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41 Cards in this Set
- Front
- Back
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What is the Centor Criteria for strep pharyngitis?
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1. Absence of cough
2. History of fever 3. Tender ant. cerv. LAD 4. Tonsillar exudates |
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What is Ludwig's angina?
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Severe cellulitis of the tissue of the floor of the mouth with involvement of bilateral submandibular and sublingual spaces
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What are the main bacteria indicated in Ludwig's angina?
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Strep and anaerobes
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What should be suspected if sx of AOM have persisted for > 2 weeks?
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Mastoiditis
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Neck masses: probable inflammatory cause vs. cyst or tumor
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Inflammatory: painful, soft or fluctuant nodule
Cyst/tumor: painless, firm mass |
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Patient presents with a smooth, fluctuant mass underlying the SCM that appeared rapidly after a URI. This is most likely what?
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Branchial Cleft Cyst
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What is the most common congenital neck mass?
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Thyroglossal Duct Cysts
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Fever + pulmonary infiltrate + erythema nodosum + recent trip to Central America =
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Histo or Coccidiomycosis
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Mass lung lesion in Midwestern farmer =
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Could be Blasto
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What is the most common non-pigmented acutely branching septate filamentous fungus that causes infections in immunocompromised hosts?
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Aspergillus
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Leukemia patient presents with recent neutropenia, fever, RUQ pain, nausea and elevated alkaline phosphatase. This is likely...
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Chronic disseminated candidiasis
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How does one treat invasive aspergillosis? Refractory invasive aspergillosis?
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Invasive aspergillosis: Amphotericin B or voriconazole
Refractory: Echinocandins |
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What are the mechanisms of action of the following anti-fungal classes?
1. Azoles 2. Echinocandins 3. Polyenes (Ampho B) |
1. Impairs ergosterol synthesis
2. Impairs B 1,3 glucan synthesis 3. Binds to ergosterol |
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Name an echinocandin
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Caspofungin
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Where is blastomycosis endemic?
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SE and south-central states on the Mississippi and Ohio River Basins, midwestern states, New York along St. Lawrence River
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T/F: Blastomycosis is only a disease of immunocompromised hosts.
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False
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Describe a skin lesion from blastomycosis.
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Begins as a papule, then progresses to elevated lesion with verrucous borders and ulcerated center.
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Treatment for pulmonary blasto
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Itraconazole (amphotericin B if disseminated, life-threatening)
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How long are patients treated for candidemia?
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14 days after last positive blood culture
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How does acute cholangitis develop?
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From obstruction, stasis and bacterial infection of the biliary tree
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What five bacteria are commonly associated with cholangitis?
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E. coli, Klebsiella, Enterobacter, Enterococci, and anaerobes
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What is the HELLP syndrome of preeclampsia?
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Hemolysis, elevated LFTs, low platelets
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What is the key to treating intra-abdominal infections?
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Drain all pus, remove all ischemic tissue
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What organisms are most commonly indicated in intra-abdominal infections?
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ANAEROBES, aerobic gram neg. rods, enterococcus, candida
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26 yo female with h/o PID presents with fever, chills, left sided pelvic pain and leukocytosis. Be suspicious of...
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Tuboovarian abscess
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Patients with diverticulitis often present with pain in the _____.
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LLQ
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What antibiotics typically treat uncomplicated diverticulitis? What is the usual duration of treatment?
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PO: Cipro + Flagyl or Augmentin
IV: Zosyn or Cefotetan + Flagyl |
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What type of patients are at high risk for spontaneous bacterial peritonitis?
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Patients with underlying cirrhosis and ascites
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How is the diagnosis of SBP made?
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PMN count of >250 cells/mm3 with positive culture of ascitic fluid
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Difference between SBP and alcoholic hepatitis
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Alcoholic hepatitis does not cause an elevation in ascitic PMN count
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What is the most common obligate anaerobe cultured after a colonic perforation?
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B. fragilis (most common isolate in general is E. coli, then B. fragilis)
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Important coverage in intra-abdominal abscess
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Gram neg and anaerobic
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Treatment for H. pylori
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1 PPI + bismuth subsalicyte + tetracycline + metronidazole
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What should be considered in any patient who develops diarrhea up to 6 weeks after abx exposure?
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C. diff infection
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Treatment for C. diff
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Flagyl, oral vanco, cholestyramine as adjunct, rifampin added for prolonged cases
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Which organisms responsible for gastroenteritis shift the balance of water and electrolyte fluxes but do not invade the intestinal mucosa?
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Cholera, enterotoxigenic e. coli, clostridium perfringens, S. aureus, B. cereus
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Which GE-causing organisms invade the colon and terminal ileum, destroying segments of intestinal mucosa and causing inflammatory changes?
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Shigella, Campylobacter, Yersinia enterocolitica, Vibrio, Invasive E. coli, Salmonella
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What GE-causing organism can transverse intact intestinal mucosa?
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S. typhi
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What organism causes Bacillary Dysentery?
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Shigella
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Preschooler presents with fever of 104, N/V, abdominal pain, and frequent loose bowel movements containing blood, mucus, and pus. What test could indicate the likely diagnosis?
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Stool culture indicative of Shigellosis
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Preferred treatment for Shigellosis
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Adults: FQs
Children: Zithromax *NO anti-diarrheals!* |
