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IM Moonlighting > Infectious Disease > Flashcards

Infectious Disease Flashcards

(62 cards)

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1
Q

1st line URTI antibx

A

Amoxicillin 500 mg TID

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2
Q

2nd line URTI antibxs

A

Coamoxyclav 625mg BID
Azithromycin 500 mg OD for 3 days
Axithromycin 250 mg OD for 5 days

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3
Q

When should you expect the fever to lyse after taking antibx?

A

24-48 hours after

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4
Q

40% of URTI patients experience this

A

Post-infectious cough

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5
Q

Factors to consider in diagnosing an allergic rhinitis pt

A

Seasonal recurrence
History of asthma and atopy
Relation to exposure to allergens/ certain settings

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6
Q

When to refer an URTI patient to ORL

A

Weight loss

Obstructive symptoms

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7
Q

AR patient complains of bothersome weekly symptoms, what can you give?

A

Fluticasone furoate 2 puffs per nostril 2x a day

for 4-6 weeks

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8
Q

Tx for AR exacerbations

A

Loratidine 10mg ODHS

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9
Q

Tx for AR patient with itching and atopy

A

Cetirizine 10mg OD

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10
Q

Tx for AR patients w/ persistent discharge

A

Oxymetazoline spray (max: 3 days)

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11
Q

If most URTI are viral, when should we give antibx?

A

Mod symptoms not improving after 10 days
Symptoms worsen after 5 days
Severe symptoms

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12
Q

Dx tests for CAP

A

CXR

CBC w/ PC

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13
Q

Factors to consider in mod/high-risk CAP

A

RR >30
PR > 125
T > 40C or

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14
Q

Co-morbids t/c in mod/high-risk CAP

A 
DM
Active malignancy
Neurologic disease in evolution
CHF Class II-IV
Unstable CAD
Renal failure on dialysis
Uncompensated COPD
Decompensated liver disease
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15
Q

Factors t/c High-risk CAP

A

Severe sepsis
Septic shock
Need for mech vent

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16
Q

1st-line Antibx for CAP

A

Amoxicillin

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17
Q

Extended macrolides for CAP

A

Azithromycin

Clarithromycin

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18
Q

B-lactam/ B-lactamase inh combination (oral)

A

Co-amoxyclav
Amoxicillin-sulbactam
Sultamicillin

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19
Q

Oral 2nd gen ceph for CAP

A

Cefaclor

Cefuroxime axetil

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20
Q

Oral 3rd-gen ceph for CAP

A

Cefdinir
Cefixime
Cefpodoxime proxetil

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21
Q

IV non-antipseudomonal B-lactam

A 
Co-Amoxyclav
Ampicillin-Sulbactam
Cefotiam
Cefoxitin
Cefuroxime
Cefotaxime
Ceftizoxime
Ceftriaxone
Ertapenem
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22
Q

