Term
| Treatment for Lyme disease? |
|
Definition
| doxycycline or ceftriaxone |
|
|
Term
| non bullous impetigo treatment? |
|
Definition
|
|
Term
| salmonella gastroenteritis treated how? |
|
Definition
| usually self limiting only give antibiotics if severe or invasive (quinolone, macrolide, 3rd gen cef) |
|
|
Term
| most common cause of osteomyelitis in patient with a nail puncture? |
|
Definition
| Pseudomonas Note Staph is most common overall cause of osteomyelitis but this is exception |
|
|
Term
| How is diptheria treated? |
|
Definition
| anti diptheria antibodies, with metronidazole, or penicillin G or erythromycin |
|
|
Term
| How is pertussis treated? Are the contacts treated? |
|
Definition
| erythromycin for 14 days and treat contacts same way |
|
|
Term
| Treatment for legionaire's disease? |
|
Definition
| azythromycin or moxifloxacin |
|
|
Term
| What is first test in suspected legionaire's? Gold standard? |
|
Definition
| Urine antigen first, sputum culture gold std |
|
|
Term
| What is test of choice for diagnosing osteomyelitis? Definitive diagnosis? |
|
Definition
| MRI test of choice, Bone biopsy with gram staining definitive |
|
|
Term
| Organism causing cellulitis in someone with DMII or burns? Treatment in burn patients? |
|
Definition
| pseudomonas, treat with topical sulfadiazine or bacitracin |
|
|
Term
| How is tuleremia treated? |
|
Definition
| tetracycline or doxycycline |
|
|
Term
| what is prophylactic treatment for any cat bite? What organism are you worried about? |
|
Definition
| amoxicillin with clavulanate for Pasturella multicodia |
|
|
Term
| What are 2nd line prophylactic agents for any cate bite? |
|
Definition
| can use bactrim or doxy or cefuroxime or quinolone with either clindamycin or metronidazole for aneorobic coverage |
|
|
Term
| treatment for bacterial conjunctivitis? |
|
Definition
| topical macrolide or topical polymixin B |
|
|
Term
| treatment of acanthomeaba infection of eyes? |
|
Definition
| propamidine and polymixin opthalmic solution |
|
|
Term
| Treatment of a chalazion or hordeolum? |
|
Definition
| warm compresses and if no improvement referral to an opthomologist |
|
|
Term
| How is osteomyelitis treated? |
|
Definition
| surgical debridement and IV antibiotics for 6 weeks Note: if vertebral osteo treat for 8 weeks |
|
|
Term
| How is inhaled anthrax treated? |
|
Definition
| ciprofloxacin or doxycycline |
|
|
Term
|
Definition
| itraconazole #1, may use lugols solution or sski which are iodine solutions |
|
|
Term
| Treatment of blastomycosis? |
|
Definition
|
|
Term
| treatment of histoplasmosis? |
|
Definition
|
|
Term
| treatment of coccidiomycosis? |
|
Definition
| itraconazole, fluconazole or ketoconazole are equal |
|
|
Term
| Treatment for systemic histoplasmosis, blastomycosis, coccicoidomycosis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Treatment of actinomyces? |
|
Definition
| penicillin G (SNAP = sulfas for nocardia and PCN for actinomyces) |
|
|
Term
| What type of bacteria is actinomyces? |
|
Definition
| gram + filamentous anearobic |
|
|
Term
| What type of bacteria is norcardia? |
|
Definition
| gram + weakly acid fast filamentous aerobic |
|
|
Term
| tx of toxic shock syndrome? |
|
Definition
|
|
Term
| suspect someone of having herpes because of vesicles and inguinal adenopathy next step? |
|
Definition
| skip Tzanck smear or any testing and treat immediately with acyclovir or valcyclovir |
|
|
Term
| tx of bartonella hensale? |
|
Definition
| z-pak #1 or doxy Note: typically is self-limiting, so do not need to treat unless severe infection |
|
|
Term
| peritonsillar abscess tx? |
|
Definition
|
|
Term
| Treatment of neurocystocercosis? |
|
Definition
|
|
Term
| when to use steroids in tx pneumocystis? |
|
Definition
| Aa grad >35 or PaO2 <70mmHg |
|
|
Term
| tx of legionella pneumonia? |
|
Definition
|
|
Term
| tx of inpatient pneumonia (Not ICU pt)? |
|
Definition
| macrolide + ceftriaxone or respiratory quinolone alone |
|
|
Term
