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132 Cards in this Set
- Front
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incubation of varicella.
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14-16 days. 28 days who receive VZIG
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treatment for entamoeba histolytica
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metronidazole
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flucytosine
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adjunct for cryptococcus and candida severe infections. Like rifampin has lots of resistance, must be used with ampho
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Rx for invasive pulm aspergillosis
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ampho.
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Rx for gc/chlamyd
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azithromycin, ceftriaxone.
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complications of measles
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pneumonia. most deaths from measles are from pneumonia. encphalitis is less common but is more common in older kids. Few die from enceph but many have perm damage.
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skinned rabbit, think and treat
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Yersinia. from flea bites. lymphadenitis regional (near bites), fever. Streptomycin
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community acquired celluluits from varicella. treat
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nafcillin/oxcillin
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highest risk factor for transmitting Hep B
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e antigen positive.
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complications of mumps
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meningeal signs, arthritis, thyroiditis, orchitis, hearing problems. test for mumps in parotitis
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most common org in peritonitis from chronic dialysis
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Staph epi and Staph aureus.
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early signs of Lyme
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erythema migrans. 90% of patients ahve rash. 1-2 weeks after tick bite. lasts for 1-2 weeks.
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seventh nerve palsy think
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early Lyme
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timing of arthritis in Lyme
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late. wks to months after infection. knees.
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giardia Rx
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metro
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ALL patient with high fever, herpetic lesions, deep seated and umbilicated, palms and soles
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varicella. HSV is grouped not generalized.
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risk from MMR vax in 1st trimester
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risk is congenital rubella syndrome. no cases reported from MMR. theoretical risk 1%. pregnant after 3 months from vax is completely safe.
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pertussis duration and complications
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6-10wks, sz, pneumonia, encephalopathy, death
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treatment of household with pertussis
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erythromycin for all household contacts, irrespective of age or vaccination status.
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cipro modifies which drugs
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theophylline
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How many months do you have to wait for HIV Ab to revert to neg in a baby that has HIV+ mom but has no HIV infection
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18 months.
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Rx for varicella exposed immunocomprimised patient
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VZIG withing 96hrs.
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chemoprophylaxis for malaria
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1 week before travel. chloroquine. Mefloquine if going to sub-saharan africa (chloroquine resistant)
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meningococcal vax covers which goups
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A, C, Y, W. none for B
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at risk groups who need meningococcal vax
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>2yrs. asplenia, copmlement def.
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Hep A IG can prevent hep A if given within 2 wks of exposure. who gets it?
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only direct contacts. If in child care with diapers, give to all kids and all employees.
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who gets invasive aspergillus
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immunocompromised pt. bone marrow is most likely. allergic bronchopulmonary aspergillosis is noninvasive.
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Don't treat salmonella enteritis in
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chronic carriers. usually self-limited illness. most cases are <1yr old. Give Abx if <3mo, bacteremia, invasive disease, hemoglobinopathyies.
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lab detection of arboviruses
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serology. acute and convalescent titers of IgG
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ulcerated tick bite, fever, chills, regional adenopathy
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tularemia
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Tularemia labs
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serology for Francisela tularensis.
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ticks or rabbit exposure, flu
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tularemia
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patients who get worse EBV infections
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cell-mediated immune system disorders. T-cell disorders
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SE of chronic fluconazle
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GIsx.. LFTs elevated
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penicillin mech of action
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disrupts cell wall synthesis. no cross linking of peptidoglycans
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how to manage Hep B exposure in a fully immunized pt
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check anti-HBs. If positive, do nothing, if neg give another hep B vax
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animals in whom to suspect rabies
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unknown cat, bats, raccoons, skunk, fox, coyote
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management of rabies suspected bite
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wash well. HRIG injected around wound within 7 days. vaccine 4 times within first 4 weeks
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when to give TD
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every 10 yrs. give if wound is complex and no vax within 5. TIG is only for bad wound and incomplete primary series of IZ
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2 week old diffuse vesicobullous lesions
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congenital syphilis
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HS megaly, mildly preterm infant, IUGR, lymphadenopathy, chorioretinitis. intracranial Ca, hydrocephalus
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Toxo
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TORCH with cataracts
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rubella > toxo
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TORCH with heart defect
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Rubella
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TORCH with hydrocephalus
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toxo
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TORCH with microcephaly and anemia
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CMV
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TORCH with intracranial Ca
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toxi, CMV
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TORCh with thrombocytopenia
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CMV
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7yr old, fever, headache, edema, palpable purpura, early Spring
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Rocky Mountain spotted fever
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recent transplant, pneumonia
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CMV from the transplant
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3 yr old fever, abdom pain, wheeze, urticaria, HSmeg, lymphadenopathy, eosinophilia
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toxocariasis. round worm from dog or cat.
