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Flashcards in Infectious Diseases - StepUp Deck (24):
1

most effective imaging study for dx osteomyelitis?

MRI

2

most direct and accurate means of dx. osteomyelitis?

needle aspiration/bone biopsy w/ culture

3

what tests are useful for monitoring response to therapy in osteomyelitis?

ESR and CRP - nonspecific for diagnosis

4

earliest tests for dx. of osteomyelitis?

technetium bone scan
MRI

5

Treatment of Osteomyelitis

1. oxacillin or vancomycin (MRSA)
2. plus aminoglycoside or 3rd gen. cephalosporin
3. surgical debridement (esp. adults)

6

patient presents with swollen, tender erythematous knee joint with a limited ROM

septic arthritis

7

what test do you do in all cases of septic arthritis?

joint aspiration and analysis of synovial fluid
- WBC count > 50 000 and > 80% PMNs

8

what lab tests would support dx. of septic arthritis?

1. blood cultures - positive in > 50 %
2. leukocytosis
3. elevated ESR and CRP
4. CT/MRI - if sacroiliac or facet joints involved

9

most important test to confirm clinical suspicion of Lyme disease?

serology - ELISA for IgM and IgG antibodies; Western Blot to confirm

10

first line therapy for early Lyme disease

oral Doxycycline for 21 days (10 days if confined to skin)
Amoxicillin for pregnant pts and children < 12 yo

11

first line therapy for serious neurological and cardiac manifestations of Lyme disease

IV Ceftriaxone for 4 weeks

12

MC neurological complication of Lyme disease

bilateral Bell's Palsy

13

MC cardiac complication of Lyme disease

AV block

14

when is C-section indicated in AIDs pregnant patient?

if viral load is > 1000 copies
(if CD4 count is > 500 and viral load is < 1000, C/S not necessary)

15

best indicator of immune status in HIV/AIDs

cd4 cell count

16

prophylaxis for PCP pneumonia in AIDs

TMP-SMX when CDC < 200

17

prophylaxis for TB in AIDs

yearly PPD - if positive PPD, isoniazid + pyridoxine

18

prophylaxis for MAC in AIDs

when CDC < 100
clarithromycin or azithromycin

19

prophylaxis for toxoplasma in AIDs

when CDC < 100
TMP-SMX

20

which vaccines should all HIV-positive pts get?

pneumococcal
influenza
hepatitis B

21

uses of CD4 cell count monitoring

1. when to start prophylaxis
2. when to start HAART
3. adequacy of response to HAART

22

best method of assessing response to therapy in HIV/AIDs

HIV viral load

23

test used to screen for HIV

ELISA

24

confirmation test for HIV

Western blot