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57 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)

Fever, Headache, Photophobia, diagnosis?

Meningitis

Fever, Altered mental status, diagnosis?

Encephalitis

Fever, neck rigidity, altered mental status, nausea/vomiting, dianosis?

Intracranial abscess

CSF values in bacterial meningitis

Gram stain indicates organism
WBC up


Glucose down


Protein up

Fever, headache, photophobia




Gram positive diplococci. Organism and at-risk population?


  • Strep pneumo (anyone)
  • Group B strep (infants)

Fever, HA, photophobia




Gram negative diplococci.

Neisseria meningitis (college-student)




Neisseria gonorrhea (sexually-active)

Fever, HA, photophobia




Gram negative coccobacilli.

H. influ (non-vaccinated)



Fever, HA, photophobia




Gram positive rods + coccobacilli

Listeria (really young infant)

Treatment of bacterial meningitis?


  • 3rd gen cephalosporins OR vancomycin
  • Ampicillin + Gentamicin

Fever, sinus pressure, headache, post nasal discharge + sinus tenderness




Diagnosis and etiology?

Sinusitis





  • Strep
  • Moraxella
  • H. influ
  • Staph aureus
  • Viral

Treatment for otitis media?

  • Penicillins

  • Macrolides

  • Cephalosporins

Sore throat, odynophagia, fever




Also, drooling, dysphagia, neck pain, refusal to lie down, tripod posture




Diagnosis?

REDPIL




Retropharyngeal abscess


Epiglottitis


Diphtheria


Peri-tonsilar abscess


Infectious mononucleosis


Lemierre's syndrome

Sore throat, odynophagia, fever




Also, drooling, dysphagia, neck pain, refusal to lie down, tripod posture




Neck tenderness




Diagnosis?

Lemierre's syndrome

Sore throat, odynophagia, fever




Also, drooling, dysphagia, neck pain, refusal to lie down, tripod posture




Bilateral swollen tonsils




Diagnosis?

Infectious mononucleosis

Treatment of REDPIL diagnoses?

  • Penicillins

  • Cephalosporins

  • Macrolides


  • Age < 2 years
  • Fever
  • SOB
  • Tachypnea
  • Cough
  • Wheezing
  • Crackles



Etiology and treatment?

  • RSV (give ribavirin)
  • Rhinovirus
  • Influenza
  • Adenovirus
  • Coronavirus



Supportive care with O2 and fluids

Bronchiolitis

Fever, productive cough, green phlegm, SOB




Tachypnea


Tachcardia


Hypoxia


Ronchi crackles


Dull to percussion




Etiology?

Bacterial:
  • Strep

  • Staph

  • Moraxella

  • Legionella

  • Fungal


Viral (flu)



Pneumonia

Treatment of pneumonia

Strep = penicillin


Moraxella = macrolide


Staph = cephalosporin or vanco




Viral = tamiflu

Fever



S3/S4 gallop


Murmur in mitral valve


Roth spots (retinal hemorrhage)


Osler nodes (palmar nodules)


Janeway lesions (palmar erythema)


Splinter hemorrhages (fingernails)




Risk factors and complications?

  • IV drug use
  • Prosthetic device like catheter, artificial valve
  • Structural heart disease



Complications


  • CHF
  • Hypotension
  • Emboli
  • Stroke




Infective endocarditis

Fever


S3/S4 gallop


Murmur


Roth spots




Etiology of the following:



  1. IV drug use
  2. Previous colon cancer
  3. Abnormal heart valve
  4. Prosthetic valve
  1. Staph
  2. Strep bovis
  3. Strep viridans
  4. Strep epidermidis




infective endocarditis

Fever, Chest pain non radiating, non-exertional, SOB


Possible S3/S4 gallop




Risk factors and complications of this disease?

