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MTB 1 Flashcards

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1
Q

What does PCN cover

A 
Viridans group strep
Strep pyogenes
Oral anaerobes
Syphilis 
Leptospira
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2
Q

What does Amoxicillin and Amp cover

A 
PCN drugs + HELPS
H.influenzae
E.Coli
Listeria 
Proteus
Salmonella
Lyme Dz
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3
Q

AE of Methicillin

A

Renal Failure from AIN

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4
Q

Pt w rash to PCN - TX?

A

Cephalosporins

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5
Q

Pt w anaphylaxis to PCN - TX?

A

Non-beta-lactam
Vanco
Linezolid
Daptomycin

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6
Q

AE of Cefotetan and cefoxitin

A

Increased risk of bleeding

Disulfiramlike Rxn w Alcohol

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7
Q

Cephalosporins that cover Pseudomonas

A

Ceftazidime

Cefepime

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8
Q

Why do avoid ceftriaxone in neonates

A

impaired biliary metabolism

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9
Q

AEs of Doxycycline

A

Tooth discoloration - children
Fanconi syndrome - Type II RTA proximal
Photosensitivity
Esophagitis/ulcer

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10
Q

TMP-SMX AEs

A

Rash
Hemolysis
Bone marrow suppression
Folate antagonist

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11
Q

MCC meningitis w recent neurosurgery

A

Staph

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12
Q

Meningitis in camper/hiker w centripetal rash and tick

A

RMSF

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13
Q

What is a centripetal rash

A

Involves wrists, ankles, moves from arms/legs to trunk

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14
Q

Meningitis - best initial test

A

LP

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15
Q

Meningitis - Most accurate test

A

LP

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16
Q

Meningitis - LP in Bacterial

A

Glucose = Low
Protein =High
Cell count = 1000s, Neutrophils

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17
Q

Meningitis - LP in Cryptococcus, Lyme, Rickettsia

A

Glucose = Possibly Low
Protein = Normal, Possibly High
Cell count = 10s-100s, Lymphocytes
No stain/culture

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18
Q

Meningitis - LP in TB

A

Glucose = May be low
Protein = VERY High
Cell count = 10-100s Lymphocytes

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19
Q

Meningitis - LP in Viral

A

Glucose = Normal
Protein = Normal
Cell count = 10-100s Lymphocytes

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20
Q

Meningitis TX w head CT if:

A
  1. Papilledema
  2. Seizures
  3. Focal neuro changes
  4. Confusion
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21
Q

Meningitis pt with CI to LP - next best step?

22
Q

Testing for Lyme and Rickettsia

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A

Serology w ELISA, Western blot, PCR

23
Q

Best initial TX for bacterial meningitis

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A

Ceftriaxone
Vanco
Steroids

24
Q

Why steroids in bacterial meningitis

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A

Lower mortality in Strep Pneumo pts

25
TX for Meningitis + 1000s neutrophils on CSF
Ceftriaxone Vanco Steroids
26
When do we add Ampicilin in meningitis
Immunocompromised for Listeria - Elderly - Neonates - Steroid use - HIV - Pregnant
27
TX for Listeria
Sensitive to PCN | Resistant to ALL cephalosporins
28
TX for TB meningitis
Extend TX + steroids
29
Neisseria meningitis TX
``` Respiratory isolation Rifampin/cIpro to close contacts - Household contacts - Kissing - Cig sharing - Utensils - HCW w exposure to resp secretions ```
30
Pt w fever, HA, stiff neck, photophobia, weakness of arm and leg - left. Next best step?
Ceftiraxone, Vanco, Steroids 1. LP 2. ABX 3. CT head
31
MC neuro deficit of untreated bacterial meningitis
8th CN deficit | Deafness
32
What is seen on CT for brain abscess
Ring/contrast enhancing lesion
33
IF Ring/contrast enhancing lesion on CT AND HIV + , next step
TX for Toxo for 2 weeks w Pyrimethazine and sulfsalazine Repeat CT 2 wks - if same, BX DDX: Toxo or Lymphoma
34
IF Ring/contrast enhancing lesion on CT AND HIV - , next step
BX | DDX: Cancer, Infxn
35
Most accurate test Herpes Encephalitis
PCR of CSF
36
Best initial therapy for Herpes Encephalitis
Acyclovir
37
Best initial therapy for Herpes Encephalitis Resistant to Acyclovir
Foscarnet
38
Malignant Otitis Externa seen in ? Etiology?
Elderly pts Diabetics Pseudomonal Infxn on External Auditory Canal (EAC)
39
MOE presentation and TX
``` Severe Ear pain Discharge Low grade fever Granulation tissue in EAC TX: Cipro ```
40
Best initial therapy for otitis media
Amoxicillin
41
Most Accurate diagnositic test for OM
Tympanocentesis | - done with multiple recurrences
42
If OM pt not responding to Amoxicillin
Amox/Clauv Azithromycin, Clarithromycin Cefuroxime, Loracarbef FQ
43
Most Accurate Dx test for sinusitis
Sinus BX or Aspirate
44
When is sinus BX done in sinusitis
Recurrent | No response to empiric tx
45
First line agents for otitis and sinusitis
Amoxcillin Doxycycline TMP-SMX
46
Tx for rhizopus and mucormycosis
Surgical Debridement | Ampho B
47
Presentation of Strep pharyngitis
``` Pain w swallowing LA -neck Exudate - whitish, scrapes off Fever NO cough, NO hoarseness ```
48
Laryngitis presentation
Hoaresness | Cough
49
Best initial test pharyngitis
Rapid Strep test
50
Pharyngitis + vesicles or ulcers
HSV | Herpangia
51
Pharyngitis + membranous exudate
diphtheria EBV Vincent angina
52
TX for Pharyngitis
1. Amoxcillin or PCN 2. Cephalexin - PCN allergic w rash Clindamycin or macrolide - PCN allergic w anaphylaxis

Infectious (4 decks)

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