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66 Cards in this Set
- Front
- Back
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2 types of infections where contact precautions are recommended?
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1. MRSA
2. VRE |
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3 types of infections where airborne precautions are recommended?
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1. Varicella (chickenpox)
2. TB 3. Rubella (measles) |
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When are sx ppx abx initiated?
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1 hour before cut
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When would a second dose of abx be indicated for sx ppx?
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1. 3-4 hours in length
2. Lots of blood loss >1-1.5 L of blood loss |
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DOCs for sx ppx? PCN allergy?
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1. Cefaz
2. Cefuroxime PCN-allergic: 1. Vanco (2 hours prior to cut) |
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What drugs should be used in ppx if a sx involves part of the bowel?
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1. Cefotetan
2. Ertapenem 3. CTX 4. Flagyl |
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What is the classic triad for meningitis?
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1. Fever
2. Change in mental status 3. Nuchal rigidity |
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Most common organisms causing bacterial meningitis?
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1. S. pnumo
2. N. mening. 3. H. influ 4. Listeria mono |
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Empiric 3 drug regimen for meningitis in pt's 2-50 y/o where it's suspected that N.mening or S. pnumo aare causing the infection?
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Erta OR CTX OR Cefotaxime
PLUS Dexamethasone PLUS Vanco |
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What drug should be added to the empiric 3 drug regimen for meningitis in pt's 2-50 y/o where it's suspected that N.mening or S. pnumo AND listeria are causing the infection?
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Ampicillin
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Meningitis: patients >50, <1 month old, or with impaired cellular immunity are at risk of which particular pathogen? What drug should be added?
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1. Listeria
2. Ampicillin |
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How should meningitis be treated in patients with an immune-compromising condition OR >50?
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1. Vanc +
2. CTX OR cefotaxime + 3. Ampicillin |
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Meningitis mgmt in patients with a severe PCN allergy?
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1. Chloramphenicol +
2. Vanc +/- 3. SMX/TMP (listeria coverage) |
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Etiology of most AOM?
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Viral
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To whom are ABX given when AOM is suspected?
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<6 mo's = ABX
6 mo - 2 yr = ABX w/ certain ddx OR severe >2 = ABX after observation of 48-72 hrs or severe |
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When is it okay to use Auralgan for AOM symptom mgmt? What else can be used to manage pain?
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>5 y/o; IBUP or APAP
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PCN dosing for AOM?
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90 mg/kg
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What do you do (drugs + doses) for AOM if you have a true PCN allergy?
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1. ZZP - 10 mg/ kg x1 then 5 mg/kg qd x days 2-5
2. Biaxin - 15 mg/ kg BID 3. SMX/TMP - 6-10 mg/kg/day (TMP) BID |
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Prevnar prevents not only meningitis & PNA, but also reduces AOM. How many serotypes are in Prevnar? To whom should this vaccine be given? How many doses & when?
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1. 13
2. 4 doses: 2,4,6, 12-15 months |
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AECB: What are some good ABX to consider using?
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1. AmoxClav
2. FQs 3. ZZP/Biax 4. Cephalo |
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CAP: No comorbidities tx. + outpatient
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Doxy of macrolide
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CAP: What comorbidities are we concerned about?
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1. Chronic conditions: dm, hf, immunosppressant drugs
2. ABX use >3 months |
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CAP: outpatient tx w/ comorbidities
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1. Macrolide + beta lactam
2. Resp FQ |
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CAP: inpatient tx w/o ICU admit?
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1. Macrolide + beta lactam
2. Resp FQ |
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CAP: ICU admit w/ No pseudomonas risk tx?
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1. Macrolide + beta lactam
2. Resp FQ If Allergy to BL: 1. Aztrenoam + Resp FQ |
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CAP: ICU admit w/ pseudomonas risk tx?
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Antipsuedomonal BL
PLUS Cipro/levo OR AMG + ZZP If there is a BL allergy, use Aztreonam in place of the anti-psedomonal BL... |
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CAP: length of treatment?
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MINIMUM 5 days
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HAP: late phase vs early phase in days?
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5 days
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HAP: Late phase treatment?
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2 antipseudomonals (one BL + one non-BL) + 1 anti MRSA and if there is a BL allergy you use Aztreonam
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How to prevent HAP:
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1. elevate HOB to 30 deg
2. Wean off the vent fast 3. Wean off NG tube 4. Judicious use of stress ulcer ppx |
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HAP duration of treatment?
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7-8 days for non psuedomonas, aceinitobacter, or bloodstream infections (14 days for those)
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Is TB highly contagious?
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Yes
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How is TB ddx'ed ? Timeframe for induration?
