MTB 2 CK - Infectious Flashcards
(130 cards)
1
Q
What abx do we use to tx oral anaerobes?
A
PCN G, V
2
Q
Aminopenicillins (amp, amox) have more _____ coverage than PCN
A
Gram (-), enterics
3
Q
Best initial therapy for endocarditis prophylaxis
A
Amox or amp
4
Q
Best initial therapy for UTI in pregnant woman
A
Amox
5
Q
What are pencillinase resistant PCN good at? Dicloxacillin, etc.
A
Killing S. aureus (not good at gram negatives or MRSA)
6
Q
What are the anti-pseudomonal PCNs?
A
Ticarcillin, Piperacillin, etc.
Good for pseudomonas and anaerobes!!!
7
Q
Best initial therapy for cholecystitis, ascending cholangitis, pyelonephritis?
A
Ticarcillin, piperacillin
*But usually not the answer when a single organism is known (too broad coverage)
8
Q
What 3 bugs are resistant to cephalosporins?
A
Enterococcus
Listeria
MRSA
9
Q
Cephalosporins with increased risk of bleeding
A
Cefotetan, cefoxitin
10
Q
First line tx for S. pneumo meningitis
A
Ceftriaxone
11
Q
Tx of Lyme involving the heart or brain
A
Ceftriaxone
12
Q
Can’t give Ceftriaxone to…
A
neonates
13
Q
Cefepime is good for
A
Staph, Pseudomonas, Gm (-)
14
Q
What is cilastatin given with (kidney breakdown)
A
Imipenem
15
Q
Aztreonam only covers
A
Gram (-) rods
16
Q
Fluoroquinolones have poor coverage of…
A
Staph, strep, and anaerobes
17
Q
FQ are good for…
A
pee, poo, bone, and intracellular pna
18
Q
Give ____ with FQ for GI infections
A
Metronidazole to cover the anaerobes
19
Q
Can’t give FQ to… and why…
A
Pregnant women, kids
Tendon rupture, bone growth abnormalities
20
Q
Aminoglycosides get in the
A
poo, pee, blood
21
Q
Aminoglycosides have good coverage of ___ and bad coverage of ___
A
gram (-) good
anaerobes bad
22
Q
Clindamycin causes
A
C. dif
23
Q
2nd line for staph/strep
A
Macrolides
24
Q
First line Txs for MRSA
A
Vancomycin, Linezolid, Daptomycin, Tigecycline, Ceftaroline
25
Best initial tx for minor MRSA of the skin
TMP/SMX
Clindamycin
Doxycycline
26
2 best tx for GI anaerobes
Metronidazole
| Beta-lactam/lactam combos
27
Only think S. aureus CNS infection in...
someone with recent NES
28
At what CD4 count do we see cryptococcal meningitis
29
When is it a TB CNS infection?
If they also have pulmonary TB
30
CSF cell count in cryptococcus, Lyme, or Ricketsial meningitis
10s-100s
| Protein and glucose inconclusive
31
What will CSF studies show in TB meningitis?
markedly elevated protein
32
When do you do bacterial antigen detection in a CNS infection?
If antibiotics are given prior to LP/ culture
33
Prophylaxis for close contacts of patient with N. meningitides
Rifampin
Ciprofloxacin
Ceftriaxone
34
MCC meningitis 0-6mo
Listeria
GBS
E. coli
35
MCC meningitides 6mo-6yr
S. pneumo
H. flu
Enterovirus
N. meningitides
36
MCC meningitis 6-60yr
S. pneumo
Enterovirus
N. meningitides
HSV
37
MCC meningitis 60+yo
```
S. pneumo
Listeria
N. meningitides
Listeria
Gram (-) rods
```
38
MCC encephalitis
HSV
39
When is the most accurate test for HSV a viral culture?
When it is a skin/genital infection
| Otherwise, PCR is most accurate
40
Most sensitive finding in AOM? (if negative, no AOM)
Tympanic membrane immobility
41
When do you do tympanocentesis for AOM?
Recurrent or no response to MULTIPLE abx
42
For sinusisitis when is culture of nasal discharge the right answer?
NEVER
43
When do you do a CT of the sinuses for sinusitis?
When the dx is equivocal
44
Don't forget mucormycosis
in chronic sinusitis in patients with DM or heme probs
45
MCC of bacterial pharyngitis
GAS, Neisseria gonorrhea, Mycoplasma pna, C. diptheria
46
MCC of viral pharyngitis
Rhino, Corona, Adeno, HSV, EBV, CMV, influenza, Coxsackie
47
Pharyngitis tx: rash to PCN/amox
GIve cephalexin
48
Pharyngitis tx: if bad reaction to PCN/amox
Clindamycin, macrolide
49
Why do we treat GAS?
To prevent rheumatic fever
50
When can you get the inactivated flu vaccine?
>6mo
51
When can you get the live attenuated vaccine?
2-49yo
52
2 MCC of HUS
E. coli
| Shigella
53
Yersinia (diarrhea) loves
iron (transfusions, hemochromatosis)
54
How do you treat scombroid?
Antihistamines (looks like anaphylaxis to shellfish)
55
In HBV, surface antigen indicates
continued carrier state
56
What % of HBV becomes chronic?
