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;
59 Cards in this Set
- Front
- Back
|
Outpatient CAP Tx
|
– Macrolide, doxy, or fluoro
|
|
|
CAP Tx in those w/ comorbitity
|
– Macrolide or fluoro
– add a 2nd gen or B-lactam |
|
|
Inpatient CAP Tx
|
– Extended cephalosporin/B-lactam/fluoro
– Add a macrolide if atypical suspected or if in ICU |
|
|
HAP Tx
|
– Extended cephalosporin/B-lactam with pseudomonal
– Add aminoglycoside or fluoro – strep pneum is the most common in nursing home patients! |
|
|
Where are pulm lesions in TB
|
– lower lobe in 1o and apical in reactivated
|
|
|
5 mm TB test is positive
|
– HIV, close contacts, CXR evidence
|
|
|
Sinusitus Tx
|
– Amox/clavulanate 500 TID for 10 days
|
|
|
Meningitis prophylaxis
|
– Rifampin, Cipro, Ceftriaxone
|
|
|
Meningitis complications
|
– subdural effusions in infants w/ H flu
– Ventriculitis is worse clinical but better CSF – subdural empyema is intractable seizures |
|
|
Meningitis Empiric Tx
|
– less than 1 month is Amp and Cefotaxime/Gent
– 1 month to adults is Vanc + Ceftriaxone/Cefotaxime – Over 65 is Amp + Vanc + Ceftriaxone/Cefotaxime |
|
|
When do you start HIV therapy?
|
– CD4 less than 350
|
|
|
Candida Thrush Tx
|
– Oral nystatin QID
– clotrimazole if that fails – Oral fluconazole if topicals fail or esophagitis |
|
|
MAC prophylaxis
|
– weekly azithromycin or daily clarithromycin
– stop when CD4 > 100 for 6 months |
|
|
Toxo prophylaxis for HIV
|
– TMP/SMX DS
– SS in PCP |
|
|
Cryptococcus defining features and Tx
|
– absent meningismus
– IV Amp + flucytosine for 2 weeks – then fluconazole for 8 weeks – need lifelong maintenance (200 mg QD) |
|
|
Histo defining features and Tx
|
– nodular and hilar densities and yeast on silver stain
– Amp for 3-10 days – then itraconalze for 12 weeks – need lifelong maintenance |
|
|
PCP Tx
|
– TMP-SMX for 21 days
– can add prednisone taper if serious hypoxemia |
|
|
Chlamydia Tx
|
– Doxy 7 days or azithro 1 time
– give pregnant patients erythromycin |
|
|
VDRL false positives
|
– Virus (EBV, HSV, HIV, hepatitis)
– Drugs (esp IV) – Rheumatic fever – SLE/leprosy |
|
|
Granuloma inguanale
|
– beefy red ulcer
– painless – give Doxy 100 for 3 weeks |
|
|
H. Ducryi
|
– aka chancroid
– deep irregular and necrotic – pain and lympadenopaty – give Ceftriaxone, erythromycin, or azithromycin |
|
|
Pyelonepritis Dx
|
– IVP unless pregnant or RF
– then do U/S – CT if not improving after 3 days |
|
|
Osteomyelitis Dx
|
– MRI test of choice for foot or back
– 3 phase scan for everything else – bone scan is sensitive, but not specific |
|
|
Osteomyelitis Tx
|
– 4-6 eeks of IV Abx
– Clinda + Cipro – Amp/sulbactam – Oxacillin/Nafcillin – cipro or ceftriaxone for Gram negative – Vanc for MRSA |
|
|
Neutropenic Abx
|
– Low risk get Cipro + Amox/clavulanate
– High risk get cefepime, ceftazadine, or carbapenem (Add aminoglycoside if two drugs) – Add Vanc if need be as well |
|
|
Lyme disease Dx and Tx
|
– Elisa and western blot
– doxy early and ceftriaxone late – if pregnant give amoxicillin |
|
|
Congenital CMV
|
– most common
– petechial rash and periventricular calcifications |
|
|
Hutchinson’s Triad
|
– congintal sypilis
– Peg shaped central incisors, deafness, and interstitial keratitis |
|
|
Endocarditis Tx
|
– Vanc or ceftriaxone + Gent
|
|
|
Anthrax Tx
|
– Penicillin G, cipro, erythromycin, tetracycline, chrlomapenicol for cutaneous for 7 days
– high dose penicillin for inhalational or GI |
|
|
Major Criteria for encdocarditis Dx
|
– two + blood cultures
– evidence by TEE or new murmur |
|
|
Coccidiodomycosis
|
– SW US
– goes to bone, CNS, and skin – IGM and IGG are positive – give AMP B or itraconozole |
|
|
Invasive asprigillosis Dx
|
– cavitary on CXR and halo sign on CT
|
|
|
Diarrhea in HIV
|
– do stool for O and P
– if negative, think about colonoscopy for CMV colitis – will see multiple ulcerations w/ Eos in nucleus and Basos in cytoplasm |
|
|
Babesiosis
|
– New york tick
– seen in jaundiced patient with no spleen (allows hemolysis) |
|
|
Nocardia
|
– gram + and weakly acid fast branching rod
– can cause cavitary pulmonary lesions in HIV |
|
|
Bacillary Angiomatosis
|
– from Bartonella
– immunocompromised with skin lesion (cherry hemangioma) – will bleed a lot and can get into liver |
|
|
Trichinellosis
|
– triad of edema/mysoitis/eosinophilia\
– have spinter hemorrhage and GI complains |
|
|
Erlichiosis
|
– tick bite w/ systemic Sx
– leucopenia and thrombocytopenia – increased LFTs – treat with Doxy |
|
|
Blastomycosis
|
– broad based budding yeast
– cutaneous can be ulcerative of verrucous – wet prep will show yeast – in south and north central US |
|
|
Cervicofacial Actinomyces
|
– chronic drainage w/ sulfur granules
– give penicillin |
|
|
Indinavir SE’s
|
– protease inhibitor
– crystal induced nephropathy |
|
|
NNRTI SE’s
|
– SJS
|
|
|
NRTI SE’s
|
– lactic acidosis
|
|
|
Nevirapine SE’s
|
– liver failure
|
|
|
Didanosise SE’s
|
– pancreatitis
|
|
|
Abacivir SE’s
|
– hypersensitivity syndrome
|
|
|
Mucormycoses
|
– from rhizopus
– need surgery and AMP |
|
|
Vibrio parahaemolyticus
|
– diarrhea from seafood
|
|
|
E. Coli diarrhea
|
– from undercooked ground beef
|
|
|
Soradic yersiniosis
|
– diarrhea from pork
|
|
|
Camp J. diarrhea
|
– from poultry
|
|
|
HSV encephalitis
|
– hallucinations
– start IV acyclovir if you even suspect |
|
|
Cat bite Tx
|
– 5 days of Amox/Clav
|
|
|
Bactiruia in pregnancy
|
– must treat
– give Amox, nitro, or ceph – bactrim can be used in 2nd or 3rd trimester |
|
|
Necrotizing bronchopneumonia
|
– a 2o pneumonia with pneumatoceles
– from SA |
|
|
Hemochromatosis patients are vulnerable to what?
|
– Listeria, yersinia, and vibrio vulnificus
|
|
|
EBV vs. HIV
|
– no rash w/ EBV
– no tonsilar exudates on HIV |
|
|
Leprosy
|
– insensate hypopigmented patch on Asian
– do skin Bx |
