Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

COPY 23 May > Infectious-Miscellaneous > Flashcards

Infectious-Miscellaneous Flashcards

1
Q

Allergic Rhinitis

Two indications for intranasal Ipratropium

A
  1. Skiers’ Nose= Vasomotor Rhinitis
  2. Allergic rhinitis with severe rinorhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Allergic Rhinitis

Recommended Tx for moderate to severe cases:

A

Intranasal Chromolyn

Or Intranasal CS like Beclomethasone

(CS is stronger than Chromolyn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Allergic Rhinitis

Safety of Antihistamines in children

A

Above 6 yo is ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Allergic Rhinitis

Safety of Decongestants in Children

A

Above 12 yo is ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Allergic Rhinitis

Safety of Decongestants like Pseudoephedrine op Phenylephrine In Pregnancy?

A

1st trimester: not safe

Then: safe

(Note: H1 blockers are safe in Pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Allergic Rhinitis

Decongestants like Pseudoephedrine or Phenylephrine: CIs:

  • HTN - MI - Hyperthyroidism - ……..?
A

With MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute Bronchitis

Dextromethorphan safety:

  1. In Pregnancy?
  2. In children?
A
  1. Safe
  2. Above 6 yo is ok
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Influenza Vaccine is recommended to 4 groups:

  1. Everybody with systemic disease like DM
  2. Everybody above …… yo of age.
  3. All pregnant women.
  4. In children ?
A
  1. Above 65 yo
  2. From 6 months to 5 yo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Influenza

What if someone is egg allergic? (Vaccination)

A

No live vaccine.

but Inactive is safe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Influenza

Amantadine in prophylaxis?

A

Not recommended any more.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Influenza Vaccines:

  1. Flu shot: TIV and QIV (Inactive) which is IM
    - in Pregnancy?
    - which age groups?
A
  • Pregnancy: ok
  • Above 6 months is ok to everyone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Influenza Vaccines:

  1. Flumist (LAIV): Nasal Spray (Live virus)
    - in Pregnancy?
    - which age groups?
A
  • Pregnancy: No
  • Age: Only between 2-60 yo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Influenza Vaccines

Which one is safe in Breastfeeding?

A

Both are safe in Breastfeeding

But no Flumist in Pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Influenza

Tx 1st line ?

Duration ?

A

Oseltamivir (Tamiflu) Start early, duration is 5 days

but it is NOT a routine Tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Influenza Tx

Why is Zanamivir 2nd line?

A

It may cause bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Influenza Tx

Safety in Pregnancy and Breastfeeding

  • Oseltamivir
  • Zanamivir
A

Both are safe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Influenza Vaccines In Children:

  • below 6 months: No Vaccines
  • 6 months to 2 yo: ?
  • above 2 yo: ?
A

6 mon- 2 yo: IM (inactive) is ok

Above 2 yo: both types are ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Strep Sore Throat

Initial test is RADT (Rapid Ag Detection Test) which takes up to 1 hour to respond. If (+) then?

A

Tx with ABs

because it is highly Specific for Strep Group A.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Strep Sore Throat

Initial test is RADT (Rapid Ag Detection Test) which takes up to 1 hour to respond. If (-) then?

A

In Children: Do Throat Culture and wait 48 h for the result. If (+) then AB, if (-) no AB

In Adults: No need for Culture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Strep Sore Throat

If we do not immediately start the Tx with ABs in a Strep pharyngitis, what about the risk of RF in children?

A

Usually, up to 7-10 days of delay is safe. Therefore, a culture (48h) has no risk at all.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Strep Sore Throat

Initial test is RADT, but what if RADT is not available in the area we work?

A

All ages: Do a throat culture and wait for 48h.

48 h is not a risky delay. Do not prescribe ABs without RADT and Culture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Strep Sore Throat How many percent of sore throats is caused by Strep beta hemolytic group A?

A

In Children: 30%

In Adults: 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Strep Sore Throat

Is RADT able to diagnose acute disease from Carriers?

