Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
CVID aka acq. hypogammaglobulinemia
|
suspect w/ recurrent GI infections (esp Giardia), resp. infections; dx by dec. serum IgG
|
|
|
drug fever
|
commonly c/b b-lactams, Eo/rash 25%;
|
|
|
sepsis classes
|
SIRS: 2+ of T>100.4, <96.8; HR>90; RR>20, PCO2<32; wbc>12, <4
Sepsis: SIRS + confirmed infection Severe Sepsis: sepsis + organ dysfx, hypoperfusion, hypoTN Septic Shock: sepsis-induced hypoTN/perfusion despite adequate fluids |
|
|
severe sepsis 2/2 pyelo w/ AG met acidosis + elev lactate...MI mgmt?
|
aggressive fluid resuscitation (also maintain CV O2>70%)
|
|
|
oseltamivir details
|
neuraminidase inhibitor against influenza A & B like zanamivir (latter c/i'd w/ asthma/copd pts b/c of AE of bronchospasm)
note: amantadine/rimantadine only effective against A, not indicated...A also very resistant to these |
|
|
rhinitis medicamentosa
|
persistnet rhinitis in setting of nasal decongestant spray overuse; dec. sensitivity to vasoconstriction & rebound congestion/discharge...w/d spray and start nasal corticosteroid spray
|
|
|
acute bacterial rhinosinusitis
|
sxs>1wk, worse after initial improvement, maxillary tenderness, purulence, poor decongestant response; target s. pneumo/h. flu...3-10d narrow-spectrum ie amoxicillin/bactrim/doxy...bsabx (ie amox-clavulanate) no more effective
pts w/ only 1/3 have <25% prob. of bact.: URI>7d, facial pain, purulence |
|
|
pyelonephritis
|
PO levofloxacin (unless n/v, noncompliant) 7-14d...alternatively, ext-spectrum cephs, es pcns/aminoglycosides, monobactams, carbapenems
|
|
|
uncomplicated uti
|
3d bactrim/TMP-SMZ...tx empirically w/ wbc/leuk esterase on dipstick, don't need cx unless refractory...cipro if unrelieved...amoxicillin not as good but is doc for enterococcus and mb used in pregnancy where bactrim/FQs can't if sensitive
|
|
|
gen. rash, low grade fever, gen. LAD + high risk sexual activity?
|
suspect secondary syphilis...patchy +/- palmar/solar...must also workup HIV
|
|
|
KS
|
face/trunk/LE...erythematous/violaceous macules to larger nodules/plaques...yellow halo around nodular lesions ~ rapidly progressive dz...hhv8...often resolves completely once HAART is initiated
|
|
|
PML
|
polyomavirus JC>demyelination; no mass effect like lymphoma/toxo; b/l, asymm, nonenhancing...50% survive if HAART is initiated but existing neuro sxs generally persist
|
|
|
PPD cutoff implications
|
>15mm low risk (don't tx/work-up unless greater)
>10mm mod risk (immigrated from high risk country past 5y, IVDA, prisoners, HCW, DM, CRF, blood Ca, bypass) >5mm highest risk (HIV, imunosuppressed, close contact, CXR ~ prior TB) |
|
|
RA pt started on infliximab develops hepatosplenomegaly, anemia, thrombocytopenia, fever, pulm. infiltrates...
|
..likely react. TB...inc. risk w/ anti-TNFalpha tx
|
|
|
pna picture + extrapulm. sxs, hypoNa, azotemia, elev LFTs/CK...
|
likely legionella; empiric tx ~ macrolide + beta-lactam or FQ alone
legionella risk ~ cig smoking, age, chronic lung dz, Ca, esrd, DM...high fever hallmark note: psittacosis tx'd w/ doxy |
|
|
bronchiectasis pt should be tx'd for which bug if presenting w/ pna picture?
|
pseudomonas...can chronically colonize airways
|
|
|
which cardiac valve most susceptible to abscess?
|
aortic; echo shows valve perf & paravalvular extension if there are conduction abnormalities 2/2 endocarditis; diastolic murmur ~ aortic regurg.
|
|
|
pre-dental sx abx px in pt w/ mult. cardiac comorbs?
|
none! px indicated for: prosthetic valves, previous endocarditis, cyanotic congenital dz, systemic pulm. shunts, MVP, rheum dz, HCM...these pts get 2g PO 1h beforehand (or 2g amp. IM/IV 30m before if unable...clinda/zithro if pen-allergic); physiologic regurg. doesn't require abx px either
|
|
|
IVDA/etoh abuse, fever, splinter hemorrhages...ddx includes?
|
infective endocarditis
|
|
|
adolescent w/ ssdz has VOC, doesn't abate w/ IVF/O2/analgesia; febrile; bony destruction femur @ metaphysis; sent for bone bx..while awaiting, start on empiric coverage for?
|
staph/strept/salmonella...tx vanc/ceftriaxone
|
|
|
DM w/ foot osteomyelitis..next step?
|
bone bx to guide abx selection
|
|
|
most sensitive for osteomyelitis?
|
MRI/CT...if hardware precludes, can do nuclear imaging
|
|
|
orthopedic implant-associated osteomyelitis mgmt?
|
surgical debridement, removal of infected implant
|
