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Internal medicine > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Septic workup components

A

Bloods
-BLOOD CULTURE
-FBC
-RP
-CRP/ESR

Procedures
-Lumbar puncture
-Catheterisation for Urine culture

Radio
-CXR+-

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2
Q

CSF WBC to RBC ratio

A

1:500, in case of traumatic tap

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3
Q

Organisms to consider with gram positive cocci in clusters

A

Staphylococci
-Coagulase positive
-Coagulase negative

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4
Q

Organisms to consider in gram positive cocci in chains

A
  1. Streptococci
  2. Enterococci
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5
Q

Main organisms that cause UTI

A

E Coli and Enterococcus

Staph if catheter associated infection

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6
Q

Drugs that are high risk for causing C Diff associated Diarrhea

A
  1. Clindamycin
  2. Floroquinolones
  3. Cephalosporins
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6
Q

Drugs that are high risk for causing C Diff associated Diarrhea

A
  1. Clindamycin
  2. Floroquinolones
  3. Cephalosporins
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7
Q

Coverage of metronidazole

A

Anaerobes

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8
Q

Treatment of MSSA

A

Cloxacillin or penicillin

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9
Q

What to suspect in crytococcal meningitis

A

Immunocompromise/HIV

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10
Q

Common pathogens causing liver abscess

A

Klebsiella pneumoniae
E Coli
Streptococci

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11
Q

Indications for surgical drainage of liver abscess

A

1 Failure of percutaneous drainage
2. Good response to abx therapy
3. Large abscess >10cm
4.multiple/multifoculated abscesses

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12
Q

What to consider to oralizing antibiotics

A

Sensitivity to the drug
Availability of oral formulation
Patient condition
Compliance

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13
Q

Treatment of entamoeba histolytica liver abscess

A

Metronidazole or tinazole for abscess

Paromomycin for luminal eradication

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14
Q

Microbes in cellitis

A

Staph and strep

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15
Q

Antibiotics for cellulitis

A

Cloxacillin or cefazolin(superior)

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16
Q

Mx of Nec fasc

A

Emergency surgical debridement

Blood cultures->triple therapy( ceftazidime, clindamycin and?)

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17
Q

Causative agent of melioidosis

A

Burkholderia pseudomallei, a safety pin shaped gram negative rod

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18
Q

Mx of Melioidosis

A
  1. Abscess drainage
  2. Induction phase: IV ceftazidime or meropenem
  3. Maintenance: Bactrim or augmentin+doxycycline
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19
Q

Risk factors for Listeria monocytogenes

A

Immunosuppressed host
Pregnancy
Alcoholics
Old
Young
Soft cheese in diet?

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20
Q

Investigations to order for Lumbar puncture

A
  1. Opening Pa
  2. Cell count
  3. CSF panel: protein, glucose paired with peripheral
  4. MicroB; cultures and sensitivity +AFB
  5. Cytology
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21
Q

Suspicion from lymphocytic meningitis

A

TB vs Fungal vs Viral(glucose and protein not as deranged)

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22
Q

Mx of HSV encephalitis

A

Acyclovir, reduces mortality rates

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23
Q

Empirical Mx of CNS infection

A
  1. IV ceftriaxone
  2. IV Ampicillin
  3. IV Acyclovir
  4. Dexamethasone
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24
Q

Cx of male UTI

A

Pyelonephritis
Pyonephrosis
Prostatitis
AKI

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25
Q

Mx of Pyonephrosis

A

Percutaneous Nephrostomy+ Abx coverage

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26
Q

Most common sources of polymicrobial bacteremia

A

GI
GU
HBS

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27
Q

5 most common sites of nosocomial infection

A
  1. SSTI
  2. GU
  3. Pneumonia
  4. C diff Colitis
  5. Line infection
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28
Q

What to rule out in Strep bovis bacteremia

A

GI malignancy

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29
Q

3 biochemical confirmations of HIV positive

A
  1. CD4 counts low with normal TW
  2. CD4:CD8 ratio increase
  3. CD4 % low
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30
Q

Risk factor for toxoplasmosis

A
  1. Cat LITTER
  2. Handling contaminated meat
  3. Vertical transmission
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31
Q

Test for Toxoplasma infection

A

Toxoplasma IgG

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32
Q

Medication for Toxoplasmosis and PCP prophylaxis

A

Bactrim

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33
Q

Dx of Toxoplasmosis

A

Positive serum IgG+MRI findings+ treatment trial

Brain biopsy not usually done

34
Q

Mx of CMV retinitis

A

Intra vitreal valgancyclovir

35
Q

Indication for stool culture

A

Acute Colitis/GE looking for bacterial cause

36
Q

Mx for esophageal candidiasis

A

Fluconazole

37
Q

Mx of CMV colitis

A

IV gancyclovir

38
Q

Pathogens that cause chronic lung infection

A

Tuberculosis
Non Tuberculosis Mycobacteria
Melioidosis
Aspergillosis

39
Q

Gold standard for Melioidosis diagnosis

A

Based on culture eg BAL

40
Q

Mx of Melioidosis

A
  1. 4 weeks IV Abx
  2. Months of oral eradication therapy
41
Q

Morphology on dengue rash

A

Diffuse petechial rash that is blanchable with islands of sparing

42
Q

Number of dengue serotypes

A

4

43
Q

Serious cx of dengue infection

A

Dengue hemorrhagic fever DHF
Dengue shock syndrome DSS

44
Q

7 warning signs of dengue

A
  1. Abdo pain from gut ischemia
    2.Persistent Emesis
  2. Fluid accumulation
  3. Mucosal bleeding
  4. Lethargy and restlessness
  5. Hepatomegaly >2cm
  6. Haematocrit rise and rapid platelet drop
45
Q