A

No, Both will be (+)

Note: we do NOT need to repeat RADT after AB therapy to make sure of eradication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Strep Sore Throat

Nonpharma Tx:

  1. Hand washing
  2. School?
A

Do not go to school until 24 h After starting the AB therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Strep Sore Throat

1st line treatment:

A

Penicillin V Oral

Or Amoxicillin Oral (Syrup)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Strep Sore Throat

If allergic to Penicillin?

A

Mild allergy: Cephalexin

Severe allergy: Azithromycin or Clindamycin

(No Erythromycin because of GI SEs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Antibiotics

Safety of Erythromycin in Pregnancy?

A

Do not use Estolate salt.

It may cause Cholestatic Hepatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Sinusitis

1st line Tx in Canada

A

Amoxicillin

7-14 days in Adults

10-14 days in Children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Sinusitis

If 1st line treatment with Amoxicillin fails?

A

Amoxicillin-Clavulanate

but If intolerant to Amoxicillin: Then Fluoroquinolone (No Macrolide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Sinusitis

Tx if allergic to Penicillin?

A

If <8 yo Clindamycin + Cefixime

If >8 yo Doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Sinusitis

If chronic (>12 weeks), DOC ?

A

Amoxicillin-Clavulanate for 3w

Or Clindamycin for 3w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Sinusitis

If the patient has received an AB within the last 3 months, then ?

A

Pick from another class of ABs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Sinusitis

Indications for HD dosing of Amoxicillin

  1. Children who go to daycare
  2. …………… 3. ……………
A
  1. Children < 2yo
  2. ABs within the last 3 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

AOM

1st line Tx in Canada is Amoxicillin

SD= Standard Dose= …….. mg/kg/day

HD= High Dose= …….mg/kg/day

A

SD: 40 mg/kg/day

HD: 75-90 mg/kg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

AOM

Duration of Tx in Canada in Children?

A

Age < 2yo: 10 days

Age > 2yo: 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

AOM

If the child is < 6 weeks old?

A

Do not treat

Refer ASAP to ER for Sepsis workup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

AOM

If the child is between 6w to 6 months old?

A

Tx: HD Amoxicillin (or maybe SD) For 10 days

If failure: HD Amoxicillin-Clavulanate

(Only the Amoxicillin part should be HD)

No watchful waiting below 6 months old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

AOM

If the child is above 6 months old?

A

Tx: HD Amoxicillin (or maybe SD) For 10 days (If above 2 yo, 5 days)

If failure: HD Amoxicillin-Clavulanate

(Only the Amoxicillin part should be HD)

Consider watchful waiting in some cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

AOM

When would you consider a watchful waiting in Children ?

  1. Age …………..
  2. No complications, No underlying disease
  3. Parents are trustworthy
A

Age above 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

AOM

Indications for 2nd line Tx (HD Amoxicillin-Clavulanate):

  1. Failure of Amoxicillin (HD or SD)
  2. …………
A

Recurrent episodes of AOM (Also consider referring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

AOM

Tx if allergic to Penicillin

A

If mild: Cefixime or Cefuroxime

If severe: Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Croup (Laryngo-tracheo-bronchitis)

Caused by Parainfluenza type 1,3

1st line Tx?

A

Dexamethasone Single dose, PO

(Oral is Preferred, but IM or IV is also Ok)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Croup

Oxygen therapy

  1. Preferably ……….
  2. Avoid ………
A

Preferably “Blow-by” Oxygen To be held in front of mouth and nose, while sitting on mother’s lap

Avoid mist tents (Increases Agitation)

Heliox might be helpful as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Croup

Tx if the child is very ill

or not responding to oral Dexamethasone

or vomiting

A

Nebulized Budenoside

+|- Nebulized Epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Croup

About Epinephrine:

  1. It is not a 1st line or routine Tx.
  2. It is L-Epinephrine 1:1,000
  3. Racemate is no longer available in Canada
  4. It lasts for ……
A

2 hours

Dose is 5 ml, independent of wt or age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Pneumonia

Severity and risk of death: CURB65

C. new Confusion

U. Urea above ……

R. RR above ……

B. BP: SBP < 90, DBP < 60

A

Urea above 7

RR above 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Pneumonia

Respiratory Quinolones 1. ? 2. ?