10%
57
What % of HCV becomes chronic?
a lot
58
Best initial tx for urethritis
Ceftriaxone + Doxy/Azithro
59
PID best first step
pregnancy test
60
PID most accurate test
laparoscopy
61
PID inpatient tx
Cefoxitin/Cefotetan + Doxy
62
PID outpatient tx
Ceftriaxone + Doxycycline
| (allergy) Levofloxacin + Metronidazole
63
One painful genital ulcer
Chancroid (H. ducreyi)
64
Syphilis screening test
VDRL, RPR
65
Syphilis confirmatory test
FTA, MHA-TP
66
Test for chancroid
Culture and stain
67
Test for lymphogranuloma venereum
Complement fixation titers
| Nucleic acid amplification
68
Syphilis tx
IM PCN benzathine (1)
| Doxycycline (PCN allergy)
69
Chancroid tx
Azithromycin (1 dose)
70
Lymphogranuloma venereum tx
Doxycycline
71
Can HSV be a clinical dx?
YES! no Tzanck necessary
72
TX secondary syph
IM PCN (one dose)
73
TX tertiary syph
IV PCN
74
Tests for genital warts
Biopsy, serology, stain, smear, culture---DON'T DO THESE!
75
Pediculosis =
crabs
76
Pediculosis tx
Permethrin
77
Scabies next best step
scrape and magnify
78
Scabies TX
Permethrin
79
Ciprofloxacin in tx of UTI
reserved for complicated cases
80
Pyelonephritis imaging
CT/US to rule out structural abnormalities
81
How do we treat prostatitis?
Same abx as pyelonephritis
| TMP-SMX 6-8wks if CHRONIC
82
Pyelonephritis that does not resolve w/ appropriate tx
perinephric abscess (get US or CT)
83
Fever + new murmur
endocarditis--> echo + blood cultures
84
Roth spots
endocarditis
85
Janeway lesions
endocarditis
86
Osler nodes
endocarditis
87
What if endocarditis is culture negative?
```
HACEK
Oscillating vegetations on echo
+
1. Fever >100.4
2. RF of IVDA, prosthetic valve, etc
3. Signs of emboli
```
88
MCC of culture negative endocarditis
Coxiella
| Bartonella
89
Best tx of endocarditis?
Vancomycin + Gentamycin
90
Best tx of endocarditis w/ HACEK?
Ceftriaxone
91
Endocarditis prophylaxis is needed when...
SIGNIFICANT cardiac defect
+
Risk of bacteremia with procedure
-->Amoxicillin
92
Joint fluid aspiration cell count in Lymes
25,000
| oligoarthritis
93
What neuro manifestations are seen with Lymes?
meningitis, encephalitis, CN palsies
94
What cardiac manifestations are seen w/ Lyme?
Myocarditis
| Third degree AV block (ventricular arrhythmia)
95
Secondary lyme
(early disseminated) migratory polyarthropathy, Bell's meningitis, myocarditis, AV block
96
Tertiary llyme
arthritis
| subacute encephalitis
97
Are diagnostic tests needed to treat Lyme?
NO
98
HIV risk of transmission
Perinatally > anal sex > needle stick > oral sex > vaginal sex
99
Infections at CD4 >200
Shingles, HSV, TB
Oral, vaginal candidiasis
Bacterial pneumonia
Kaposi's
100
2 prophylaxis for HIV
PCP--TMP-SMX @
101
PCP prophylaxis: sulfa allergy
Dapsone
| Atovoquone
102
PCP prophylaxis: sulfa allergy & G6PD
Atovoquone
103
Toxoplasmosis prophylaxis?
TMP-SMX--already on it
104
Anemia w/ HIV tx
Zidovudine (AZT)
105
Peripheral neuropathy/pancreatitis w/ HIV tx
Stavudine
| Didanosine
106
HSR, Steven Johnson reaction w/ HIV tx
Abacavir
107
Hyperlipidemia, hyperglycemia w/ HIV tx
Protease (-)
108
Kidney stone w/ HIV tx
Indinavir
109
Renal insufficiency w/ HIV tx
Tenofovir
110
HIV med CI in pregnancy
Efavirenz
111
Best HIV test for an infant?
PCR or viral culture
112
First sign of tx failure in HIV
rising PCR-RNA level
113
C-section indicated in HIV when...
CD4 1000
114
Discuss FQ or macrolides in tx of otitis media
Can be used, would expand coverage against atypicals like mycoplasma, intracellulars, etc.
But no greater EFFICACY than amoxicillin
115
Best initial therapy for AOM
Amoxicillin + Decongestant
116
Sore throat + COUGH
Bronchitis or pneumonia!!!!!!!!!!!!!!!!!!!!!!! NOT pharyngitis!
Cough= lung problem!!!!!
117
Hoarseness means
a laryngitis
118
GAS pharyngitis can cause...
glomerulonephritis and rheumatic fever
119
GAS skin infections can cause
only glomerulonephritis
120
GAS TX
Penicillin
121
Amantadine and Memantine are only good for
Influenza A
122
Oseltamavir is good for
both influenza A and B
123
MCC of needed liver transplant in the US
chronic HCV
124
Chronicity of hepatitis is based on which test?
surface antigen
125
Old, healed, past, cured hepatitis has what markesr
core and surface antiBODY
126
e antigen determines in HBV
the degree of transmission
127
IFN MC adverse effect
flu-like symptoms
128
MC adverse effect of Ribavirin
red cell aplasia
129
TX for HCV
IFN and Ribavirin
130
TX for HBV
IFN OR Lamivudine OR Inticavir OR Edefavir
