Flashcards in Infectious Diseases - StepUp Deck (24):
most effective imaging study for dx osteomyelitis?
most direct and accurate means of dx. osteomyelitis?
needle aspiration/bone biopsy w/ culture
what tests are useful for monitoring response to therapy in osteomyelitis?
ESR and CRP - nonspecific for diagnosis
earliest tests for dx. of osteomyelitis?
technetium bone scan
Treatment of Osteomyelitis
1. oxacillin or vancomycin (MRSA)
2. plus aminoglycoside or 3rd gen. cephalosporin
3. surgical debridement (esp. adults)
patient presents with swollen, tender erythematous knee joint with a limited ROM
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
what lab tests would support dx. of septic arthritis?
1. blood cultures - positive in > 50 %
3. elevated ESR and CRP
4. CT/MRI - if sacroiliac or facet joints involved
most important test to confirm clinical suspicion of Lyme disease?
serology - ELISA for IgM and IgG antibodies; Western Blot to confirm
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
first line therapy for serious neurological and cardiac manifestations of Lyme disease
IV Ceftriaxone for 4 weeks
MC neurological complication of Lyme disease
bilateral Bell's Palsy
MC cardiac complication of Lyme disease
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)
best indicator of immune status in HIV/AIDs
cd4 cell count
prophylaxis for PCP pneumonia in AIDs
TMP-SMX when CDC < 200
prophylaxis for TB in AIDs
yearly PPD - if positive PPD, isoniazid + pyridoxine
prophylaxis for MAC in AIDs
when CDC < 100
clarithromycin or azithromycin
prophylaxis for toxoplasma in AIDs
when CDC < 100
which vaccines should all HIV-positive pts get?
uses of CD4 cell count monitoring
1. when to start prophylaxis
2. when to start HAART
3. adequacy of response to HAART
best method of assessing response to therapy in HIV/AIDs
HIV viral load
test used to screen for HIV