A
  1. Moxifloxacin
  2. Levofloxacin

ML: MaLe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Pneumonia

DOC if Strep Pneumoniae (Pneumococcus)

A

MIC to Penicillin:

If <2, Penicillin G or Amoxicillin

If >2, Cephalo 3rd or Resp Quinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Pneumonia

DOC if Hemophilus

A

Cephalo 3rd

or Amoxicillin-Clavulanate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Pneumonia

DOC if Staphylococcus

A

MSSA: Cloxacillin

MRSA: Vancomycin or Linezolide

(No Daptomycin or Tigecycline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Pneumonia

DOC if Legionella

A

Macrolide or Resp Quinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Pneumonia

DOC if Mycoplasma or Chlamydia

A

Macrolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Pneumonia

DOC if Q Fever (Coxiella Brunetti)

A

Resp Quinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pneumonia

DOC if Gram negative aerobic (Like Klebsiella)

A

Cephalo 3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Pneumonia

Duration of Tx in CAP

A

If outpatient and good condition: 5 days

Otherwise: 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Pneumonia

Tx If aspiration happens:

Pneumonitis: ……..

Pneumonia: ………

A

Pneumonitis: no AB

Pneumonia: Metronidazole or Clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Pneumococcal Vaccines

  • 23 Valent (Capsular, Polysaccharide)
  • 13 Valent (Conjugated)

Which one is used in HIV+ and in Infants?

A

13V: infants and HIV+

23V: children above 2 yo and adults >65 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Antibiotics

SEs of Linezolide

  1. Myelosuppression 2……..
A

Serotonin Sd with SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Pneumonia

Criteria for the day of discharge:

  1. SaO2> 92%
  2. RR ……. 3. HR …….
A

RR <24

HR <100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

TB Mantoux test (PPD)

CIs:

  • Proven active TB
  • Eczema or burns (if severe)
  • ……….
A

Live viral vaccine in past 1 month (Like MMR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

TB

Hepatotoxic medications: PYR, INH, RIF

Definition of hepatotoxicity

  1. If asymptomatic: LFT x5 NL
  2. …….
A

If symptomatic, LFT x3 NL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

TB Indications for CS:

  1. TB Meningitis
  2. TB Pericarditis
  3. ……..
A

IRIS in AIDS (Immune Reconstitution Inflammatory Sd)

If antiretrovirals are used with anti TBs at the same time, Fever+ malaise + local reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Diabetic Foot

DOC if infection is localized

A

Amoxicillin-Clavulanate Oral

Or Cephalexin oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Diabetic Foot

DOC if infection is extensive

A

If oral: Amoxicillin-Clavulanate or Ciprofloxacin

If IV is needed: Cephalosporin + Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Osteomyelitis

Empiric Tx in Neonates?

A

Cloxacillin + Cefotaxime

Or Vancomycin + Cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Osteomyelitis

Empiric Tx in Children

A

Either Cloxacillin or Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Osteomyelitis

Empiric Tx in adults?

A

Cloxacillin

Note: Cloxacillin can be replaced by Cefazolin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Osteomyelitis

Duration and route of AB therapy

A

Usually 4-6 weeks

Usually 2w IV then switch to oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Osteomyelitis

Empiric therapy if penetrating wound

  • in Children? - in Adults?
A

Ch: Cloxacillin + Ceftazidim + Gentamicin

Ad: Quinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Bacterial Meningitis

1st line Tx In Adults

A

Vancomycin + Ceftriaxone 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Bacterial meningitis

Tx in Children If > 3 months?

