosis
- < 100 : Pneumocystis jiroveci
- < 50 : MAC
use
- trimethoprim-sulfamethoxazole : for toxo and PCJ
- azithromycin : for MAC
diabetic foot ulcer anti?
mild infection : PO amoxicillin-clavulanate
deep or widespread infections, osteomyelitis : piperacillin-tazobactam, ticarcillin-clavulanate, meropenem, ertapenem, carbapenem,
moxi or ciprofloxacin + metronidazole
3rd cephalosporin + metronidazole
a man travelled to Thailand recently
presented with
fever, joint pain, retro-orbital pain, rash all over body,
no LAP,
leukopenia, thrombocytopenia. elevated AST
dengue fever
diffuse patchy infiltrates on x ray
suspected atypical pneumonia
What is the most common pathgen in each age group?
children < 2 yrs
school aged children
children < 2 yrs : viral pneumonia
school aged children : mycoplasma pneumoniae
scabies Tx
permethrin 5% cream
adult, recurrent sinusitis, failed with amoxacillin, trimethoprim/sulphamethoxazole.
Tx?
a fluoroquinolone 14-21 days
roundworm infection Tx?
(Ascarid lumbricoid infection)
Pyrantel