| tx of outpatient pneumonia? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| lung skin and bone problems |
|
|
Term
| tx of candidia inf of nipple? |
|
Definition
|
|
Term
| most common cause of cavernous sinus thrombosis? |
|
Definition
|
|
Term
| drug to prophylax with for influenza? |
|
Definition
| oseltamivir if given within 72 hours |
|
|
Term
| 2nd line tx for Pneumocystis? |
|
Definition
| dapsone and pyrimethamine 2nd line pentamidine is 3rd line Note: bactrim still #1 for treatment and prophylaxis |
|
|
Term
|
Definition
| 5% pimethrin cream from neck down on 2 separate occassions |
|
|
Term
| HIV drug causing weird dreams? |
|
Definition
|
|
Term
| s aureus pneumonia most often occurs in who? |
|
Definition
| IV drug users, cystic fibrosis (<10yo), post viral inf, chronically ill |
|
|
Term
| Late post surgical incision infection (4-10 days) most likely caused by? |
|
Definition
| S aureus #1, Pseudomonas #2, E coli #3 |
|
|
Term
| Early post surgical site incision infection (<72 hours) most likely caused by? |
|
Definition
| GAS or clostridium (if clostridium the infected site will have few leukocytes and mild erythema, but extreme pain compared to exam findings) |
|
|
Term
| empiric tx for infective endocarditis? |
|
Definition
|
|
Term
| Treatment of hepatitis C? |
|
Definition
| Unlikely to ask given that new treatments are out, but in case new meds are sofosbuvir and simeprevir adn old meds are interferon with ribavirin |
|
|
Term
| pt with SCD and osteomyelitis tx empirically with? to cover for? |
|
Definition
| Salmonella #1 and staph with vanco or nafcillin or cefazolin + aminoglycoside |
|
|
Term
| most common cause of osteomyelitis in SCD pt? |
|
Definition
|
|
Term
| aminoglycoside side effect? |
|
Definition
| sensorineural hearing loss |
|
|
Term
| most common cause of meningitis <3 months? |
|
Definition
|
|
Term
| most common cause of meningitis 3 months to 9yrs? |
|
Definition
|
|
Term
| most common cause of meningitis 10-18? |
|
Definition
|
|
Term
| most common cause of meningitis >18? |
|
Definition
|
|
Term
| tx of meningitis <3 months? |
|
Definition
| IV vancomycin, ampicillin, cefotaxime |
|
|
Term
| tx of meningitis 3 months to 50 yo? |
|
Definition
| IV vancomycin and cefotaxime |
|
|
Term
|
Definition
| IV 3rd gen ceph + vanco +ampicillin |
|
|
Term
| tx of meningitis in immunocompromised? |
|
Definition
| IV vanco, cefotazidime, ampicillin |
|
|
Term
| What is the role of steroids in meningitis? |
|
Definition
| used to prevent negative neurologic sequale of S pneumoniae meningitis. Note: give to all pts where S pneumoniae may be suspected |
|
|
Term
| tx of gonorrheal conjunctivitis? |
|
Definition
| IM ceftriaxone and topical erythromycin |
|
|
Term
|
Definition
| clean canal, topical cipro or acidic antibiotic + hydrocortisone cream |
|
|
Term
| most common cause of prosthetic valve endo? |
|
Definition
|
|
Term
| tx of gonoccocal conjunctivitis in neonate? |
|
Definition
| oral penicillin or IM cef with topical erythromcyin eyedrops |
|
|
Term
| hemochromatosis is suscpetable to? |
|
Definition
| susceptable to iron loving bacteria: listeria, vibrio and yersina enterolytica |
|
|
Term
| tx for yersinia enterolytica? |
|
Definition
| ciprofloxacin or doxycycline |
|
|
Term
|
Definition
|
|
Term
|
Definition
| pruritus, redness above waist, hypotension, dyspnea associated with vancomycin... stop giving drug then readminster later at a slower rate |
|
|
Term
| Is lymphogranuloma venerum painless or painful lesion? |
|
Definition
|
|
Term
| How is amebic liver dz tx? |
|
Definition
|
|
Term
| A pt with asplenia is at risk for what infection if bitten by a dog? |
|
Definition
|
|
Term
| A pt with asplenia has erythema chronica migrans and a severe hemolytic anemia and thrombocytopenia. What coinfection do they likely have? |
|
Definition
| babesia, asplenia predisposes to severe babesia infection, therefore if question looks like lyme dz but is very severe and they say pt had spleenectomy then suspect babesia |
|
|
Term
| intraleukocytic morulae are concerning for? How does rash on pt appear? |