A

Like adults:

Vancomycin + Ceftriaxone 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Bacterial meningitis

Tx in Children

  1. If between 6w to 3 months
  2. If below 6w
A

6w-3mon Ampicillin+Vancomycin+Ceftriaxone/Cefotaxime

< 6w Ampicillin + Cefotaxime

(For Listeria, GBS, Enterobacteriacea : 21 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Bacterial meningitis Tx in Adults if above 50

A

Ampicillin + Vancomycin + Ceftriaxone

(Note: the same Tx is used for alcoholics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Bacterial meningitis

Use of CS:

  1. Decreases risk of neurological sequels
  2. DOC is Dexamethasone
  3. ………
A

It must be used either before the first dose of AB or together with the first dose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Bacterial meningitis

Post-exposure Tx for Hemophilus:

  1. DOC is Rifampin
  2. Dosage is 20 mg/kg ………….
  3. Prophylaxis in Pregnancy ?
A
  1. Once daily for 4 days
  2. Not recommended.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Bacterial meningitis

Post-exposure Tx for Meningococcus:

  1. DOC is Rifampin
  2. Dosage is 20 mg/kg ………….
  3. Prophylaxis in Pregnancy ?
A
  1. Once daily for 2 days
  2. Single dose of Ceftriaxone
77
Q

Infective Endocarditis

DOC if Staphylococcus on NL valve

A

MSSA: Cloxacillin

MRSA: Vancomycin

78
Q

Infective Endocarditis

DOC if Staphylococcus on Prosthetic valve

A

Add (Rifampin + Gentamicin) To Cloxacillin

or to Vancomycin

79
Q

Infective Endocarditis

DOC if Streptococcus (any type, any valve)

A

Vancomycin

80
Q

Infective Endocarditis

DOC if Enterococcus

  1. All sensitive
  2. Penicillin resistant
  3. Gentamicin resistant
  4. All resistant
A

1,2 Vancomycin + Gentamicin

3 Vancomycin + Streptomycin

4 Linezolide or Imipenem

81
Q

Infective Endocarditis

DOC if HACEK

A

Ceftriaxone or Cefepime

82
Q

Infective Endocarditis

DOC in Prophylaxis

A

Amoxicillin 2 g Oral

Or Ampicillin 2 g IV or IM

83
Q

Infective Endocarditis

DOC in Prophylaxis If allergic to Penicillin

A

Cephalexin 2 g PO

Or Cefazolin 1 g IV or IM

84
Q

Sepsis, Septic Shock

  1. Do not use bicarbonate, unless ……
  2. The best vasoactive is …….
A

PH < 7.15

NE (Neurepinephrine)

85
Q

Sepsis, Septic Shock

Empiric AB if the source of infection is

  • Unknown - Nosocomial - GI or GUT
A

All: Meropenem

86
Q

Febrile Neutropenia

DOC If Inpatient?

If possibly outpatient?

A

In: Meropenem or Ceftazidime

Out: Amoxicillin-Clavulanate + Ciprofloxacin

87
Q

Traveller’s Diarrhea Nonpharma Tx:

  • Na+ Hypochlorite, filters, iodine are good
  • Alcohol is not disinfectant for water
  • No ABs for prophylaxis is needed
  • Boil it, cook it, ……….
A

Peel it or forget it!

88
Q

Traveller’s Diarrhea

BSS: Bismuth Sub Salicylate is a good choice, but caution:

  1. Do not use if taking Warfarin
  2. ……….
A

Do not use if taking Salicylates Or in Children < 3 yo Risk of Rey’s Sd or Encephalopathy

89
Q

Traveller’s Diarrhea

AB therapy?

A

Is not always needed

If needed: DOC is Quinolone

90
Q

Traveller’s Diarrhea

Tx in Children

  1. AB ?
  2. Loperamide?
A
  1. Quinolones are CI, use Azithromycin
  2. Loperamide is CI below 3 yo
91
Q

Traveller’s Diarrhea

Tx in Pregnancy

  1. AB?
  2. BSS, Loperamide ?
  3. Iodine ?
A
  1. Quinolones are CI, use Azithromycin
  2. BSS is CI, Loperamide is ok.
  3. Iodine is CI
92
Q

Traveller’s Diarrhea

How to prepare an ORS by ourselves?

