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50 Cards in this Set
- Front
- Back
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PCP manifestations
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Subacute that worsens over days-weeks
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PCP CXR
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diffuse, bilateral, symmetrical interstitial infiltrates
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PCP characteristic
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hypoxemia
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PCP CT
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patchy ground glass attenuation
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PCP diagnosis
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Induced sputum, bronchoscopy with bronchoalveolar lavage, transbronchial bipsy
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PCP tx + duration
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TMP/SMX 21 days
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TMP/SMX ADE
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steven-johnson syndrome, fever, BM, azotemia, hepatitis, hyperkalemia
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PCP alt severe
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pentanamine
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PCP alt mild-mod
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Dapsone + TMP
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PCP alt mild-mod
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Primaquin + clindamycin
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PCP alt mild
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Atovaquone
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PCP adjunctive
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prednisone with po2<70
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PCP prophylaxis start
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CD4<200
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PCP prophylaxis
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TMP, alt: dapsone, atovaquone
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MAC tx duration
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12 months
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MAC DOC
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clarithromycin + ethambutol
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MAC disseminated
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clarithromycin + ethambutol + rifabutin
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when to consider rifabutin
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cd4<50, high load, no good art, DR
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MAC prophylaxis start
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cd4<50
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MAC primary prophylaxis
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azithromycin or clarithrymycin
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MAC prophylaxis primary alternative
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rifabutin or azithromycin + rifabutin
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MAC secondary prophylaxis DOC
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clarithromycin + ethambuton
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MAC secondary prophylaxis alternative
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azithromycin + ethambutol +- rifabutin
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Cryptococcosis causitative agent
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cryptococcosy neoformans
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cryptococcus manifestations
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headache, meningitis
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Cryptococcus diagnosis
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CrAg in CSF or serum, elevated opening pressure
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Cryptococcus tx duration
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induction (2 wks), consolidation(8wks), chronic maintenance
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Cryptococcus tx DOC
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induction: amphotericin B + flucytosine, consolidation/maintenance: fluconazole
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amphotericin toxicity
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hypokalemia, hypomagnesemia
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flucytosine ade
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BM
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Cryptococcus primary prophylaxis
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n/a
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cryptococcus secondary prophylaxis
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fluconazole
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toxoplasma infection associated
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cerebral or disseminated
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toxoplasma manifestations
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focal encephalitis/neurological abnormaliities
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toxoplasma diagnosis
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serum + antitoxoplasma IgG, imaging + clinical syndrome + detection
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toxoplasmosis doc
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pyrimethamine + sulfadiazine + leucovorin
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toxoplasmosis duration
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6 weeks
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toxoplasma gondii alt tx
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primethamine + clindamycin + leucovorin, TMP/SMX, atovaquone + sulfadiazine
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toxo prophylaxis start
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positive toxo IgG and CD4<100
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Toxo prophylaxis primary
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TMP/SMX alt dapsone + pyremethamine + leucovorin, or atovaquone + pyrimethamine + leucovorin
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toxo prophylaxis, secondary
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sulfadiazine + primethamine + leucovorin, atovaquone + pyrimethamine + leucovorin
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CMV risk
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cd4<50
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CMV complications
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colitis, esophagitis, retinitis, pneumonitis, neurological disease
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CMV dx
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PCR, antigent assay, blood culture (colon brush not diagnostic)
ab levels not useful, false negs possible. |
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What is the preferred treatment for retinitis caused by CMV?
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sight threatened: gancyclovir io implant + valgancyclovir PO, periperheral lesions: valgancyclovir
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cmv retinitis alt tx
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gancyclovir, foscaranet, cidofovir, fomivirsen
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At what CD4 does prophylaxis for CMV start?
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CD4<100-200
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CMV prophylaxis tx doc
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valganciclovir or foscarnet, ganciclovir implant + PO valgancyclovir
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CMV prophylaxis alt
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cidofovir IV + probenecid
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When to start prophylaxis for:
PCP MAC Crypto Toxo CMV |
PCP: CD4<200
MAC: CD4<50 Crypto: n/a Toxo: +IgG, CD4<100 CMV: CD4<100-200 |
