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36 Cards in this Set
- Front
- Back
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Urethritis dx?
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PCR analysis of vaginal or penile swab or urine.
Usually due to venereal or GI causes Discharge of gonorrhea purulent, chlamydia non-purulent |
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Treatment of urethritis?
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Single dose:
Ceftriaxone IM 125 mg (for Gonorrhea) Azithromycin 1g PO (for Chlamydia) |
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Vaginitis: 3 types
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Candida
Bacterial vaginosis Trichomonas baginalis |
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Diagnosis of vaginitis:
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KOH applied to wet mount used for all three:
BV: Clue cells (epithelial cells with bacteria) Trich: Motile trichomonads Yeast: Psseudohyphae |
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Treatment of vaginitis:
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BV: Metronidazole
Trichomonas: Metronidazole Candida: Nystatin, Diflucan |
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Syphillis diagnosis:
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RPR
VDRL When above positive, do: Fluorescent treponemal antibody absorpiton test (TRA-ABS). Remains positive throughout life. - Darkfield microscoopy *T.palladium does not grow in regular blood cultures** |
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Treatment for syphillis
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Penicillin G
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Treatment for Balanitis
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Nystatin - due to candida
NSAIDs - |
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Herpes Dx
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Tzanck smear
Herpes serology |
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HPV DX
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colposcopy - white lesions biopsied
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Prostatitis
Bacterial (E.cole, pseudomonas) and non-bacterial |
Bacterial - urinalysis shows bacteriuria and pyuria. CBC - elevated WBC with neutrophil predominance
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Treatment - bacterial prostatitis
*Tender prostate |
Septra, cipro x 3 weeks
Admit if immunosuppressed or noncompliant or septic |
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Non-bacterial Prostatitis
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More likely to lead to chronic prostatitis
?Viral or autoimmune *Non-tender, enlarged prostate leukocytes seen on prostatic secretions but urinalysis and CBC normal. NSAIDs |
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Typical Pneumonia treatment
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Strep pneumonia:
Amoxicillin fluroquinolone (moxifloxacin) Beta-lactam |
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Strep pneumonia
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rusty coloured sputum
Lobar consolidation gram positive chains |
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Pneumonia
Staph aureus |
Vrial infection 2 weeks prior
salmon pink sputum Large cavitary lesions, air fluid levels Gram positive cocci in clusters Treatment: Beta-lactams, vancomycin |
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Pneumonia
Klebsiella |
Current jelly sputum.
CXR: bulging fissure CAP, progress to empyema May cause UTI Treatment: Cephalosporin, aminoglycosides |
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Pneumonia
Moraxella catarrhalis |
Gram neg
COPD, immunocompromised patients. Treatment: penicillin/clavulanic acid Clarythromycin, amoxicillan |
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Pneumonia
Mycoplasma pneumonia Atypical |
CAP.
Insidious onset Fever, pharyngitis, h/e, chills, arthritis, hemolytic anemia. Erythema multiforme. CXR: hazy infiltrates Treatment: Macrolide and cehalosporin Quinolone |
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Pneumonia
Chlamydia pneumonia |
CAP - children and young adults
Fever, non-productive cough CXR: segmental infiltrates Treatment: Quinolone, Ceph and macrolide |
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Pneumonia
Chlamydia psittaci |
Obligate intracellular, avian host
Pet stores Bilat infiltrate Splenomegaly Treatment: Tetracycline |
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Pneumonia
Legionella Atypical |
Gram negative rod, anaerobic
Change in mental status, pneumonia, nausea and vomiting, hyponatremia Dx: Direct immunofluorescent antigen, urinary antigen Treatment: macrolide, quinolone, doxycycline |
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Hospital acquired pneumonia:
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Pseudomonas, Enterobacter, Klebsiella, E.Coli, H.influenza, Staph a
- Pseudomonas - ventilator acquired Post CHF in hospital with new pneumonia. Think pseudomonas. MUST ALWAYS COVER FOR PSEUDOMONAS: Pip-tazo, Tobramycin, 4th gen Ceph |
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Aspiration Pneumonia
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Anaerobes: Bacteriodes, fusobacterium, peptostreptococcus
Treatment: Clindamycin |
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Viral Pneumonia:
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Adenovirus (spring and fall)
EBV (also assoc with hairy leukoplakia) Influenza virus Parvo B19 - hand arthritis, symmetric (tx with NSAIDS) Rhinovirus - supportive Treatment: Supportive |
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Strep Pyogens:
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Causes Scarlet Fever, Poststrep glomerulonephritis (2 wks post pharyngitis), Streptococcal TSS
Treatment: Penicillin |
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Mycoplasma
- Upper and lower respiratory infection |
Diagnosis:
Bullous myringitis and bilat infiltrates on CXR. Not seen on gram stain. DX BY HIGH TITERS OF IgM COLD AGGLUTININS Treatment: Erythromycin, Clarythromycin |
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Mono
Can cause hemolytic anemia (increased retics and LD), decreased Hct) |
Dx: Heterophile antibody / monospot test
Tx: Corticosteroids for severe hemolytic anemia |
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Actinomyces
(Anearobe) |
"lumpy jaw"
Treatment: Penicillin |
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H. Influenza
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Amantadine
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Toxoplasmosis:
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Visual blurring, CD4 count of 50
Treatment: Ganciclovir |
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Genital warts
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Interferon alpha
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Infant with RSV, ventilated
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Ribavirin
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CMV
Visual blurring at low CD4 counts Opacity on fundoscopy exam |
Treatment: Gancyclovir
(Foscarnet for preventative recurrances after) |
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Lyme disease diagnosis:
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FTA-Abs positive, Western blot
Rash - bulls eye pattern Neuro changes Athralgia, facial nerve palsy Heart block Treatment: Penicillin |
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Cryptococcus:
Meningitis |
CSF to diagnos
India Ink - |