A

5 mL salt + 30 mL sugar In 1 Liter of water

93
Q

HIV

  1. All patients should take an allergy test to ………
  2. All patients are recommended to take a tropism test for ………
A
  1. Abacavir (NRTI)
  2. Maraviroc (Entry Inhibitor)
94
Q

HIV

Vaccinations in AIDS:

Pneumococcal: Yes

Influenza: Yes

MMR? Varicella?

A

MMR, Varicella: Yes, as long as CD4 is above 200

95
Q

HIV

Protease Inhibitors SEs in general:

  1. Enzyme Inhibitors
  2. ………….
A

Hyperglycemia

Hyperlipidemia

96
Q

HIV

Common SEs of NRTIs in general:

  1. BM Suppression 2………. 3. Lactic acidosis
A

Peripheral Neuropathy

97
Q

HIV

NNRTIs general SEs

  1. Rash 2……..
A

Hepatitis

98
Q

HIV

Tenofovir (NtRTI) is infamous for?

A

Osteoporosis

99
Q

HIV

  • Indinavir (PI) is infamous for renal stones.
  • Didanosine (NRTI) is infamous for: 1. Pancreatitis 2……….
A

Gout

100
Q

HIV

Efavirenz (NNRTI) is infamous for 1. Teratogenicity 2…………

A

CNS toxicity

Psychiatric SEs

101
Q

HIV In Pregnancy:

  1. Start Tx at week …….
  2. Efavirenz is CI
  3. Cesarean?
A
  1. 14th
  2. Only if CD4 is low or Viral load is high
102
Q

HIV with Breastfeeding?

A

Breastfeeding is CI in HIV

103
Q

HIV After a needle stick?

A

4 weeks Three medications

Usually: Zidovudine + Lamivudine + Nelfinavir

104
Q

HIV

Etravirine (NNRTI) is infamous for ………

A

SJS

105
Q

HIV

Nevirapine (NNRTI) is infamous for ………

A

Hepatotoxicity

106
Q

HIV

Atazanavir (PI) Is infamous for ………

A

Increased Bil

Renal stones

107
Q

HIV

Darunavir (PI) is infamous for ………

A

Hepatotoxicity

108
Q

HIV

Fosamprenavir (PI) is infamous for ………

A

Cardiovascular risks

109
Q

HIV There is an exception in which you should not do CART with specific treatment of the opportunistic infection at the same time.

A

Cryptococcal Meningitis

110
Q

HIV There are two opportunistic infections that we don’t recommend prophylaxis

A
  1. Cryptococcal
  2. CMV
111
Q

HIV

Indication of Prophylaxis for:

  1. PCP?
  2. Toxoplasmosis?
  3. MAI?
A

CD4 <200

<100

<50

112
Q

HIV

DOC in Prophylaxis for PCP?

For Toxoplasmosis?

A

Both: SMX/TMP

113
Q

HIV

DOC in Prophylaxis of MAI?

A

Azithromycin 1 dose/week

114
Q

HIV

DOC in Prophylaxis of Candidiasis?

A

Fluconazole

115
Q

HIV

DOC in Tx of Bartonellosis

A

Doxycycline

116
Q

HIV

DOC in Tx of Cryptococcal meningitis

A

Amphotericin B +/- Flucytosin

Then Fluconazole as maintenance

117
Q

HIV

DOC in Tx of CMV infection

A

Valgancyclovir

118
Q

HIV

DOC in Tx of Candidiasis

  • Oral: Nystatin
  • Vaginal: Clotrimazole cream or tablet
  • Systemic?
A

Either Fluconazole PO or Amphotericin B IV

119
Q

HIV

DOC in Tx of Intestinal infections: Cryptosporidium?

A

Paromomycin + Nitazoxanide

120
Q

HIV

DOC in Tx of Intestinal infections:

  1. Cyclospora 2. Isospora 3. Microspora
A

1,2 SMX/TMP

  1. Albendazole
121
Q

HIV

DOC in Tx of MAI

A

Thriple: Clarythromycin + Ethambutol +/- Rifabutin

122
Q

HIV

DOC in Tx of PCP:

SMX/TMP for 21 days +|- ………………..

