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59 Cards in this Set

  • Front
  • Back
Outpatient CAP Tx
– Macrolide, doxy, or fluoro
CAP Tx in those w/ comorbitity
– Macrolide or fluoro
– add a 2nd gen or B-lactam
Inpatient CAP Tx
– Extended cephalosporin/B-lactam/fluoro
– Add a macrolide if atypical suspected or if in ICU
– Extended cephalosporin/B-lactam with pseudomonal
– Add aminoglycoside or fluoro
– strep pneum is the most common in nursing home patients!
Where are pulm lesions in TB
– lower lobe in 1o and apical in reactivated
5 mm TB test is positive
– HIV, close contacts, CXR evidence
Sinusitus Tx
– Amox/clavulanate 500 TID for 10 days
Meningitis prophylaxis
– Rifampin, Cipro, Ceftriaxone
Meningitis complications
– subdural effusions in infants w/ H flu
– Ventriculitis is worse clinical but better CSF
– subdural empyema is intractable seizures
Meningitis Empiric Tx
– less than 1 month is Amp and Cefotaxime/Gent
– 1 month to adults is Vanc + Ceftriaxone/Cefotaxime
– Over 65 is Amp + Vanc + Ceftriaxone/Cefotaxime
When do you start HIV therapy?
– CD4 less than 350
Candida Thrush Tx
– Oral nystatin QID
– clotrimazole if that fails
– Oral fluconazole if topicals fail or esophagitis
MAC prophylaxis
– weekly azithromycin or daily clarithromycin
– stop when CD4 > 100 for 6 months
Toxo prophylaxis for HIV
– SS in PCP
Cryptococcus defining features and Tx
– absent meningismus
– IV Amp + flucytosine for 2 weeks
– then fluconazole for 8 weeks
– need lifelong maintenance (200 mg QD)
Histo defining features and Tx
– nodular and hilar densities and yeast on silver stain
– Amp for 3-10 days
– then itraconalze for 12 weeks
– need lifelong maintenance
– TMP-SMX for 21 days
– can add prednisone taper if serious hypoxemia
Chlamydia Tx
– Doxy 7 days or azithro 1 time
– give pregnant patients erythromycin
VDRL false positives
– Virus (EBV, HSV, HIV, hepatitis)
– Drugs (esp IV)
– Rheumatic fever
– SLE/leprosy
Granuloma inguanale
– beefy red ulcer
– painless
– give Doxy 100 for 3 weeks
H. Ducryi
– aka chancroid
– deep irregular and necrotic
– pain and lympadenopaty
– give Ceftriaxone, erythromycin, or azithromycin
Pyelonepritis Dx
– IVP unless pregnant or RF
– then do U/S
– CT if not improving after 3 days
Osteomyelitis Dx
– MRI test of choice for foot or back
– 3 phase scan for everything else
– bone scan is sensitive, but not specific
Osteomyelitis Tx
– 4-6 eeks of IV Abx
– Clinda + Cipro
– Amp/sulbactam
– Oxacillin/Nafcillin
– cipro or ceftriaxone for Gram negative
– Vanc for MRSA
Neutropenic Abx
– Low risk get Cipro + Amox/clavulanate
– High risk get cefepime, ceftazadine, or carbapenem (Add aminoglycoside if two drugs)
– Add Vanc if need be as well
Lyme disease Dx and Tx
– Elisa and western blot
– doxy early and ceftriaxone late
– if pregnant give amoxicillin
Congenital CMV
– most common
– petechial rash and periventricular calcifications
Hutchinson’s Triad
– congintal sypilis
– Peg shaped central incisors, deafness, and interstitial keratitis
Endocarditis Tx
– Vanc or ceftriaxone + Gent
Anthrax Tx
– Penicillin G, cipro, erythromycin, tetracycline, chrlomapenicol for cutaneous for 7 days
– high dose penicillin for inhalational or GI
Major Criteria for encdocarditis Dx
– two + blood cultures
– evidence by TEE or new murmur
– goes to bone, CNS, and skin
– IGM and IGG are positive
– give AMP B or itraconozole
Invasive asprigillosis Dx
– cavitary on CXR and halo sign on CT
Diarrhea in HIV
– do stool for O and P
– if negative, think about colonoscopy for CMV colitis
– will see multiple ulcerations w/ Eos in nucleus and Basos in cytoplasm
– New york tick
– seen in jaundiced patient with no spleen (allows hemolysis)
– gram + and weakly acid fast branching rod
– can cause cavitary pulmonary lesions in HIV
Bacillary Angiomatosis
– from Bartonella
– immunocompromised with skin lesion (cherry hemangioma)
– will bleed a lot and can get into liver
– triad of edema/mysoitis/eosinophilia\
– have spinter hemorrhage and GI complains
– tick bite w/ systemic Sx
– leucopenia and thrombocytopenia
– increased LFTs
– treat with Doxy
– broad based budding yeast
– cutaneous can be ulcerative of verrucous
– wet prep will show yeast
– in south and north central US
Cervicofacial Actinomyces
– chronic drainage w/ sulfur granules
– give penicillin
Indinavir SE’s
– protease inhibitor
– crystal induced nephropathy
– lactic acidosis
Nevirapine SE’s
– liver failure
Didanosise SE’s
– pancreatitis
Abacivir SE’s
– hypersensitivity syndrome
– from rhizopus
– need surgery and AMP
Vibrio parahaemolyticus
– diarrhea from seafood
E. Coli diarrhea
– from undercooked ground beef
Soradic yersiniosis
– diarrhea from pork
Camp J. diarrhea
– from poultry
HSV encephalitis
– hallucinations
– start IV acyclovir if you even suspect
Cat bite Tx
– 5 days of Amox/Clav
Bactiruia in pregnancy
– must treat
– give Amox, nitro, or ceph
– bactrim can be used in 2nd or 3rd trimester
Necrotizing bronchopneumonia
– a 2o pneumonia with pneumatoceles
– from SA
Hemochromatosis patients are vulnerable to what?
– Listeria, yersinia, and vibrio vulnificus
– no rash w/ EBV
– no tonsilar exudates on HIV
– insensate hypopigmented patch on Asian
– do skin Bx