Respiratory fluoroquinolones for CAP

A

Levofloxacin

Moxifloxacin

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23
Q

Aminoglycosides for CAP

A

Gentamicin
Tobramycin
Netilmicin
Amikacin

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24
Q

IV antipseudomonal B-lactams for CAP

A 
Ceftazidime
Cefoperazone-sulbactam
Piperacillin-tazobactam
Ticarcillin-clavulanic acid
Cefepime
Cefpirome
Imipenem-cilastatin
Meropenem
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25
Low-risk CAP dx test
Sputum GS/CS (optional)
26
Antibx for prev healthy low-risk CAP pt
Amoxicillin | Extended macrolides
27
Antibx for low-risk CAP pt with stable comorbid
B-lactam/ B lactamase inhibitor | 2nd or 3rd gen ceph +/- extended macrolide
28
Dx tests for CAP-MR
Blood CS Sputum GS/CS Urine antigen for L. pneumophila Direct fluorescent Ab test for L. pneumophila
29
Antibx for CAP-MR
IV non-antipseudomonal B-lactam + extended macrolide | IV non-antipseudomonal B-lactam + respiratory FQ
30
Dx test for CAP-HR
``` Blood CS Sputum GS/CS Urine Antigen for L. pneumophila Direct fluoresecent Ab test for L. pneumophila ABG ```
31
Antibx for CAP-HR without risk for Pseudomonas
Same as CAP-MR
32
Antibx for CAP-HR with risk of Pseudomonas
IV antipseudomonal + IV extended macrolide + aminoglycoside | IV antipseudomonal + IV high-dose ciprofloxacin or levofloxacin
33
Factors determining risk for pseudomonal infx
``` Antibx use (for at least 1 week for the past month) Malnutrition Steroid use (Prednisone 2.5 mg in the past week) ```
34
What to do if pt is w/ pleural effusion or lung abscess?
Do thoracentesis | Refer to TCVS for CTT if warranted
35
What to do when there is hemodynamic instability/ progressing sepsis?
Refer to Pulmo, IDS
36
What to WOF in intubate patients
Hospital-acquired pneumonia
37
Upon resolution of CAP-LR...
follow-up after 3-5 days
38
Upon resolution of CAP-MR/HR
Step down but some ESBL organisms need full course via IV route
39
For how many months will the CXR return to normal?
6 months
40
Vaccinations for CAP patients with co-morbids
Influenza yearly | Pneumococcal vaccine once every 5 yrs
41
Sign of urethritis
Grossly purulent discharge expressed in the genital tract
42
Signs of cystitis
Suprapubic tenderness | Fever
43
Signs of acute pyelonephritis
CVA tenderness Fever Other signs of sepsis
44
Signs of catheter-related UTI
Turbid/ foul-smelling urine Purulent discharge Suprapubic tenderness
45
RFs for complicated UTI
``` Symptoms >7 days DM Immunosuppression Antibx use for the past 2 weeks Recent UTI or tract instrumentation (past 2 weeks) Renal disease/transplant Anatomic/ functional abnormality Urinary catheter use Hospital-acquired ```
46
Dx test for Complicated UTI
Urine GS/CS
47
When to tx complicated UTI in an outpt basis?
No signs of sepsis Without marked debilitation Ability to comply with tx Ability to maintain oral hydration/ take oral meds
48
Tx for uncomplicated cystitis
Antibx for 7 days (Nitrofurantoin 100mg QID or Cotrimoxazole 800/160 mg BID) Inc OFI No need for UA or urine culture except in Males Follow-up after 7 days (if unresolved, tx as complicated)
49
Dx tests for acute uncomplicated pyelonephritis
UA (WBC cast pathognomonic) | Urine GS/CS
50
Factors for tx of uncomp pyelonephritis in OPD basis
``` No s/sx of sepsis Nonpregnant Likely to comply with tx Able to tolerate oral meds Ff-up after 3-5 days ```
51
Empiric oral tx for uncomp pyelonephritis | remind pt to submit specimen for culture 1st
Ofloxacin 400 mg BID for 14 days Cefuroxime 500 mg BID for 14 days Co-amoxyclav 625 mg TID for 14 days (if GS is G+)
52
Empiric IV tx for uncomp pyelonephritis
Ceftriaxone 1-2g IV OD | Ampicillin-sulbactam 1.5 g IV q6 (if GS is G+)
53
What to do if fever persists after 72 hrs of tx?
Imaging (KUB-UTZ, or KUB-IVP if crea clearance is acceptable) Repeat urine culture
54
Urine culture b/w initial and repeat is the same, what is the duration of the tx?
4-6 weeks
55
Imaging studies show urologic ab(N), how long should you tx the pt?
2 weeks
56
Dx criteria for asymptomatic bacteriuria
>100,000 cfu in 2 consecutive midstream urine specimens | OR 1 catheterized specimen
57
Tx for asymptomatic bacteriuria
Same as uncomp cystitis
58
Recurrent UTI
more than 2x a year with no GUT abnormalities
59
Prophylaxis for recurrent UTI
(give post-coital, daily for 6-12 mos) Nitrofurantoin 100mg at bedtime Cotrimoxazole 200/40 mg at bedtime
60
Antibx prophylaxis that may be given for recurrent UTI as soon as sx 1st appear
2 double-strength cotrimoxazole
61
Oral antibx for complicated UTI
Ofloxacin 200 mg BID for 14 days | Levofloxacin 500 mg OD for 10 days
62
IV antibx for comp UTI
Ampicillin-sulbactam 1.5-3 g IV Q6 Ceftazidime 1-2 g IV Q8 Imipenem-cilastatin 250-500 mg IV Q6-8 (for 7-14 days)

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