A

Penthamidine IV

or Prednisone PO (If PO2<70)

123
Q

HIV

DOC in Tx of Toxoplasmosis (New)

A

SMX/TMP high dose PO or IV

Old Tx was: Pyrimethamine+Sulfadiazine+Leukovorin

124
Q

Herpes Infections:

Tx is Acyclovir, if mild to moderate: PO, but if severe: IV

  1. G.Stomatitis in children
  2. Anogenital
  3. Proctitis
  4. ………
A

Eczema Herpeticom

(Eczema + Fever + LAP)

125
Q

Herpes Infections

DOC in Cold Sore (Recurrent orolabial)

A

Oral Acyclovir (Not topical)

126
Q

Herpes Infections in CNS:

  1. Encephalitis: Emergency, Acyclovir IV
  2. Aseptic meningitis: ………….
A

HSV2, usually recurring Tx: Valacyclovir (1w)

127
Q

Herpes Infections

Keratoconjunctivitis, DOC

A

Topical Trifluridine

128
Q

Herpes Infections

Shingles: -Topical AB? -Topical Acyclovir?

A

Both: No

DOC: Oral Acyclovir

129
Q

UTI in Pregnancy:

  • Routine screening: ………..

DOC: Amoxicillin or Cephalexin or ……….

A

Week 12-16

Nitrofurantoin

130
Q

UTI

DOC for Pyelonephritis in Pregnancy?

A

Ceftriaxone

131
Q

UTI in Pregnancy, safe or not?

SMX/TMP? Quinolones?

A

S: not 1st trimester, not after week 32

Q: not safe

132
Q

UTI Cystitis (Uncomplicated UTI)

  1. DOC (2)
  2. If sulfa allergic (2)
A
  1. SMX/TMP for 3 days Or Fosfomycin 3 g Single dose
  2. TMP 3 days or Nitrofurantoin 5 days
133
Q

UTI

DOC for Pyelonephritis or complicated UTI (in anatomical or functional abnormalities)

A

Mild to moderate: Quinolones PO 7-14 days

Severe: Aminoglycoside IV +|- Ampicillin IV

134
Q

UTI

Acute Prostatitis DOC

A

AG IV +|- Ampicillin IV +|- Cloxacillin IV

135
Q

UTI

Chronic Prostititis DOC

A

Quinolones PO 4-6 weeks

136
Q

STI

Tx for partners:

In Chlamydia, Gonorhea, PID, LGV ?

A

All partners within last 60 days:

Tx + No Sex for 1 week

137
Q

STI Tx for partners:

In Trichomonas, Vaginosis, Candidiasis?

A

V,C: not needed

Trichomonas: Only current partner:

AB + Avoid sex until the end of Tx

138
Q

STI

DOC for LGV

A

Azithromycin for 3w

139
Q

STI

Chlamydia and Gonorhea, DOC

A

C: Azithromycin single dose

G: Ceftriaxone single dose

(Both: ok in Pregnancy)

140
Q

STI

PID, DOC

  1. If outpatient? 2. If inpatient?
A

Out: Quinolone + Metronidazole PO

In: Quinolone + Metronidazole IV

141
Q

STI Genital warts (HPV), Tx, safety in Pregnancy:

  1. Imiquimod
  2. Podophyline, Podophylotoxin
  3. DCA, TCA
  4. Cryo, Laser
A

Non Pregnant: all ok Pregnant: 1,2 no, 3,4 ok

142
Q

Antibiotics

Metronidazole safety In Pregnancy and Breastfeeding?

A

Pregnancy: safe

Breastfeeding: ok, but 24 h interval to Breastfeeding

143
Q

Antibiotics

Safety in Pregnancy

  • Vaginal Clindamycin cream?
A

Not safe

144
Q

Malaria Nonpharma:

  1. Insect repellents containing DEET
  2. Use bed nets, impregnated with Permethrin
  3. ………..
A

Use insecticide generators containing pyrethroids.

145
Q

Malaria

Areas that are still chloroquine sensitive

A

Central America [except Panama], Haiti and parts of the Dominican Republic and Middle East

146
Q

Malaria

Two CIs for Chloroquine 1. ? 2. ?

