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131 Cards in this Set

  • Front
  • Back
what are the most common organisms for cellulitis
• Most common organism: Staph aureus or Group A Strep
1st line treatment for cellulitis
o 1st line – Anti-staph PCN (Nafcillin), Cafazolin, Ceftriaxone
name a complication of cellulitis
If PCN allergic, how do you treat cellulitls
allergic to PCN, then Vancomycin or Linezolid
how do you trat a subsequent outbreak of cellulitis
o Subsequent treatment: Dicloxicillin, Cefalexin
describe the presentation of Psoriasis
• Swelling, erythematous, scaly white lesions, sharply-demaracated, silvery scales
• Positive Auspitz sign
• Located on palms, soles, scalp, nails
name the different types of psoriasis
o Psoriasis vulgaris
o Psoriatic arthritis
what are topical treatments for psoriasis
• Tx. Calcipotriene (Dovonex) or Oraflex cream: topical corticosteroids which normalizes proliferation. Inhibits leukotrines.
what do you use for systemic treatment of psoriasis
• Use MTX for systemic infection and tegasin
Photo therapy is effective in the treatment of psoriasis. TRUE or False
what sre complications found in children with psoriasis
arthritis, kids: Guttate (following a URI/strep pharyngitis)
what are some agents that can cause a flair up of psoriasis
• BB can cause flare, lithium and systemic steroids
what is the Koebner phenomena:
• Koebner phenomena: lesion after trauma
What is the Auspitz sign:
after scratching= blood
where can candidiasis occur
Can occur in the mouth, vagina, intertrigo (under the breast)
what test is used to diagnose candidiasis
identified by KOH and pseudohyphae
what are treatment options for candidiasis
topical anti-fungal (Nystatin or –azole cream)
what is significant about Oral Candidiasis
AIDS-defining condition
how do you treat oral candidiasis
magic mouthwash (Nystatin, Lidocaine)
what is the MCC of Impetigo
Staph aureus
what are the etiologies of Bullous type and non-bullous impetigo
• Bullous type (caused by Staph); non-bullous = honey crusted = strep pyogenes(caused by GABHS or Staph)
what is the most common area effected by impetigo
what is the treatment for Non-penicillinase producing impetigo Pen G,
Pen G, (DOC for pyogenes)
how dou you treat Penicillinase-producing impetigo
dicloxacillin, cloxicillin (for severe infection nafcillin or oxacillin)
describe the lesions of the vericwlla virus
Tear-drop rose petal lesion that starts at the head and descends to trunk and extremities
what is the TX for peds with vericella
supportive, calamine lotion
what is the TX for adults with vericella
acyclovir (can be used reduce the duration)
how dou you treat complicated cases of vericella
refer to Dermatology
What are the stages of acne
Mild, moderate, & severe acne
what population developes Acne fulminans
(seen in teenage boys)
when do you see Tropical acne
(usually seen with folliculitis)
o On the trunk and buttocks in tropical climates
what is, and when dou you see Acne excoriee
Mild acne usually in young women. Usually seen in patients with OCD
All acne drugs are teratogenic. TRUE or FALSE
TRUE(all acne meds are teratogenic agents)
what are some treatment options for Mild acne
Tx with topical antibiotics (clindamycin, erythromycin)
Benzoyl peroxide gels Topical retinoids (ex. Adapaline)
what are some treatment options for moderate acne
Oral antibiotics are added to above regimen
Most affective antibiotic: Minocycline or Doxycycline
Dosage is tapered as acne lessens
what is a hormonal treatment optiotion for females with moderate acne
In females, moderate acne can be controlled with oral estrogens
What are treatment options for severe acne
Treat with above + Isotretinoin (Accutane)
What 2 drug should not be combined in the treatment of acne, and why
Do not give tetracycline and accutane together (can get pseudotumor cerebri)
What is Myasthenia Gravis
An autoimmune disorder against acetylcholine receptors that effects the proximal muscles,
what are some of the manifestations of My asthenia Gravis
Fluctuating muscle weakness
Causes ptosis, diplopia, dysphagia
Activity increases weakness of affected muscles; improves with rest
How is MG diagnosed
Diagnosis confirmed by edrophonium, electromyography, serum testing of AcH
How is MG treated
oxygen, neostigmine, severe MG (high dose steroids)
What is Guillain-Barre
A polyradiculoneuropathy of ascending semetric weakness
what will the CSF in MG show CSF show
high protein, normal glucose and cell count
