6_20 StepUp ID
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| MC community acquired PNA? Nosocomial? | CAP=S Pneu
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| PNA in EtOH? Nursing home? | EtOH=Klebsiella
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| PNA in COPD? | S Pneu, H Flu, Moraxella
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| top 3 causes of typical CAP | S Pneu, H Flu, Klebsiella
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| causes of atypical PNA | Mycoplasma, Chlamydia, Coxiella, Legionella + viruses (flu, adeno, parainflu, RSV)
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| how dx Legionella PNA | need urinary Ag assay
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| what's empiric PNA tx for pts<60 without comorbidities | macrolide (ie erythromycin) or doxycline
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| what's empiric PNA tx for pts>60 or w comorbities | fluoroquinolone (levofloxacin) OR cefuroxime and azythromycin or doxycycline
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| for lung abscess what Abx use if 1) gram + cocci, 2) anaerobe, 3) gram - | 1) ampicillin or amoxicillin/clavulonic acid or vanc for S Aureus, 2) cindamycine or metronidazole, 3) fluoroquinolone or ceftazidine has hi gram - coverage
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| where TB lesions found during difft stages of dz | 1) lower lobe (Ghon's focus, or Ghon's/Ranke's complex if also Ca++ hilar LN), 2) 2ry TB: apical cavitating lesion
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| which meds are used to decrs common flu | amantidine or rimantidine
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| what virus family is Flu A, B | orthomyxovirus
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| t/f: viral flu has rapid onset | t (usually)
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| if PPD + but no active TB dz how tx? | INH 9 mos
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| how tx active TB | 1) pt in isolation until sputum is -, 2) 2 mos: RIPE, 4 mo Rifampin and INH
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| for which pts is PPD + 10mm cut off | homeless, prisoners, health care workers, nursing home, prevalent area
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| for which pts is PPD + 5mm cut off | HIV, close contacts, CXR evidence of 1ry TB
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| MC causes bac meningitis in <3mo | Grp B Strep > E Coli, Klebsiella > Listeria
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| MC causes bac meningitis in <50yo | N Mening > S Pneu > H Flu
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| MC causes bac meningitis in >50yo | S Pneu > N Mening > Listeria
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| MC causes bac meningitis in immunocomp | Listeria > N Mening, Pseudo > S Pneu
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| empiric tx of bac meningitis of < 3 mo | cefotaxime + ampicillin + vanc
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| empiric tx of bac meningitis of <50yo, >50yo | Ceftriax or Cefotax + vanc (+ ampicillin for > 50yo bc Listeria)
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| meningitis signs + maculopap rash w petichae suggests which bug | N Mening
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| meningitis signs + vesicular rash suggests which bug | varicella or HSV
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| CSF findings for TB and fungal meningitis | low glu (<50) and >100 cells that are LYMPHs
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| how Guillan Barre CSF look? MS? | Guillan Barre=greatly incrsd protein but nml cell #-- MS=oligoclonal IgG nml cell#
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| difft bac and vira/aseptic meningitis by CSF | bac=>1000 PMN, <50 glu, 100 protein, >200 pressure-- viral=100-1000 lymph, nml glu, nml/sl incrsd protein and pressure
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| MC cxn (1) of meningitis | sensorineural hearing loss
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| tx aseptic meningitis | none, just Rx pain and F
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| prophylaxis close contacts of N Mening meningitis | rifampin or ceftriaxone
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| name named signs for meningitis | Kernigs=can't extend legs when sitting-- Brudzinski=flex neck causes flex legs
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| 2 MC causes of encephalitis | HSV and Arbovirus
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| what clue if HSV-1 encephalitis | temporal lobe location
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| before performing LP for meningitis or encephalitis check for | incrsd ICP (ie papillodema), focal neural defects [would have to image before LP]
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| how tx cerebral edema in encephalitis | hypervent, IV mannitol, steroids
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| what's the difftl for F and altered mental status | 1) infxs: sepsis, UTI/urosepsis, PNA, meningitis/encephalitis--2) Rx: neuroeleptic malignant syndrome, delirium tremens--3) metabolic: thyroid storm
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| how dx HSV meningitis? CMV? | both can be done PCR on CSF (also EBV, VZV)
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| tx for encephalitis: HSV? CMV? RMSF, Lyme? | HSV=acyclovir 2-3 wks--CMV=ganciclovir +/- foscarnet-- RMSF, Lyme=doxycycline