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when to give VZIG
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within 72hrs of exposure to immunocprimised. If receiving monthly IVIG, no need.
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risk factor for hepC
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transfusions, IV drug, hemodialysis. perinatal transmission is low.
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late onset GBS sites
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meningitis.
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conjunctivitis, cervical adenopathy lasting weeks
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Bartonella henselae
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bad complication of VZ in immunocomprimised
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pneumonia
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most common complication of mumps in young child
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meningitis. orchitis is common only after puberty.
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PPD + sib of INH resistant TB, Prophylaxis
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Rifampin alone
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etiology of atypical pneumonia in teen
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Mycoplasma. viral and bacterial causes less likely.
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Abx causing fever, morbilliform rash, neutropenia
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bactrim
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drugs that suppress bone marrow
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chloramphenicol, sulfonamides, anticonvulsants.
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Initial therapy for fever, neutropenia
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gram+ and Gram -. with pseudomonas covered. aminoglycoside + anti-pseudo abx, meropenum
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IVIG SE
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fever, chills, headaches. rarely hypotension, shock.
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reasons to not give further doses of DTaP
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anapylactic reaction. encephalopathy within 7 days,
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PPD neg with known TB
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severe disseminated TB has sufficiently immunesuppressed the response.
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6yr old, tick bite, HA, photophobia, myalgia, HSmeg, pancytopenia
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ehrilichiosis. A ricketsial infection similar to RMSF but with more leukopenia and pancytopenia. Rash is not as common.
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Malaria like illness, anorexia, high fevers, chills, myalgia, arthralgia.
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Babesiosis (parasite)
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ketoconazole common SE
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nausea.. can also increase LFTs
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CMV retinitis Rx
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gancyclovir, if recurs foscarnet
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immunocomprimised. pneumonitis and retinitis
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CMV
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VZ maternal infection 1st tri, sx
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2% risk of congeintal VZ. limp hypoplasia, eye, brain abnormal, skin lesions.cataracts, chorioretinitis
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Viruses which can be cultured
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CMV, HSV, enterovirses, respiratory viruses
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mono rash from Abx, which Abx
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ampicillin, less so amox, less augmentin
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organism in nephrotic S peritonitis
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Strep pneumo
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fever, tachycardia, low BP
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myocardial vs pericardial disease. pulsus paradoxus favors pericardial.
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treatment of RMSF or Ehrlichiosis
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Tetracycline for any rickettsiae.
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<4yrs old exposed to active TB
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PPD, CXR. INH if ppd (-), retest in 12 weeks. INH for at least 9 months
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SCC pneumococcus prevention
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oral penicillin prior to age 4mo.. Prevnar and later pneumococcal im
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when does C3 return to normal after post strep gmn
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6-8weeks. if still low at 10weeks work up for something else.
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MMR not to be given to
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pregnant women. Or planning to be in 4 months. immunocomprimised, not including healthy HIV. OK for breastfeeders. OK for egg allergic.
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signs of anaphylaxis in IVIG
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IgA deficiency. most common immunodef. often unknown. Presence of IgA provokes anaphylaxis. IVIG has a small amount of IgA. Same problem to blood products.
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timeline for maternal varicella
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<20wk gestation 2% risk for congenital VZ
>20wk sensitized without problem up to: 5 days prior to delivery to 2 days after (in mother) infant at risk for primary VZ |
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who gets VZIG
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exposure of suseptible household contact or playmates
mother has onset 5 days prior to 2 days after delivery, then give to baby. |
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potential complication of EES therapy in <6wk old
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hypertrophic pyloric stenosis.
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who gets pertussis prophylaxis
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household and close contacts of known patient
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Pertussis prophylaxis in classmates
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no Abx, give IZ if not up to date.