How do you treat GB
Consult neurology
Tx. Plasmpheresis
In Bacterial Meningitis, what will the CSF show
low glucose, elevated protein, and markedly elevated opening pressure
What is the most common treatment of bacterial meningitis
Most common treatment is Ceftriaxone 2 g IV Q12hr
How do you treat BM if PCN alergic
treat with Vanco, Rifampin, & Chloramphenicol
how does Wernicke Encephalopathy present
Ataxia, confusion, nystagmus leads to ophthalmoplegia
What is the treatment for W.E.
what is the treatment for Patients that present with AMS
narcan, D50, and thiamine
What is the Inpatient TX of Diverticulitis
Aminoglycoside IV + (Metronidazole or Clindamycin)
what is the Outpatient TX for diverticulitis
Ampicillin, Bactrim, or Cipro + (Metroniazole or Clindamycin)
what are causes of small bowel obstruction
1. Adhesion
2. Hernias
3. Volvulus
What should you susoect with 1st Trimester Bleeding
Threatened abortion
What are the conditions that define a threatened abortion
Vaginal bleeding in the first 20 weeks
• Cervical os is closed
• If the cervix is dilated, then is an inevitable abortion
What are the conditions that define an Incomplete abortion
• Partial passage of fetus
• Most common in 6-14 weeks
What is the treatment for am incomplete abortion
What is a complete abortion
Passage of entire fetus before 20 weeks
Define a Missed abortion
Fetal death at less than 20 weeks without expulsion of fetus
Who should recieve the RH D immunoglobulin (Rhogam
rH negative women
What imaging study is best for Ectopic Pregnancy
Ectopic Pregnancy
Ultrasound will show no sac
What will HCG readings be in ectopic pregnancy
HcG > 1000 suggest ectopic pregnancy
What will progesterone levels be in an ectopic pregancy
Very low progesterone level suggest ectopic pregnancy
How do you treat an ectopic P
surgical removal (done via laproscopy)
what lab should be drawn post treatment od an ectopic P
• Post-abortion, perform serial hcG counts
What tests are used to diagnose syphilis
Diagnosed by darkfield microscopy, FTA, VDRL, RPR
Describe the presentation of Primary syphilis
Painless ulcer (chancre)
Bilateral inguinal adenopathy
Usually asymptomatic
describe the presentation of secondary syphilis
Diffuse rash
Condylomata lata
describe the presentation of tertiary syphilis
Neurovascular, neurosyphilis
Meningovascular (stroke-like presentation)
Syphilitic aortitis
CN 2,3,7,8 involvement
How do you treat syphilis
What is the treatment for Gonorrhea
Ceftriaxone and Doxycycline (to cover for Chlamydia)
• Alt: Spectinomycin
What is the etiology and treatment of a Chancroid
Caused by Haemophilus Ducreyi
Tx. Macrolide or Rocephin
What are treatment options for Chlamydia
Doxycycline 100 mg BID x 7 days + Azithromycin 1 gm PO (single dose)
Altneratives: Erythromycin + Ofloxacin
What will the discharde of Trichomonas look like
Green-yellow discharge
Waht will be seen on a saline wet prep with Trichomonas
Motile flagella on saline prep
What is the treatment of Trichomonas
Metronidazole 2 gm PO (single dose)
What is the MCC of skin abscess, and how do the lesions appear
Staph aureus
Skin lesions are red, hot, and painful
Pus collects within a central space, characterized by fluctuance of the central portion
How does Hidradenitis suppurativa present, and how do you treat
abscess in the axillae, groin, and vulva
TX: I & D
How does Bell’s Palsy present, and how do you treat it.
Facial paralysis/droop
Unable to raise eyebrows
TX: supportive
How do you treat PCP
TX: Bactrim IV
If allergic to bactrim how do you treat PCP
If allergic to bactrim, treat with Pentamidine with Primaquine or Clindamycin
How do you treat Toxoplasmosis
Sulfadiazine and Pyrimethimine
What are viral Causes of colitis
•Viral (CMV)
What are protozoal Causes of colitis
(Entamoeba histolytica)
What are bacterial Causes of colitis
Cytoxic (E. Coli 0157:H7, Vibrio, C. Difficile)
o Mucosal (Shigella, Campylobacter, Salmonella, Yersinia, Shigella (TX with Cipro)
What causes primary peritonitis and how is it diagnosed
Caused by cirrhosis
Most organisms, E. coli, proteus, klebsiella
Diagnosed by paracentesis
What causes secondary peritonitis
Due to rupture (appendicitis, diverticulitis, cholecystitis)
What are etiologies of Atypical pneumonia
Legionella, Mycoplasma, Chlymydia, TB, PCP
What will a CXR show in Atypical pneumonia
bilateral interstitial infiltrates
The CXR of Atypical pneumonia caused by Legionella will show ?, and is treated with