Risk factors


  • Parvo
  • Influenza
  • HSV



Complications


  • CHF
  • Pericarditis
  • Dilated cardiomyopathy




Myocarditis

Fever, breast pain, engorgement




Etiology?


  • Staph aureus
  • MRSA

Treatment of mastitis?

  • Dicloxacillin
  • Cephalosporins
  • Trimethoprim/Sulfamethoxazole
  • Vancomycin

Fever, RUQ pain, + murphy sign, no jaundice



Treatment

  • Ampicillin/sulbactam
  • Piperacillin/Tazobactam
  • Ceftriaxone/Metronidazole




Cholecystitis

Fever + jaundice + RUQ pain.




Etiology and Treatment?

Etiology:
  • E. coli
  • Klebsiella
  • Enterobacter
  • Enterococcus
  • Anaerobes



Treatment:


  • Ampicillin/sulbactam

  • Piperacillin/Tazobactam

  • Ceftriaxone/Metronidazole





Cholangitis

Fever, RUQ pain, Malaise, jaundice, pruritis, dark urine, light stool, hepatomegaly




Diagnosis?

Acute viral hepatitis

Fever, diarrhea, abdominal pain, N/V




Treatment

  • Rehydration
  • FQ's
  • Macrolides
  • Vancomycin
  • Metronidazole (for entamoeba)



(Gastroenteritis)

Dysuria, frequency, flank pain, flank tenderness




Etiology?

  • E. coli MC

  • Staph saprophyticus (if there's already a stone and treatment doesn't help)

  • Proteus

  • Klebsiella




(pyelonephritis)

Dysuria, frequency, flank pain




Treatment?

  • Nitrofurantoin
  • Trimethoprim/Sulfamethoxazole
  • Oral fluids
  • Ciprofloxacin




Uncomplicated pyelonephritis

Dysuria, frequency, flank pain, fever and vomiting




Treatment?

  • Ciprofloxacin

  • IV fluids

  • Hospitalization





Complicated pyelonephritis

Fever, lower ab/pelvic pain, dysunia, abnormal vaginal bleeding, vaginal discharge, cervical motion tenderness




Etiology and complications

Etiology
  • Gonorrhea
  • Chlamydia
  • Mixed flora



Complications


  • Fitz Hugh Curtis (hepatic abscess)
  • Tubo-ovarian abscess
  • Tubal pregnancy
  • Contiguous spread
  • Infertility




PID

Fever, lower ab/pelvic pain, dysunia, abnormal vaginal bleeding, vaginal discharge, cervical motion tenderness




Treatment?

  • Cephalosporin + IV doxycycline

  • Drainage of abscess if not responding





PID

Fever, hypotension, macular erythema, desquamation, multi-organ involvement, vomiting/diarrhea




Etiology and complications

  • Staph aureus
  • MRSA



  • Multi-organ failure
  • DIC




TSS

Fever, hypotension, macular erythema, desquamation, multi-oran involvement




Treatment?

  • Vancomycin
  • Clindamycin
  • Linezolid
  • Immunoglobulins
  • Removal of tampon




TSS

Fever, dysuria, urgency, incontinence, perineal/pelvic pain, male




Etiology?

  • Gonorrhea/Chlamydia



  • E. coli
  • Proteus
  • Klebsiella
  • Staph




Prostatitis

Fever, dysuria, urgency, incontinence, perineal/pelvic pain, male




Treatment?

  • Ciprofloxacin

  • Trimethoprim/Sulfamethoxazole

  • Cephalosporin

  • Azithromycin





Prostatitis

Fever, localized bone pain, erythema and tenderness




Microbe cause with each of the following:



  1. No risk factors
  2. Prosthetic joint
  3. Sickle cell
  4. Dog/Cat bite
  5. IV drug use






  1. Staph aureus
  2. Staph aureus and Staph epidermidis
  3. Staph aureus and Salmonella
  4. Pasteurella multocida
  5. G+ rods (pseudomonas), staph




Osteomyelitis

Fever, localized bone pain, erythema and tenderness




Treatment?

