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Flashcards in Infectious disease Deck (44)
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1

Criteria for in patient, IV tx for pneumona

>65, comorbidities (ETOH, COPD, DM, malnutr), immunospr, malignancy, unstable vitals, AMS, multilobular

2

Empiric coverage: outpatient CAP

macrolide (eg azithromycin) or doxycycline

3

Empiric coverage: CAP requiring hosp

flouroquinolone or antipneumococcal b-lactam (eg piperacillin, ceftazidime) + macrolide (eg azithromycin)

4

Empiric coverage: CAP requiring ICU

antipneumococcal b-lactam (eg piperacillin, ceftazidime) + azithromycin or flouroquinolone

5

Empiric coverage: pneunomonia, critically ill, not responding to abx

vancomycin or linezolid, broad gram neg coverage

6

Empiric coverage: HAP

Extended-spectrum cephalosporin or carbapenem with antispeudomonal activity
Add aminoglycoside or flouroquinolone while sensitivity pending

7

Tb findings for normal host, immunocompr

Normal host: cavitary infiltrate upper lobe
Immunocompr, primary tb: lower lobe infiltrates, can be without cavitation
Miliary tb: multiple fine nodular densities

8

Tx: active and latent Tb

Active: 4x therapy (INH, pyriazinamide, rifampin, ethambutol) x2mo, INH+ rifampin x4mo
Latent: INHx9mo or rifampinx4mo

9

Common side effects:
-Rifampin
-Ethambutol
-INH

-Rifampin: turns fluids orange, P450 inducer
-Ethambutol: optic neuritis
-INH: peripheral neuropathy, hepatitis

10

Therapy for GAS

penicillin x10d
cephalosoprin, amoxicillin, azithromycin= alternatives

11

Lemierre's syndrome: defn, causative organsm

Thrombophlebitis of jugular vein after pharyngitis
fusobacterium (oral anaerobe)

12

odynophagia, trismus, muffled voice, asymmetric uvula: dx and tx

peritonsallar abscess, US or CT + Cx
Abx + surgical drainage

13

HIV+, filipin, Af Am, pregnant from SW US who present with respiratory infxn: dx and tx

Coccidiomycoisis
Tx: PO fluconazole or itraconozaole
IV amphotericin B for severe
progressive symptomatic disease: surgery+ long term azole (8-12mo)

14

Meningococcal meningitis: Ppx and tx

Ppx: rifampin
Tx: ceftriaxone

15

Important adjunctive treatment for meningitis

Dexamethasone: (esp S. pneumo, H flu), give 15-20min before abx

16

Cerebral edema: dx tests and tx

loss oculocephalic reflex
CT/MRI
tx: IV mannitol

17

subdural empyema: presentation and tx

intractable seizures
Tx: surgical evacuation

18

CSF findings: bacterial vs viral menigitis

Bacterial: incr WBC (>1000 PMNs), decr glc, incr prot (>45) and opening pressures (>20)
Viral: Incr WBCs (mono/lymph), prot and opening pressure may be incr or normal

19

CSF finding: MS

incr gamma globulin

20

RBCs in CSF without a hx of trauma

HSV encephalitis

21

India ink stain (CSF)

cryptococcus

22

Giemsa stain (CSF)

trypnaosomes

23

Empiric treatment: meningitis

ampicillin + cefotaxime or gentamicin

24

Empiric treatment: Meningitis >1mo-adult

vancomycin + cetriaxone or cefotaxime

25

Empiric treatment: meningitis >60/ETOH

ampicillin + vancomycin + cefotaxime or cetriaxone

26

cranial nerve defects assoc with incr ICP, nature of headache

CN III, VI

27

headache, fever, local neuro deficit: dx and tx

typical of brain abscess (consider brain met if no fever)
Surgical drainage if >2cm
3rd gen cephalosporin (ceftazidime, ceftriaxone) + metronidazole +/- vancomycin (6-8wks)
Dexa/ IV mannitol

28

When start HAART, what use?

symptomatic pt, CD4

29

pseudohyphae + budding yeast, germ tupes at 37 deg: dx and tx

candida
PO azole

30

45 deg branching septate hyphae with rare fruiting bodies: dx and tx

aspergillus