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| how manage brain abscess | if <2cm can manage medically, otherwise aspiration/surgical excision IV Abx 6-8 wks, PO 2-3--then serial CT to watch progress
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| how would brain abscess due to bac PNA hematogenous spread look | MCA distribution, mltpl abscesses at gray-white jxn
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| brain abscess s/p trauma or surgery MC organism | S Aureus
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| what bug causes descending flaccid paralysis starting w dry mouth, diplopia, trbl speaking--what progresses next? | C Botulinum, then muscle paralysis (limbs)
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| what's phenazopyridine, aka? | urinary analgesic for UTI, aka pyridium
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| how tx preg woman w UTI? Why (what at risk for)? | NOT quinolone (fetal arthropathy), ampicillin, amoxicillin or cephalosporin for 7-10d--at risk for IUGR, premature labor, cxns in preg
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| how tx acute, uncomplicated UTI in non pregnant woman? if doesn't respond? | Bactrim 3d, if doesn't respond tx for presumptive pyelonephritis (10-14d)
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| how tx acute, uncomplicated UTI in man? if doesn't respond? | 7d Bactrim, if doesn't respond do urology w/u
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| if relapse UTI within 2 wks of treatment? If >2 UTI/yr | continue 2 wks longer and obtain urine culture
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| what does a dipstick urine test? | urine leukocyte esterase (pyuria), nitrite (grame neg bac)
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| what sympt would make think pyelonephritis not UTI | if F, or if back pain/costovertebral pain/flank pain' (not just suprpub tenderness see in UTI)
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| MC causes UTI | 80% E Coli, also Staph Sapro and Enteroccoc
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| in what ppl is pyelonephritis considered complicated | men, elderly, underlying renal dysfxn, DM, immunocompromised
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| when is a UTI considered complicated | any time spreads beyond bladder, if fxnl/structural abnmlty, metabolic or neuro dysfxn
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| how tx pyelonephritis outpt | based on gram stain: GNR: Bactrim or fluoroquinolone 10-14d, Amoxicillin for gram + cocci (Enterococc, Staph Sapro)
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| MC causes pyelonephritis | E Coli (MC), Proteus, Enterobac, Klebsiella, [PESK urease + exc Serratia] Pseudo
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| how tx pyelonephritis if relapse | if relapse w same bug treat 6wks longer, if difft bug tx 2 wks
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| how tx pyelonephritis in patient | broad IV Abx for 24 hrs (ie ampicillin + gentamicin or ciprofloxacillin), then oral Abx 14-21d
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| how tx pyelonephritis w urosepsis, how is it diagnosed? | urosepsis need IV Abx 2-3wks-- anytime blood cx is positive
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| how tx prostatitis | if mild acute: bactrim or fluoroquinolone + doxycycline for 4-6wks--severe may need hospital and IV--chronic: fluoroquinolone for extended time but may relapse
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| bugs for prostatitis | PESK=Proteus, enterobac, serratia, klebsiella + E Coli and Pseudo
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| when do you need a urine culture? | in all pyelonephritis cases (to see if urosepsis), if UTI need to get if pt >65, DM, recurrent UTI, presence of sympt >7d, use of diaphragm
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| what's the MC STD? MC bac STD? | MC STD=genital warts (HPV)--MC Bac STD= Chlamydia
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| how dx Chlamydia STD? | urine PCR, DNA probes/IF--gram stain: PMN but no organism (intracell)
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| tx of Chlamydia | azythromycin (oral 1 dose) or doxycycline (oral 7d)--need to tx all sex partners
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| Chlamydia is more or less freq asympt in women | more freq (80% v 50%men) so some say all sex active adolesc esp women should be screened
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| complications Chlamydia in women | cervical cancer, PID, Fitz-Hugh (infects liver capsule), salpingitis, tubo-ovarian abscess, ectopic preg, infertility (bc scarring)
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| tx of gonorrhea | ceftriaxone (IM 1 dose, bc also covers Syph), and give azythro (1 dose) or doxycyline (7d) to cover Chlamydia
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| dx of gonorrhea | gram stain showing organisms within WBC, need to get cultures in all cases and see if dissem
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| features of 1ry HIV infxn, when it occurs, how long it lasts | mono-like w F, sweats, malaise, HA, sore throat, maculopap rash, diarrhea, LAD 2-4 wks after exposure, lasts 3d-2wks
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| sympt HIV | persistent generalized LAD, night sweats, wgt loss, diarrhea, vaginal yeast and trichomonal infxns, thrush, oral leukoplakia, derm: seborrheic derm, psoriasis exacerb, molloscum, warts
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| dx of HIV and when test becomes + | ELISA (+ 1-12 wks after infxn), need confirm w W Blot