  • Debridement or hyperbaric oxygen

  • Cephalosporin if staph

  • Vancomycin if MRSA

  • Ciprofloxacin for salmonella





Osteomyelitis

Fever, joint pain, restricted ROM, joint swelling, erythema




What will synovial fluid show, and what is the etiology?

  • Fluid = Opaque, very high WBC, PML's, and gram positive culture


Etiology:
  • Staph
  • Gonorrhea
  • Lyme disease




Septic arthritis

Fever, joint pain, restricted ROM, joint swelling, erythema




Treatment?

  • Vancomycin

  • Cephalosporins

  • Metronidazole

  • Joint drainage or surgery



Septic arthritis

Severe back pain, fever, neuropathic pain, decreased sensation/strength




Etiology?

Staph


G- rods





Spinal epidural abscess

Severe back pain, fever, neuropathic pain, decreased sensation/strength




Treatment?

  • Drainage

  • Vancomycin

  • Metronidazole

  • Cephalosporins

  • Pain control





Spinal epidural abscess

Fever, malaise, sore throat, HA, lymphadenopathy, myalgia, diarrhea, night sweat, rash




IV drug user, multiple sex partners, prison inmates




Treatment and AIDS criteria?

Treat with anti-retroviral therapy




HIV + CD4 < 200 OR


HIV + Opportunistic infection

Fever, malaise, sore throat, HA, lymphadenopathy, myalgia, diarrhea, night sweat, rash




IV drug user, multiple sex partners, prison inmates




CD4 < 150




What opportunistic infections should you test for?

  • Histoplasmosis
  • Pneumocystis carini
  • Coccidiodomycosis
  • TB

Fever, malaise, sore throat, HA, lymphadenopathy, myalgia, diarrhea, night sweat, rash




IV drug user, multiple sex partners, prison inmates




CD4 < 50




What opportunistic infections should you test for?

  • MAI

  • Toxoplasma

  • Cryptococcus

  • Histoplasmosis

  • Pneumocystis carini

  • Coccidiodomycosis

  • TB

Treatment of histoplamosis?

Itraconazole



Treatment of toxoplasma, cryptococcus, pneumocystis carini

TMP-SMX

Treatment of MAI

Macrolides/Rifabutin

Treatments of coccidiodomycosis

Fluconazole

Fever, HA, Malaise, Anemia, Splenomegaly, recent travel



Treatment


  • Chloroquine
  • Mefloquin
  • Quinidine

Malaria

Fever, Chronic cough, hemoptysis, weight loss, night sweats




Treatment?


  • Pyrazinamide
  • Isoniazid (+ PYRIDOXINE)
  • Ethambutol
  • Rifampin

TB

Fever, weight loss, anemia, splenomegaly, thrombocytopenia



Cause?

CML - Philadelphia chromosome (abl:bcr on 9:22)

Fever, weight loss, starry sky pattern




Cause?

EBV = Burkitt lymphoma

Fever, muco-cutaneous, bullous skin lesions




Diagnosis if <10% of body, > 10% body

< 10 % body surface area = Steven-Johnson Syndrome




> 10 % = toxic epidermal necrolysis

Fever, morbiliform rash, lymphadenopathy, eosinophilia




Diagnosis?

DRESS (drug reaction with eosinophila and systemic symptoms)


  1. MOA of penicillin/cephalosporins
  2. MOA of Trimethoprim/Sulfamethoxazole
  3. MOA of FQ's
  4. MOA of macrolides
  5. MOA of tetracyclines
  1. Cell wall synthesis
  2. Folic acid inhibitor
  3. DNA gyrase
  4. Protein 50S inhibitors
  5. Protien 30S inhibitors

Indications for tetracyclines?

Mycoplasma


Borrelia burdgorferi (lyme)


Rickettsia


Chylamydia