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Look for induration in 48-72 hours
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Latent TB regimen of choice? (drug + length of tx)? What is the alternate tx? What should not be used and why?
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1. INH x 9 months
2. Rifampin x 4 months 3. Rifampin + pyrazinamide b/c of liver tox |
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RIPE: Take the 4 drugs for how long? If you check sensitivities at this time and you see you are fully susceptible, what do you do?
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1. x 2 months
2. continue RI for 18 weeks TOTAL OF 26 weeks! |
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Dental PPX. DOC + regiment? What happens if you have an allergy to the DOC?
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1. AMOX IV x 1 hour PTDC
2. Either: Clinda 600 or ZZP 500 mg 1 hr PTDC |
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Primary peritonitis DOC?
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CTX x 5-7 days
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Secondary peritonitis in the ICU. What are we covering? What are our drug options?
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Covering for pseudomonas and anaerobes.
ANTI-PSEUDOMONAL + FLAGYL Or just a ANTI-PSEDO 'penem ex) (Ceftaz/ Cefepime) OR (FQ) OR (Aztreo) OR (AMG) + Flagyl |
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Name the 4 Rickettsial Dzs that are treated with Doxy. Name the 1 that IS NOT. What is it treated with?
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1. Lyme
2. Typhus 3. RMSF 4. Ehrlichiosis ------------------------------ 1. Tularemia w/ gent/tobra |
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Inpatient SSTI (complicated).
Drugs? Length of tx? |
1. Vanco
2. Linezolid 3. Dapto 4. Telavancin 5. Clinda IV x 7-14 days |
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UTI: What is the E.Coli resistance % cut-off to use SMX-TMP for uncomplicated infections?
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20%
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UTI: What abx is used for 5 days for UNcomplicated infections? Which is only used for 1 dose?
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Nitrofurantoin; fosfomycin.
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UTI: PPX. How many episodes/ yr would justify ppx? What is acceptable ppx?
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1. >=3 episodes/ yr
2. Bactrim SS qdaily; nitro 50 mg qdaily; Bactrim DS post sex |
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UTI: What happens if you dont respond to 3 day treatment?
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Continue and tx for 2 weeks
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UTI: How long should preggers be treated?
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7 days
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Acute uncomplicated pylonephritis. Tx options for outpatient? Inpatient? Length of tx?
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Outpatient options:
FQs x 5-7 days (if resistance: amox clav, cefdinir, cofactor, vantin) Inpatient: FQ, AMP+Gent, Piptazo, CTX x 14 days |
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Do you treat a woman with bacteriuria but no sxs or (-) UA?
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Yes. Treat all women x 7 days.
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CrCl limits for Phenazopyradine?
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50; avoid use
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Should Azo be taken with or without food?
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With food
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How many days of Azo treatment?
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Max of 2.
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DOC for Travelers diarrhea?
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Generally Cipro/ FQ
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DOC for Travelers diarrhea in preggers/ kids?
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ZZP
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CDI: What SCr is considered severe? What WBC is considered severe?
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> 1.5; >= 15,000
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CDI: Tx of mild-moderate infection; 1st occurrence?
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Metronidazole 500 TID x 10-14 days
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CDI: Tx of mild-moderate infections 2nd occurrence?
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Metronidazole 500 TID x 10-14 days
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CDI: Tx of mild-moderate infections 3rd occurrence?
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Vanc taper/ pulse:
125 QID x 10-14 125 BID x 7 125 q2-3 days x 2-8 weeks |
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CDI: Tx of severe infection; 1st occurrence?
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Vanc
125 QID x 10-14 |
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CDI: Tx of severe infection; 2nd occurrence?
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Vanc
125 QID x 10-14 |
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CDI: Tx of severe infection; 3rd occurrence?
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Vanc taper/ pulse:
125 QID x 10-14 125 BID x 7 125 q2-3 days x 2-8 weeks |
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CDI: Tx of megacolon/complicated infection?
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Vanc 500 QID
PLUS Metro(sexual)nidazole 500 mg (IV) q8h |
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Do you use Bicillin LA or Bicillin CR for syphillis?
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LA
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You only treat syphillis weekly if it's late latent. When does it become late latent?
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Have it for greater than 1 year.
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DOC for Gonorrhea?
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CTX (one dose) + ZZP (1 gram once)
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DOC for chlamydia
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ZZP (one gram once)
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Bac Vag options:
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Metro pillz 500 BID x 7 days
Metro gel x 5 days Clinda cream 5g x 7 days |
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Tric- vag drug and dose?
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Metro 2 g x 1 time (or tinida)
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