Biochemical sequence in primary dengue

A

NS1 positive D1-5
IgM D5
IgG D10

46
Q

Purpose of trending platelets in dengue

A

Not for recovery but to help cfm the dx of dengue

47
Q

3 rules in dengue

A
  1. Fever in dengue is 7> day
  2. Platelets will fall during febrile phase, and a big fall in critical phase(day fever settles)
  3. Platelets will only recover/rise 1-2 days after fever settles
48
Q

Causes of death in Severe dengue

A
  1. Multi organ failure(Liver, myocardium,
  2. Third spacing and shock
  3. DIVC?
49
Q

Vancomycin vs cloxacillin for MSSA bacteremia

A

Cloxacillin lower mortality outcomes

50
Q

Criteria for IE

A

Duke criteria

51
Q

Virus that causes oral hairy leukoplakia

A

EBV

52
Q

Common causative agent of viral meningitis

A

HSV 1 and 2

53
Q

Test for Gonorrhea and chlamydia

A

GC swab of relevant anatomical areas

54
Q

Test for Gonorrhea and chlamydia

A

GC swab of relevant anatomical areas

55
Q

Differential diagnosis for hands on hands and feet

A
  1. HFMD: RVEV and coxsackie
  2. Secondary syphilis
  3. Rocky Mountain spotted fever
56
Q

Window for HIV testing

A

4-6/52 and 3/12 from exposure

57
Q

How Chlamydia is screened

A

First pass urine NOT mid stream
Swab if visible lesions/discharge

58
Q

Regimen for daily prep

A

Take 1/52 before, stop 1/52 to 1/12 after sexual act
- good for CSWs

59
Q

Cx of VZV

A
  1. Secondary bacterial skin infection
  2. VZV pneumonitis
  3. Transaminitis
  4. Bleeding diathesis
  5. Guillian barre
60
Q

Mx of VZV

A
  1. Symptomatic Mx
  2. Mx lesions
  3. Acyclovir/Valacyclovir(renal adj.)
  4. Contact tracing
  5. Vaccination
61
Q

Virus most likely to cause arthralgia

A

Chikugunya

62
Q

Triad of flu like symptoms

A

Fever
Sore throat
Cough

63
Q

Triad of Infectious Mononucleosis Syndrome

A

Fever
Sore throat
Lymphadenopathy

64
Q

What is Dengue duo

A

PCR and Ab

65
Q

Cutoff for high grade fever

A

38.5

66
Q

Most common areas enterococci can be found without being virulent

A

Skin, gut and biliary tree

67
Q

Mx of fibroepithelial polyps(skin tags)

A
  1. Snip excision
  2. Electrocautery
  3. Liquid nitrogen
68
Q

Causative agents of viral related cancers

A

HHV8: Kaposi Sarcoma
EBV: Primary CNS Lymphoma, NPC
HPV: Cervical Ca

69
Q

Linezolid coverage

A

Drug resistant gram positives eg VRE MRSA

70
Q

Antibiotic choices for CAP

A

Septic Shock: Augmentin + Ceftazidime + Azithromycin

Stable: Augmentin/Ceftriaxone + Azithromycin

71
Q

Antibiotic choice for HAP

A

Pip Tazo

72
Q

Mx of Cellulitis

A

Cefazolin or cloxacillin

Add ciprofloxacin if marine/freshwater exposure

73
Q

Mx of osteomyelitis

A

IV cefazolin/ cloxacillin

add
Pip Tazo if immunocompromise
Vancomycin if prosthetic joint

74
Q

Contraindications in neutropenic sepsis

A

DRE and Per Vaginal examinations: May cause bacterial translocation

75
Q

Why pyridoxine is given with isoniazid

A

To reduce risk of isoniazid induced neuropathy

76
Q

Indication for IV dexamethasone for COVID patients

A

2-4l of O2 supplementation required

77
Q

Ring enhancing lesions on CT brain suggest

A

CNS toxoplasmosis

Ddx: CNS lymphoma

78
Q

Duration of treatment for MSSA/MRSA bacteremia

A

4-6 weeks Abx

79
Q

New name for red man syndrome

A

Vancomycin flushing syndrome

80
Q

First line abx for febrile neutropenia

A

Pip tazo or cefepime

Mero IF neutropenic sepsis

81
Q

Treatment for candida fungemia

A

Fungins eg micafungin, fluconazole not 1st line

82
Q
A

Internal medicine (15 decks)

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