A
  1. Epilepsy 2. Psoriasis
147
Q

Malaria Duration of Tx:

1- For Chloroquine, Mefloquine ?

2- For Doxycycline, Atovaquone/P, Primaquine ?

A

1: 1 dose/week, start 1-2w before trip, until 4w after returning
2: 1 dose/day, start 1-2 days before trip, until 1-4w after returning

148
Q

Malaria

DOC if Chloroquine resistant and no CIs:

In order of preference:

  1. Mefloquine 2. Doxycycline 3………..
A

Atovaquon/P

149
Q

Malaria Mefloquine limitations:

  1. Resistance in Thailand, Cambodia, Vietnam
  2. ?
A

SEs: Serious Neurological and Psychiatric

150
Q

Malaria

Doxycycline is a good choice after Mefloquine. What are the limitations?

  1. CI in Pregnancy and Children <8yo
  2. Photosensitivity
  3. ……………
A

Usage is daily

151
Q

Malaria

Atovaquone/Proguanil is another alternative for Mefloquine. Specially in last minute trips.

Limitations: 1. Daily usage 2. ?

A

CI in Pregnancy and Breastfeeding

152
Q

Malaria

When would you consider Primaquine for Prophylaxis?

  1. Last line alternative for Mefloquine
  2. ……..
A

Central and south America for dormant form of P.Vivax in liver Called: PART: Presumptive Anti-relapse therapy

153
Q

Malaria

Limitations of Primaquine

  1. Not 1st or 2nd choice
  2. CI in Pregnancy
  3. ………..
A

Risk of hemolysis in Favism

154
Q

Malaria Prevention

In Pregnancy, Nonpharma is more important. Medications safety?

A

Safe: Chloroquine and Mefloquine

Unsafe: the rest of medications (The same for breastfeeding)

155
Q

Thermoregulatory

Heat Cramps (Mild form) is usually caused by dilutional hypernatremia after exercise

Tx?

A

Rest

+ Oral rehydration (5 ml salt in 500 ml water)

156
Q

Thermoregulatory

Heat Exhaustion (Moderate form) is usually caused by loss of water and salt, Core body temp is 37-40

Tx?

A

Rest + Rehydration (IV)

+ External cooling (fans, ice packs)

157
Q

Thermoregulatory

Heat Stroke (Severe form) is usually associated with Core body temp > 40.6 and may result in DIC, ARF, Seizures, Neurological damage.

Tx?

A

ABC + Rehydration (IV)

+ Rapid cooling (fan evaporation, ice packs, tepid water sponging)

No cold water immersion!

158
Q

Thermoregulatory

DOC for

NMS Vs Malignant Hyperthermia

A

NMS: Bromocriptine PO

MH: Dantrolene IV

159
Q

Thermoregulatory

Three Rewarming ways:

Passive External Vs Active External Vs Active Core

A

PE: Ordinary blankets + removing wet clothes

AE: Warming blanket or Warm water immersion

AC: Warmed IV NS (40-45) or Peritoneal lavage or heated cardiopulmonary bypass

160
Q

Chemotherapy SEs

If VTE, Tx ?

If “Chemo Fog”, Tx ?

A

LMWH (Not Warfarin)

Ritalin or Modafinil

161
Q

Chemotherapy SEs

If extravasation: generally, cold compress

If with Antracyclines: ………………..

If with Meclorthamin: ……………….

A

A: DMSO or Dexrazoxane

M: Sodium Thiosulfate

162
Q

Chemotherapy SEs

In hand foot reaction,

Prophylaxis?

Tx?

A

P: Vit B6

Tx: Emolients like Bag Balm

163
Q

Chemotherapy SEs

Rash with EGFR inhibitors, Tx ?

A

Topical Clindamycin or CS

or if severe: Oral Tetracycline

164
Q

Chemotherapy SEs

Hemorrhagic Cystitis with Cyclophosphamide

Prophylaxis and Tx

A

P: Mesna + Diuresis

T: Tranexamic Acid

165
Q

Radiotherapy SEs

Proctitis ? Esophagitis?

