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Flashcards in MTB Infectious Disease Deck (38):
1

What is the treatment for MRSA

Vancomycin
Linezolid
Daptomycin

2

What is the treatment for cellulits

minor dz: dicloxacillin or cephalexin
Pen allergic: macrolides or clindamycin

Severe dz: Oxacillin, nafcillin, cefazolin
Pen allergic: Vancomycin or Daptomycin

3

What is the treatment for gonorhea or chlamydia

Always treat both as it is a common co-infection

1. ceftriaxone for gonorrhea (can use cipro)

2. Azithromycin for chlamydia

4

What antibiotics are safe in pregnancy

Penicillin
Cephalosporins
aztreonam
Erythromycin
Azythromycin

5

What is the treatment for syphilis

2.4 million units IM of Penicillin G benazathine

6

What is the treatment for syphilis in the penicillin allergic patient

Doxycycline 100mg PO q12hrs x 14 days

For pregnancy or tertiary syphilis the only treatment is penicillin desensitization

7

What is the treatment for a Jarisch-Herxheimer reaction

aspirin and continue treatment against syphilis

8

What test should be run for suspected syphilis if an RPR or VDRL is negative

Darkfield microscopy

25% of RPR and VDRL are negative

9

What symptoms are present with cystitis

Dysuria
WBC in Urine
Suprapubic tenderness

10

What symptoms are present with pyelonephritis

Dysuria
WBC in Urine
Flank pain
Fever

11

What should be considered when a pyelonephritis does not respond to treatment

Perinephric abscess

12

How is endocarditis diagnosed clinically

Presence of:
- 2 Major criteria or,
- 1 Major and 3 minor criteria or,
- 5 minor criteria

13

What are the major Criteria associated with Dukes classification of Infective Endocarditis

1) 2 positive blood cultures Staph Aureus, Strep Viridans, Bovis etc. (HACEK cultures are typically negative)
-
2) Abnormal Echocardiagram
- Intracardiac mass
- abcess
- partial dehiscence of prosthetic valve

14

What are the minor Criteria associated with Dukes classification of Infective Endocarditis

1. Fever > 38c
2. Presence of risk factors
3. Vascular findings
4. Immunological findings
5. Microbiological findings insufficient for a major criteria

15

What are the vascular findings associated with infective endocarditis

1. Janeway lesions (flat and painless in hands and feet)
2. Septic pulmonary infarct
3. arterial emboli
4. mycotic aneurism
5. Conjonctival Hemorhage

16

What are the immunological findings associated with Infective Endocarditis

1. Roth Spots (Retina)
2. Osler Nodes (raised, painful, pea shaped)
3. glomerular nephritis

17

When should therapy for HIV be started

1. CD4 < 500
2. Symptomatic patients
3. Pregnant Women
4. Needle stick by known HIV positive pt

18

What is the recommended therapy for starting a patient with HIV

HAART (one of the following combinations)

1. Tenofovir + entricitabine + efavirenz (single pill combination)
2. Zidovudine + lamuvudine + efavirenze
3. Zidovudine + lamuvudine + ritonavir/lopinavir

*** Never use AZT (zidovudine) as a mono therapy

19

What are the adverse effects of NRTI class

lactic acidosis

20

What are the adverse effects of Protease Inhibitors

hyperglycemia
hyperlipidemia

21

What are the adverse effects of NNRTI class

drowsiness

22

What are the adverse effects of zidovudine

anemia

23

What are the adverse effects of didanosine

pancreatitis
neuropathy

24

What are the adverse effects of stavudine

pancreatitis
neuropathy

25

What are the adverse effects of abacavir

rash

26

What are the adverse effects of indinavir

kidney stones

27

Name the NRTI's

zidovudine
didanosine
stavudine
lamivudine
abacavir
emtricitabine
tenofovir

28

Name the Protease Inhibitors

Indinavir
ritonavir
lopinavir
Nelfinavir
Saquinavir
Darunavir
Tipranavir
Amprenavir
Atazanavir

29

Name the NNRTI's

Efavirenz
Nevirapine
Etravirine
Rilpivirine

30

What is the treatment for post exposure prophylaxis to to HIV

HAART for one month

31

If a pt is diagnosed as HIV positive during the routine pregnancy and is not currently on treatment what options are available

1. CD4 < 500: start HAART

2. CD4 > 500 and low viral load: HAART immediately is better than waiting to 2nd or 3rd trimester

32

When should prophylaxis be initiated for HIV positive patients

CD4 < 200: TMP/SMX against Pneumocystis Jiroveci Pneumonia

CD4 <50: Azithromycin once a week against Myconacterium avium Intracellular

33

How will an HIV + patient present when infected with PCP

Shortness of breath
Dry cough
Hypoxia
Increased LDH

34

How is PCP diagnosed

Bronchoalvolar lavage

CXR will demonstrate increased interstitial markings bilaterally

35

What should be considered in an HIV patient with nausea, vomiting, headache and focal neurological deficits?

Toxoplasmosis
PML (progressive multifocal leukoencepholapathy)

Contrast head CT will show Ring enhancing lesions in Toxoplasmosis

36

What treatment is needed for an HIV patient with a CD4 count < 50 that presents with blurry vision?

Patient requires dilated opthomalogic evaluation

If treatment is needed for CMV use valgancyclovir

37

If an HIV patient presents to the ER with fever, headache and stiff neck what is the next course of action

Lumbar puncture.
- India Ink initially (60% sensitive)
- Cryptococcal Antigen test (95% sensitive)

If positive treat with Amphotericin B followed by fluconazole

38

What are the opportunistic infections associated with HIV

CD4 < 300: Candidal Esophogitis

CD4 < 200: (PCP) Pneumocystis Jiroveci Pneumonia

CD4 <50: CMV, Mycobacterium avium Intracellular