|
Definition
| erlichosis and rash appears like lymes w/o central clearing |
|
|
Term
| what is the antibiotic of choice for prophylaxis against endocarditis? |
|
Definition
|
|
Term
| what is the antibiotic of choice for prophylaxis against endocarditis when pt is unable to take PO med? |
|
Definition
| Either ampicillin or ceftriaxone or cefazolin |
|
|
Term
| What is the antibiotic of choice for prophylaxis against endocarditis when PCN allergic? |
|
Definition
| clindamycin or azithromycin or if can take cephalosporin cephalexin |
|
|
Term
| What are agents are used to treat CNS toxoplasmosis? |
|
Definition
| sulfadiazine and pyramethamine |
|
|
Term
| What agents are used to treat prophylax against toxoplasmosis? |
|
Definition
|
|
Term
| What are 4 common agent that inhibit dihydrofolate reductase, such that leucorvin (folinic acid) or folic acid should also be prescribed? |
|
Definition
| phenytoin, methotrexate, pyramethamine, trimethoprim |
|
|
Term
|
Definition
| 3 drug regimen: ethambutol, azithromycin or clarithromycin +/- rifampin or ribabutin |
|
|
Term
| What candidial species are resistant to the azole antifungals and require an echinocandin (caspofungin/micafungin)? |
|
Definition
| C. krusei and C. glabrata |
|
|
Term
| treatment of lymes dz causing bells palsy? |
|
Definition
| oral doxy Note: only give ceftriaxone if meningitis or heart block |
|
|
Term
| it is generally best to avoid treating travelers diarrhea, unless moderate or severe; however, what medications can be used? |
|
Definition
| quinolones (#1) or azithromycin Note: do not give antibx prophylaxis |
|
|
Term
| What antibiotics are recommended for treatment of vibrio cholarae/volnificus/parahemolyticus? |
|
Definition
|
|
Term
| How is babesiosis treated? |
|
Definition
| Mild or moderate: azithromycin + atovaquone (preferred) or clindamycin + quinine and Severe: clindamycin + quinine |
|
|
Term
| treatment for N meningitidis meningitis? |
|
Definition
| ceftriaxone or cefotaxime. Remember the vanco is added only for possible penicillin resistant pneumococcal pneumonia not the neisseria |
|
|
Term
| Treatment for Allergic bronchopulmonary aspergillosis? |
|
Definition
|
|
Term
| Treatment of invasive aspergillosis? |
|
Definition
| voriconzale #1, but amphotericin can be used also |
|
|
Term
| Blood stream infection with which 2 bacterial species warrants a colonoscopy to r/u GI malignancy? |
|
Definition
| strep bovis, strep gallolyticus and clostridium septicum |
|
|
Term
| ribavirin is used in the treatment of which 2 viruses? |
|
Definition
| RSV and HCV Note: it is pregnancy category X |
|
|
Term
|
Definition
| floroquinolone or 3rd gen ceph |
|
|
Term
| best prophylactic med to chloroquine resistant areas when pt is pregnant? |
|
Definition
|
|
Term
| At what CD4 count do you prophylax against pcp? What med? |
|
Definition
|
|
Term
| at what CD4 count do you prophylax against toxoplasmosis? What med? |
|
Definition
|
|
Term
| At what CD4 count do you prophylax against MAC? What med? |
|
Definition
| CD4 <50 with azithromycin and continue until 3 months after CD4 count has been >100 |
|
|
Term
| Which vaccines should be avoided in AIDS pts? |
|
Definition
| MMR, intranasal influenza, varicella, zoster, yellow fever. Note: all are live virus |
|
|
Term
| Penicillin is the TOC for all stages of syphillis. How should you treat your pt if they are PCN allergic (anaphyllactic) in primary, secondary and tertiary syphillis? |
|
Definition
| doxycycline in primary and secondary. Ceftriaxone in tertiary. Note: If PCN desensitization is answer for tertiary syphillis, this will be answer, even if ceftriaxone is a choice |
|
|
Term
| How is post-herpetic neuralgia managed acutely? And after 30 days? |
|
Definition
| opiates, tramadol, lidocaine patches acutely. Longterm consider TCA's or gabapentin |
|
|
Term
| Who is the zoster vaccine recommended in? |
|
Definition
| age >60, immunocompromised states (DM, renal failure, liver failure, severe COPD, etc...), HIV if CD4 >200 |
|
|
Term