A

P: Topical CS

E: Topical Lidocaine

166
Q

Radiotherapy SEs

Xerostomy?

Pneumonitis?

A

X: Pilocarpine

P: Prednisone

167
Q

CINV

DOC 1st and 2nd?

A
  1. Ondansetron +/- Dexamethasone
  2. Aprepitant +/- Dexamethasone
168
Q

CINV

DOC in Anticipatory Nausea?

A

BZPs: Lorazepam or Alprazolam

169
Q

CINV

Alternative Tx (other than 5HT, NK1, CS) ?

A

Dopamine antagonists:

Prochlorperazine and Metoclopramide

(Prochlorperazine has a rectal form if unable to eat)

170
Q

End of Life Care

Two medications for death rattle?

A

Scopolamine (Hyoscine) is sedative

Glycopyrolate is non-sedative

171
Q

End of Life Care

Agitation DOC

A

Sedation with Midazolam

(Do not use opioids as sedatives)

172
Q

End of Life Care

Delirium DOC

A
  1. Haloperidol
  2. Sedation with Midazolam
173
Q

End of Life Care

Respiratory problems, DOC

A
  1. Opioids
  2. CS (If Obstruction or COPD or Cancer)
174
Q

Safety in Pregnancy?

  • Statins?
  • Quinolones?
A

St: Not safe

Q: Is recently considered safe (short term)

175
Q

Safety in Pregnancy?

  • Li?
  • Valproate?
A

Li: Not safe (May be used with echography of fetal heart)

Val: Not safe.

176
Q

Safety in Pregnancy?

  • Carbamazepin?
  • Phenytoin?
A

C: Not safe (unless with high dose folate)

P: Not safe

177
Q

Safety in Pregnancy?

  • BZPs?
  • Opioids?
A

B: Preferably No (may cause cleft palate/lip) or only short term

O: Preferably No (Codeine and Meperidine not at all)

178
Q

Safety in Pregnancy?

CS Systemic

A

No for 1st trimestre

later is OK

179
Q

Safety in Breastfeeding

Codeine, Meperidine: No

Ergot derivatives: No

Li ?

A

Li, Amiodarone are OK

but serum level should be measured.

180
Q

Safety in Breastfeeding

BZP? OK

OCP? Progestin-only

Warfarin?

A

OK in breastfeeding

181
Q

Fever in children:

Definition: Rectal > 38

Standard in Canada: Oral or Rectal?

A

< 5 yo : Rectal

> 5 yo : Oral

182
Q

Fever in children:

Definition: Rectal > 38

What about Axillary and Tympanic?

A

A: All ages, screening if low risk

T: >2yo, screening if low risk

183
Q

Fever in children:

ASA? Naproxen?

A

ASA: never below 15 yo

Nap: not below 12 yo

184
Q

Nutritional Supplements

Three deficinecies in Vegans:

  1. B12

2 ?

3.Omega 3

A

Vit D and Calcium

185
Q

Nutritional Supplements

4 indications of Vit D:

  1. Osteoporosis
  2. If high risk for IHD

3,4. In elderly?

A

Falls

Cognitive impairments

186
Q

Nutritional Supplements

Calcium in Pregnant women:

-If 14-18 yo ?

If 19 yo or above?

A

14-18: 1300 mg/day

19 and above: 1000 mg/day

187
Q

Nutritional Supplements

Vitamin D in Pregnant women?

A

2,000 units/day during winter

188
Q

Dosage Adjustment

Which one(s) should not be adjusted?

  1. If the drug is nephrotoxic.
  2. If the drug is needed immediately
  3. If there is a chance to titrate
  4. If more than 50% is excreted by kidneys
A

1,2,3 No adjustment

  1. YES

(But no adjustment if <50% is excreted by kidneys)

189
Q

Dosage Adjustment

How to calculate Cr Clearance by age?

A

ClCr = 1.5 x (140-Age) / Cr Serum (Males)

Females= 0.85 x (Males)

NL is above 1

COPY 23 May (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions