Infectious Disease Flashcards by Ashley Hamel

Things that dont grow on culture?

pneumocystis, syphilis.

How well did you know this?

Not at all

Perfectly

Bacteria covered by amoxicillin

HELPS

H.flu
E.coli
Listeria
Proteus
Salmonella

How well did you know this?

Not at all

Perfectly

only cephalosporin that will cover MRSA?

ceftaroline

How well did you know this?

Not at all

Perfectly

drugs that cover MRSA?

vanc, dapto, ceftaroline, linezolid

How well did you know this?

Not at all

Perfectly

what 3 organisms are resistant to all forms of cephalosporins?

Listeria, MRSA, Enterococcus

How well did you know this?

Not at all

Perfectly

why avoid ceftriaone in neonates?

impaired biliary metabolism

How well did you know this?

Not at all

Perfectly

what cephalosporin covers pseudomonas?

ceftazidime

How well did you know this?

Not at all

Perfectly

carbapenams are highly active against?

gram negative bacilli

How well did you know this?

Not at all

Perfectly

side effects of quinolones?

bone growth abnormalities

tendonitis and achilles tendon rupture

How well did you know this?

Not at all

Perfectly

moxifloxacin can be used as a single agent against?

diverticulitis/GI infections (vs other quinolones that need to be paired with metronidazole)

How well did you know this?

Not at all

Perfectly

what antibiotic can lead to Fanconi syndome (type II RTA)

doxycycline

How well did you know this?

Not at all

Perfectly

minor MRSA infection of skin are treated with?

TMP/SMX
Clinda
Doxy
Linezolid

How well did you know this?

Not at all

Perfectly

all of the ______ abx cover anearobes with equal efficacy to metronidazole?

lactam/beta-lactamase inhibitors

How well did you know this?

Not at all

Perfectly

meningitis in those with recent neurosurgery?

staph aureus

How well did you know this?

Not at all

Perfectly

meningitis with CD 4<100 ?

cryptococcus

How well did you know this?

Not at all

Perfectly

camper/hiker meningitis?

lyme

How well did you know this?

Not at all

Perfectly

what will cell count look like on LP for crypto, lyme, rickettsia, TB, viral?

10s-100s. lymphocytes

How well did you know this?

Not at all

Perfectly

How can you differentiate TB from others with protein level on LP?

TB protein- markedly elevated

How well did you know this?

Not at all

Perfectly

Answer head CT before LP whenever these signs are present??

papilledema, seizure, focal neuro abnml, confusion, blurred disc

How well did you know this?

Not at all

Perfectly

if contraindication to immediate LP, what do you do first?

abx

How well did you know this?

Not at all

Perfectly

when are bacterial antigen tests indicated in terms of meningitis?

patient received abx prior to LP and culture might be falsely negative

How well did you know this?

Not at all

Perfectly

most accurate test for TB meningitis?

acid fast stain and culture on 3 high volume LPs with centrifuge to concentrate organisms due to high protein load

How well did you know this?

Not at all

Perfectly

test for lyme and rickettsia meningitis?

serologic testing- ELISA, western blot, PCR

How well did you know this?

Not at all

Perfectly

Most accurate test for crypto in descending order?

culture > antigen > india ink

How well did you know this?

Not at all

Perfectly

How to treat meningitis if 1,000 of PMNs and on CSF?

ceftriaxone, vanc, steroids. add amp if immunocompromised. (steroids- dexamethasone)- has only been shown to lower mortality in S. pneumoniae infection but still give them because we wont have culture!

additional treatment considerations for neisseria meningitidis patients?

rifampin, cipro, ceftriaxone for close contacts (those with major contact- household, kissing, sharing things- not classmates) respiratory isolation

most common neuro deficit in untreated bacterial meningitis?

VIII CN deficit or deafness

Most common cause of encephalitis?

HSV

most accurate diagnostic test for HSV?

PCR of CSF

what is used for acyclovir resistant herpes meningitis?

Foscarnet

what should you do if a patient with HSV enceph on acyclovir gets a creatinine bump?

lower acyclovir dose and hydrate! (foscarnet is more toxic to kidney) valacyclovir and famciclovir are PO and not good enough for Enceph

when is tympanocentesis indicated for otitis media

multiple recurrences or no response to multiple abx

what is never the answer to "most accurate test" in ID questions?

Radiology!

most accurate test for sinus infection?

sinus biopsy or aspirate

should you ever culture nasal discharge for sinusitis?

NO!! (most common wrong answer)

What do you use for strep pharyngitis is allergy to penicillin is anaphylaxis?

clinda or a macrolide

Association with Yersinia infectious diarrhea?

Yersinia has a high association for iron (hemochromatosis- blood transfusions)

Best initial test for infectious diarrhea?

blood and or fecal leukocytes

what is more sensitive- stool lactoferrin or stool leukocytes?

stool lactoferrin (choose this if its an answer choice)

scombroid? found in? treat with?

most rapid onset of non-bloody diarrhea. wheezing, flushing, rash, found in fish, treat with antihistamine

Giardia treatment?

metronidazole, tinidazole

cryptosporidiosis tx?

treat AIDS, nitazoxanide

Hep D exists exclusively in those with?