| Treatment for zoster should be administered within how many hours? |
|
Definition
| 72 hrs with acyclovir, valcyclovir, etc... |
|
|
Term
| What fungus has narrow angle branching with septae? Which is wide angle and w/o septae? |
|
Definition
| aspergillous = narrow angle, septae. mucor = wide angle, NO septae (spagetti and meat ball appearance on microscopy) |
|
|
Term
|
Definition
|
|
Term
| Besides surgical consultation what are the treatment regimens in necrotizing fascitis? |
|
Definition
| Need to have MRSA coverage: vanco or dapto or linezolid. Also need gram neg and aneorobic coverage: cefepime + clindamycin or a carbapenem |
|
|
Term
| If cause of necrotizing fascitis is suspected to be from strep pyogenes or clostridial species what should treatment regimen be? Why? |
|
Definition
| PCN + clindamycin. Note: clindamycin translation of bacterial toxin protein |
|
|
Term
| treatment for yersinia pestis (plague)? |
|
Definition
| a tetracycline or streptomycin or quinolone |
|
|
Term
| If you suspect meningitis do you give antibiotics first, get imaging first or LP first? |
|
Definition
| always treat meningitis when suspected clinically before obtaining other tests |
|
|
Term
| If you suspect SBP do you give antibiotics first or obtain paracentesis first? |
|
Definition
|
|
Term
| Who should receive prophylaxis for N meningitidis when exposed to someone that has it? |
|
Definition
| people in household, anyone handling respiratory secretions, i.e. intubating physician. Note: triage nurse, doctor who did spinal tap do NOT need it |
|
|
Term
| What drug is used for N meningitidis prophylaxis? |
|
Definition
|
|
Term
| epididymitis in men <35 is most commonly caused by? And in men >35? |
|
Definition
| <35 is gonorrhea/chlamydia and >35 E. coli |
|
|
Term
| How is leptospirosis treated? |
|
Definition
|
|
Term
| How is stronglyoides treated? |
|
Definition
| ivermectin #1, albendazole #2 |
|
|
Term
| What are 3 painless ulcers caused by STD's? |
|
Definition
| syphillis, lymphogranuloma venereum, klebsiella granulomatosis |
|
|
Term
| How should the initial episode of C. diff be treated if it is mild to moderate? |
|
Definition
|
|
Term
| If the initial episode of C diff is severe w/o other organ failure how should it be treated? |
|
Definition
|
|
Term
| If the initial episode of C diff is severe with multiple organ failure how should it be treated? |
|
Definition
| PO vancomycin + IV metronidazole |
|
|
Term
| How should the first recurrence of C diff be treated? |
|
Definition
| same as initial episode and based on severity, i.e. if not severe infection and pt was treated before with PO metronidazole he can have that again, or if it was severe and he had PO vanco he should have that again |
|
|
Term
|
Definition
|
|
Term
| Treatment of cryptococcal meningitis? |
|
Definition
| amphotericin with flucytosine. Note: the only time on boards you will use flucytosine is for crypto! |
|
|
Term
| Treatment of reactive arthritis following a GI infection with either shigella, salmonella, camplobacter, etc...? |
|
Definition
| Give NSAIDS for diarrheal causes, can use antibiotics if a chlamydial GU infection is causing |
|
|
Term
| Treatment of Bacteroides infection in mouth? |
|
Definition
| Need aneorobic coverage: amoxicillin, clindamycin, ampicillin |
|
|
Term
| What medications are used to treat male UTI? |
|
Definition
| either bactrim or quinolone. Note: if male UTI you are treating prostatitis, course is minimum of 2-4 weeks |
|
|
Term
| Which antibx are safe to use for UTI in pregnancy? |
|
Definition
| nitrofurantoin, ampicillin, cephalosporins |
|
|
Term
| ESBL UTI is best treated with? |
|
Definition
|
|
Term
| the majority of pts with candiduria have catheters, which if removed tends to clear infection. If the infection does not clear with catheter removal or the pt is high risk (neutropenic) how should you treat them? |
|
Definition
|
|
Term
| Which antibx class is preferred for pyelonephritis in pregnancy? |
|
Definition
| cephalosporins w/ or w/o aminoglycoside |
|
|