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At what age do you discontinue pen prophylaxis for sickle cell
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5yrs
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fever, sweats, weakness, lymphadenopathy, (flu-like) unpasteurized milk
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brucellosis. doxycycline
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flu-like illness, conjunctivitis, no pus, can have jaundice, rash. Myalgias of calf and back.
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Leptospirosis
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Treatment of Lepto, complications
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Penicillin. jaundice, renal failure, hemorrhagic pneumonitis
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Lepto, where do you get it?
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animal urine, mucosa or abraded skin, wacontminated water, veterinarians, famers, sewer workers
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flu-like illness, painful maculopapular lesion with regional lymph adenitis
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Tularemia
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tularemia Rx and epi
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Streptomycin, rabbits, domestic animlas, tick and mosquito bites from these animals.
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fever, leuikocytosis, eosinophilia, hepatomegaly
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toxocariasis. roundwroms of dog and cat. get from eating contaminated soil. mebendazole
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seizures, pork
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cysticcercosis, taeniasis. forms cysts anywehere. . one adult worm in intesine, larbae cause the illness. months to years between ingestion and sx.
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school exposure to VZ
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if not immunized do so within 72 hrs
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meningococcus prophylaxis
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household contacts, childcare congacts, including 7 days prior to onset. Rif for kids, cipro for adults
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Salmonella return to school crit
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24hrs no diarrhea if >5yrs. 3 neg stool cx if <5yrs test all in school
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TB in healthcare worker
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PPD+, CXR neg, INH alone
PPD+, CXR+, therapy, no work until cough gone and sputum neg x 3 |
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best test for HSV encephalitis
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PCR of CSF
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best time to measure Gent Peak
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1hr after infusion
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tests for congenital rubella
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IgM or IgG over time
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TORCH with calcifications on head CT
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diffuse = toxo
periventricular = CMV |
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PPD>15mm withhx of BCG
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+ PPD, if CXR - treat with INH
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who is PPD + at 5mm
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close contact has active TB, clincal signs of TB, CXR shows signs of TB
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PPD + at 10mm
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<4yrs, immunocopm, increased exposure to TB
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intial treatment of dental abscess
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pen VK oral
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gentamycin peak and trough
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peak 5-12, trough 0.5-1
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chloramphenicol SE
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rare dose independent aplastic anemia. dose dependent bone marrow suppression. check CBC twice weekly
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rifampin drug interactions
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OCPs don;t work as well
warfarin, digoxinm, chloramphenicol all affected |
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meorpenem use and SE
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resistant enterobacter. Long time in PICU, suddenly worsened. increased risk of seizures
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amantadine, rimantadine, oseltamivir
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oseltamivir keds to 1yr flu A or B
Rimantadine amantadine: flu A |
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ganciclovir SE
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anti-CMV for immunocomprimised or congenital. bone marrow suppression is most common.
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foscarnet use and SE
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acyclovir resistant herpes viruses, nephrotoxic
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ampho Se
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low K, nephrotoxicity, rigors
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ketoconazole, use and SE
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GI SE, most dangerous is hepatic failure.
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EBV labs
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primary infection goes to B cells, lifelong latent infection established.
EBV capsid Ag. IgG rises quickly, IgM + in acute EBV nuclear Ag takes weeks to months to see. |
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contagious period for VZ
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1-2 days before rash until lesions crusted
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measles contagious period
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4 days on either side of rash.
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incubation for measles
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8-12days
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neonate, septic, rash: 1-2mm light papules
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Listeria
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Staph aureus is different than other staph in what way
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coagulase +
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animal bite bacteria
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Pasteurella, penicillin
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human bite bacteria
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eikenella
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treatment of primary Lyme
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doxcycline. amoxicillin for kids younger than 8.
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Camping trip Colorado, fever, painful unilateral lymphadenitis
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Yersinia pestis, bubonic plague
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bacterial diarrhea associated with animal contact or uncooked meat
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Yersinia. self limited in most
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H. pylori Rx
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only treat in patients with EGD proven ulcers. amox, metro, bismuth
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HUS signs
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pallor, oliguria, hematuria
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types of acid fast stain
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Kinyoun and Ziehl-Neelson
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treatment for amebiasis
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iodoquinol
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treatment for ascaris
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vague GI sx, chronic low level infectino. mebendazole
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treatment for schistosomiasis
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praziquantel
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