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| what are CD4 cut offs for infxns AIDS at risk for | <200 PCP, <100 Toxo, <50 MAC
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| AIDs prophylaxis and cut-offs | <200 Bactrim (or dapsone and pentamidine), <100 erythro or clarithro
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| when start retro viral for AIDs | any sympt HIV pts or asympt CD4<500
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| features of HAART therapy | 2 nucleoside RT inhibitors + either a non-nucleoside RT inihibitor OR protease inhibitor
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| what pul infxns manifest during AIDs (4) | bac CAP much more common esp CD4<200 (>1/yr is AIDs defining)--PCP (MC initial opport infix)--CMV and MAC (CD4<50)
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| what CNS manifest during AIDs(3) | AIDs dementia in 1/3--Toxo (esp CD4<100)--Crypto meningitis
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| presentation of PCP, dx, tx | hypoxia despite mild CXR, diffuse interstitial infiltrate-- dx: Silver/Giemsa-- tx: Bactrim 3 wk + steroids if hypoxis or incrsd A-a
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| imaging suggesting Toxo CNS | >3 contrast mass lesions
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| dx and tx of Crypto meningitis in AIDs | dx: CSF Crypto Ag or India Ink, tx Amph B 10-14d, then 8-10 wks oral fluconazole and lifelong maintenance w fluconazole
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| GI, oral, esophagus manifest in AIDs | diarrhea (MC GI) can be many things incl Abx, Rx, CMV-- oral: thrush, ulcers (HSV, CMV), leukoplakia (EBV)-- esophagitis Candida, (also CMV, HSV)
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| Derm manifest in AIDs | kaposi's sarcoma (vascular lesions), HSV, molloscum, shingles
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| what watch for w CMV in AIDs-- tx? | retinitis that can cause blindness-- tx ganciclovir or foscarnet
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| MC bac opport infxn in AIDs--MAC |
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| define HIV wasting syndrome | loss 10% wgt with either chronic diarrhea or F and persistent wknss (not from other causes)
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| what should preg AIDs pt take | AZT (ziduvidine)
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| what virus assoc w Bell's palsy | HSV1
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| vesicle on end of finger think | Herpetic whitlow-HSV inoculated into open sore--don't drain
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| what ocular problems can see w HSV | keratitis, blepharitis, keratoconjunctivitis
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| describe 3ry syph | CV syph, neurosyph (dementia, personality changes, tabes dorsales), gummas (subQ granulomas)
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| describe 1ry, 2ry syph | 1ry: painless chancre (3-4wks after infxn, lasts 14wks)-- 2ry: 4-8wks after chancre healed maculopap rash (MC), +/- flu like, aseptic meningitis hepatitis
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| dx syphilis | RPR/VDRL screening test, then FTA-Abs/MHA-TP
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| tx syph, if allergy | 1 dose IM PCN (if allergy doxycycline, tetracycline oral 2wks)
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| what organism causes chancroid, what class of bug | Haemophilus ducreyi (gram - rod)
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| what causes lymphogranuloma venereum | Chlamydia trachomatis
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| tx C trachomatis | doxycycline oral 21d
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| what genital ulcer is purulent w shaggy border | Chancroid
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| what genital ulcer is beefy red nodules, coalescing to form granulomatous ulcers | granuloma inguinale (klebsiella granulo)
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| which genital ulcer starts as papule, then vescle, then ulcer, usu only 1 | lymphogran venereum
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| MC causes of cellulitis | Strep Pyo and Staph Aureus
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| Cellulitis if wound, abscess: bug? | Staph Aureus
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| Cellulitis if local trauma, skin break: bug? | strep Pyo
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| Cellulitis if water, burns: bug? | Pseudo
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| Cellulitis if fisherman: bug? | Vibrio vulnificus
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| Cellulitis if acute sinusitus: bug? | H Flu
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| define erysapelas | S Pyo infxn of dermis and lymph causes well-demarcated bright red lesion
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| tx erysapelas | IM or oral PCN or erythromycin
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| Nosocomial osteomyelitis: bug? | Pseudo
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| osteomyelitis if prosthetic joint: bug? | Staph epi
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| catheter septicemia and osteomyelitis:bug? | S Aureus
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| how long and what route use for Abx for osteomyelitis | 4-6wks IV
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| which PCN have good gram - coverage | ampicillin and amoxicillin
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| what b lactamase inhibitor can be combined w amoxicillin | clavulanic acid