patchy infiltrates (Tx: Erythromycin)
The MCC of Commuinity-aquired pneumonia is
Strep pneumo
Commuinity-aquired pneumonia is treated with
Ceftriaxone + Azithmycin OR Fluoroquinolone
Polyarteritis Nodosa presents with
Multiple subcutaneous nodules with ulceration occurring on the medial and lateral aspects of the lower extremities
Polyarteritis Nodosa is associated with
Hep B & C
Polyarteritis Nodosa is treated with
corticosteroids or immunosuppressive drugs
Giant Cell Arteritis
Aka temporal arteritis is
Associated with ?
polymyalgia rheumatic (proximal muscle weakness of the shoulder and hip)
Giant Cell Arteritis often presents with?
Headaches, jaw claudication, scalp tenderness,
Painful, pulseless temporal artery.
Age over 50, elevated ESR
How is Giant Cell Arteritis diagnosed and treated?
temporal artery biopsy
Tx: prednisone
Takayasu is defined as?
Large vessel vasculitis
Affects mostly young women
Aka “pulseless disease”
Churg-Strauss is also known as?
Allergic granulomatosis
Churg-Strauss effects what size vessels?
Small-to-medium vessel vasculitis
Churg-Strauss Classic patient presentation is?
middle-aged asthmatic with pulmonary infiltrates, vasculitis and eosinophila
Churg-Strauss is diagnosed with, and treated with?
Positive P-ANCA
TX: steroids
What size vessels are effected by Kawaski Disease
Medium-large cell arteritis
What age group is MC effected by Kawaski Disease
Children less than 5
What are physical findings of Kawaski Disease
Fever, strawberry tongue, desquamation of the fingers and toes
What are complications of Kawaski Disease
coronary aneurysms
What size vessels are effected by Wegener’s Granulomatosis
Medium vessel vasculitis
Wegener’s Granulomatosis is diagnosed by?
Positive ANCA
Wegener’s Granulomatosis is associated with?
Recurrent URI and LRI
Define Scleroderma
A chronic disorder charcterised by difuse fibrosis of the skin and internal orgins
Scleroderma is associated with the acronym CREST, what does it stand for
Cutaneous calcinosis
Raynaud’s phenomenon
Esophageal Dysmotiliy
Describe a LeFort I:
transverse fracture separates the body of the maxilla from the lower portion pteryoid
Describe a LeFort II:
LeFort II: a pyramidal fracture of the central maxilla and the palate
Describe a Lefort III:
Lefort III: cranial-facial disjunction, occurs when the facial skeleton separates from the skull
Describe a Lefort IV:
Lefort IV: fracture includes the frontal bone and the midface
Name the large vessel vasculitides
Takayasus, Giant Cell, Polymyalgia Rheumatica, Aortitis
Name the medium Vessel vasculitides
polyarteritis Nordosa, Churg-Schonlein purpura, Kawasaki Disease
Name the small vessel vasculitides
wegeners granulomatosis, henoch-shonlein purpura, leukocyto clastic, microscopic polyangitis, cryoglobulinemic, primary angitis of the CNS, vasculitis associated with connective tissue diseases.
describe henoch-schonlein purpura
small vessel affecting children and young adults. classic trid(Victor) palpable purpura, arthritis, and abdominal pain, fever and glomeruloephritis are common. IgA levels are elevated
What is acute retroviral syndrome?
A mononucleosis like syndrome that affects > 50% of HIV patients.
describe the asymptomatic phase of HIV
The part of the disease free from illness, most are unaware of their illness untill the CD4 count falls < 200
Name some opportunistic infections associated with HIV
MTB, kaposis sarcoma, recurrent bacterial pneumonia, non-hodgkins lymphoma. CMV retinitis, cryptococcus meningitis, CMV esophagitis, CMV colitis, CNS lymphoma.
How is early HIV managed
H&P every 3-4 months
baseline plasma HIV RNA and CD4 count every 3-4 months
What are other studies used to manage early HIV
PPD, toxoplasma antibody, LFT, CXR
What are vaccine's used to help manage early HIV
Pneumococcal , Hep-B(if H-B seroneative), yearly flu vac.
What are guidelines to initiate antiviral theropy in the chronically infected.
Symptomatic(THRUSH, AIDS)with CD4 any value.

Asynptomatic with CD4 < 200

Asymptomatic with CD4 > 200, with recomendation based on the decline rate of the CD4, HIV RNA plasma levels, and the commitment to long term therapy
What is an ACRONYM for the NRTI's
L lamivudine
E emtricitabine
A abacavir
D didanosine

S stavudine
T tenofovir
Z zidovudine
What is the ACRONYM for the PI's
I indinavir
N nelfinavir

S saquinavir
A amprenavir
R retonavir
A atazanavir

(Sara, a girl I used to know)
E efavirenz
N nevirapine
D delavirdine

(the END in near)