Infectious Disease 6 Flashcards
(15 cards)
What are the three most common organisms that cause acute Otitis Media?
- Strep Pneumoniae
- Untypable Haemophilus Influenzae
- Moroxella Catarrhalis (much less that first two)
Dx of Otitis Media is clinical… with observation of middle ear effusion with bulging erythematous tympanic membrane, ext.
- What is the first line ABX for treatment?
- What ABX is treatment of choice for recurrence of OM within 1 month of treatment with ABX?
- Amoxicillin
2. Amoxicillin + Clavulanic Acid
- How is Chlamydia Screened in Pregnancy?
- What are the three complications of Chlamydia infection in pregnancy?
- How do you Treat Chlamydia in Pregnancy?
- Universal screening at FIRST prenatal visit.
IF HIGH RISK, repeat screen in 3rd Trimester. - PPROM
- Pre-term Labor
- Post Partum Endometritis
- Azithromycin (same as non-pregnant), BUT retest to ensure eradication (non-pregnant don’t need retesting.)
Bacterial Prostatitis can be acute or chronic (>3 months) and presents with UTI symptoms + GU area pain +/- prostate tenderness +/- “boggy prostate” +/- painful ejaculation…
How do you treat Bacterial Prostatitis?
6 week of a Fluoroquinolone (Ciprofloxacin) or TMP-SMX
Health care workers (HCW) are required to get 3 vaccination series for Hep B. Several months after finishing vaccines, you should get tested to ensure Anti-HBs is >10 (suggesting immunity)…
What do you do if a HCW gets a needle stick from a patient who is HEP B positive (HBsAg positive)?
- IF HCW is immune (finished 3 course vaccine and Anti-HBs titer >10): NO INTERVENTION
- IF HCW not immune: Hep B Immunoglobulin + start Vaccine series (0, 2 and 6 mths.)
What is the treatment for Acute (<4 weeks) Bacterial Rhinosinusitis?
AMOXACILIN - CLAVULANATE for 5-7 days.
A person recently travelled to a developing country, develops brief pulmonary symptoms (cough) that resolved and gives way to GI problems (diarrhea, nausea, abd pain). They are Eosinophilic and CBC shows Iron def anemia.
What is the diagnosis?
Hos do you TRX?
Intestinal Helminth Infection.
TRX with Abendazole or any other “-bendazoles”
After successful treatment of Otitis Media with ABX, you can continue to have Serous otitis media (SOM) with tympanic retraction, yellow fluid behind TM, and decreased TM mobility. Usually no treatment is needed except in these 3 circumstances.
- Continued symptoms of infection
- Bilateral effusion present
- > 3 month duration.
What percent of Adults with Acute Hep B infection progress to chronic disease?
What percentage of Infant with vertical transmission from mom progress to chronic?
What percentage of Children (1-5 yo) with Acute Hep B infection progress to chronic?
Adults –> 5 %
Infants –> 90 %
Children –> 25-50%
What are the symptoms of EARLY LYME?
What are the Symptoms of EARLY DISSEMINATED LYME (weeks to months)
What are the symptoms of LATE lyme (months to years?)
EARLY:
- Erythema Migrans/Target lesion at site of bite (starts macular)
- Constitutional symptoms
- Myalgia/Arthralgia
EARLY DISSEMINATED:
- Several Target lesions
- Bilateral or unilateral Bells balsy
- MIGRATORY Arthralgia
- AV block
- Meningitis
LATE:
- Arthritis (PMNs but no bugs)
- Encephalitis
- Peripheral Neuropathy.
How do you diagnose LYME?
TRX?
TRX if pregnant?
EARLY disease = Clinical, because serological testing may be negative.
DISSEMINATED or LATE –> B. Burgdorgeri ELISA, then western blot.
TRX = Doxycycline 10-14 days
Pregnant TRX = Amoxicilline 14-21 days.
What is the tetanus PPX given in the following scenarios?
- Clean or MINOR wound, AND 3 or more tetanus vaccines in past?
- Clean of MINOR wound, and LESS than 3 prior tetanus vaccine doses?
- Dirty or SEVERE wound, and 3 or more tetanus vaccines in past?
- Dirty or SEVER wound, and LESS than 3 prior tetanus doses?
- CLEAN + 3 prior Tetanus vaccine doses = Tatanus vaccine if > 10 years ago. NO IVIG.
- CLEAN + < 3 vaccine doses = Tetanus vaccine. No IVIG
- DIRTY + 3 prior tetanus vaccines doses = Tetanus vaccine if > 5 years ago. NO IVIG.
- DIRTY + < 3 vaccine doses = tetanus vaccine + IVIG.
PCP PNA (Pneumocystic Jirovecii Pneumonia) is found in what group of people?
What are the four hallmark symptoms?
CXR of PCP PNA classically shows?
HIV with CD4 < 200 (opportunistic fungi)
Symptoms:
- indolent fever
- Weight loss
- DRY cough
- Profound hypoxia
CXR = BILATERAL interstitial and alveolar infiltrates.
How do you diagnose PCP PNA?
Isolation of fungus in sputum sample.
HOWEVER, can be negative in 10-50%, so do FIBEROPTIC BRONCHOSCOPY AND LAVAGE, if clinical suspicion is high (sensitivity 90-100%)
HOW do you treat PCP PNA?
IN what situation do you add Steroids in trx?
TMP-SMX
ADD STEROIDS IF:
- A-a gradient >35mmHg
(or) - Pao2 <70mmHg on room air.