Hep B

Which Hep rarely presents with acute infection- but is found incidentally on blood tests

What abnormal lab test correlates best with increased likelihood of mortality?

Prothrombin Time

what lab marker becomes abnormal first in hep B?

Surface antigen

e-antigen for Hep B indicates a high level of?

DNA polymerase activity

what lab marker indicates that a patient is no longer at risk for transmiting hep B infection?

No surface antigen found

what lab marker is best indication for needed treatment with antiviral meds for hep B?

e-antigen

best indicator that a pregnant woman will transmit hep B to her child?

1. Hep B viral load (more precise) and e-antigen (DNA polymerase)

chronicity of hep B is defined as?

persistence of surface antigen > 6 months

adverse effects of interferon

arthralgia/myalgia leukopenia and thrombocytopenia depression and flu (interferon is never the first right choice because it an injection and SE)

Ribavirin causes?

anemia

should you test for Hep C based on risk factors?

What is the only acute viral hepatitis infection that needs treatment?

Hep C

What predicts response to therapy in Hep C?

genotype

how to differentiate urethritis and cystitis?

both have urinary frequency and burning. cystitis does not have urethral discharge

what is the most accurate test for PID?

laparoscopy (although you diagnose with cervical swab)

What is the most sensitive test of CSF for neurosyphilis?

FTA!!

does a negative FTA of CSF exclude neurosyphilis?

yes

Does a negatie VDRL/RPR of CSF exclude syphilis?

NOoo

Titers of VDRL or RPR are reliable at greater than ___?

1:8

What can give you a false positive VDRL/RPR?

infection, older age, IV drug use, AIDS, malaria, antiphospholipid, endocarditis

Jarisch-Herxheimer rxn?

fever and worse symptoms after treatment for syphilis | Give ASA and antipyretics- it will pass

If patients with tertiary syphilis are allergic to penicillin what do you do? exception?

desensitize. Not in pregnant women!

how to diagnose condyloma accuminata?

PE- physical appearance

Imiquimod and pdophyllin (trichloroacetic acid) are both used for?)

HPV warts

how do you treat crabs?

permethrin

best initial therapy for pyelo?

ceftriaxone

what do you treat pyelo with until urine culture results are known?

amp and gent

diagnostic yield of a urine culture for prostatitis is greatly increased with?

prostate massage

how to treat prostatitis?

6-8 weeks of ciprofloxacin or TMP/SMX

fever and heart murmur =

endocarditis

Man comes in to ED with fever and murmur and blood cultures grow Clostridium Septicum. What should you do next?

Colonoscopy- Clostridium Septicum has more of an association with colon cancer than Strep Bovis

Best initial empiric therapy for endocarditis?

Vanc and Gent

treatment of viridans strep endocarditis?

ceftriaxone for 4 weeks

treatment of staph aureus endocarditis (sensitive)

oxacillin, naf, cefazolin

fungal endocarditis treatment?

amphotericin and valve replacement

staph epidermidis or resistant staph aureus treatment for endocarditis?

Vancomycin

Treatment for enterococcus endocarditis?

amp and gent

when is surgery the answer for endocarditis management?

CHF from ruptured valve or cordae tendineae, prosthetic valves, fungal endo, abscess, AV block, recurrent emboli while on abx

What drug should you add for a prosthetic valve endocarditis infected with Staph?

Rifampin

most common cause of culture negative endocarditis?

Coxiella

single strongest indication for surgery with endocarditis is?

valve rupture with CHF

How do you treat the HACEK organisms?

Ceftriaxone

Best management for endocarditis prophylaxis?

amoxicillin prior to procedure

If the patient is penicillin allergic- what is the best prophylaxis for endocarditis?

clindamycin, azithromycin, clarithromycin

Is valvular heart disease- including mitral valve prolapse a reason to give prophylaxis for endocarditis?

When is a single dose of doxy indicated for tick bite?

-If within 72 hours of tick bite- you can identify ixodes scapularis clearly as identifying cause, tick is attached for longer than 24 hours, engorged tick on skin, endemic area

how do you diagnose HIV in babies?

viral load. ELISA unreliable because of maternal antibodies.

what antiretroviral is contraindicated in pregnancy?

efavirenz

Management of anaphylactic reaction?

epinephrine, antihistamines s(H1-blocker) and ranitidine (H2 blocker), Glucocorticoids- methylprednisolone or hydrocortisone, emergent airway protection if needed

Hereditary angioedema does not respond to what management?

glucocorticoids

best test for angioedema diagnosis?

C2 and C4. Deficiency of C1 esterase inhibitor

Specific therapy for angioedema?

FFP or Ecallantide | Long term with androgens (danazol or stanazol)

CVID gives a marked increase in a patients risk of?

lymphoma

recurrent skin infections with staph indicates what syndrome?

Hyper IgE

only definitive treatment for Wiskott-Aldrich syndrome?

bone marrow transplant

Infectious Disease Flashcards

(98 cards)