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| what bugs is aztreonam good for | Pseudo and Serratia (aerobic GNR)
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| which PCN is used for syph | PCN G
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| which Abx is used for sickle cell prophylaxis | PCN
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| PCN works synergistically w which Abx | aminoglycosides
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| name Abx that are cell wall inhibitors | PCN, cephalosporins, Vanc, imipenem/meropenem, aztreonam
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| name some bugs PCN is ineffective ag | Rickettsia, Chlamydia (intracell), mycoplasma (no cell wall)
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| which PCN use for Staph coverage | nafcillin or methcillin
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| what biggest SE for vanc | red man syndrome--histamine release
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| name properties of ea cephalosporin generation | 1st gen: like PCN + Proteus, Klebsiella, E Coli-- 2nd: more gram - and less gram +H Flu and Enterobac-- 3rd gen: more gram - and can cross blood-brain barrier-- 4th gen: most broad spec w Pseudo, Neisseria, MRSA
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| name Abx in ea cephalosporin class | 1st gen: cefazolin, cephaloxin, cefadroxil the faz fad fell-- 2nd: cefaclor, cefoxitin, cefuroxime the fac fox furrowed-- 3rd gen: ceftriaxone, cefotax, ceftazidine-- 4th gen: cefipime
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| which Abx used CAP>60yo or w comorbidities | cefuroxime
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| which cephalosporin used for gonorrhea | ceftriaxone
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| vanc is often used with which Abx for enteroccoc | aminoglycosides (gentamicin, streptomycin)
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| what Rx is imipenem or meropenem used w | cilastatin
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| empiric coverage for gram - sepsis | imipenem or meropenem w cilastatin
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| which bugs do tetracycline/doxycycline work on | intracellul (Chlamydia, Rickettsia, Mycoplas), Vibrio Cholera, Lyme (Borrelia Burgd)
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| SE of tetracyclines | GI, deposits Ca++ in tissues (can't use in preg or kids <8)-- also decrsd absorb if taken w milk or antacids
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| name some macrolides | erythromycin, azithromycin, clarithromycin
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| name aminoglycosides | gentamicin, streptomycin, neomycin
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| what bugs are aminoglycosides good for, name some Ags | gram - aerobes (Klebsiella, E Coli)-- gentamicin, streptomycin, neomycin
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| what are macrolides good for? Name some | intracellul (Mycoplasm, Legionella)-- erythromycin, azithromycin, clarithromycin
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| what PCN alternative can use in preg woman | Erythro (since can't use tetracycline in preg)
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| which macrolides also work ag Staph and Strep | erythro and clarithro
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| which macrolides also work ag H Flu | Clarithro and Azithro
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| key use of clindamycin | anaerobes
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| key use fluoroquinolones, name some | gram - (ie UTI)-- levofloxacin, ciprofloxacin
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| which fluoroquinolone also has good gram + coverage, can be used CAP | levofloxacin
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| which 2 classes of Abx can't be used in kids | tetracyclines (Ca++ deposits into tissues), fluoroquinolones (damage cartilage)
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| what key use of metronidazole | anaerobes [also E histolytica, Giardia, Trichomonas
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| which Abx can't consume w EtOH | metronidazole (gives disulfiram like rxn]
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| in 2nd stage of Lyme dz, how present, cxns | flu like w HA, stiff neck, F, chills musculo skel pain-- after several wks can get meningitis/encephalitis, cranial neuritis, peripheral radiculoneuropathy-- wks/mos can get carditis (heart block, pericarditis, carditis)
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| longterm effects Lyme dz | arthritis (esp knee), chronic CNS, acrodermatitis chronica atrophicans (rare)
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| dx Lyme dz | 1) erythema migrans w h/o tick exposure in endemic area-- 2) ELISA can detect within 1 mo and confirm w W Blot
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| tx of Lyme dz, cxns of Lyme dz | oral doxycyline 21 d-- for cxns: 30-60d-- meningitis needs IV Abx 4wks
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| what abnml lab values might see w RMSF--increased LFTs and decrsd plts |
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| describe present of RMSF | F, chills, N/V, myalgias, photophobia, HA, papular rash starts peripheral, becomes maculopap and then petichae-- can get interstitial pneumonitis
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| tx RMSF | doxycyline 7d [preg or CNS: chloramphenicol]
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| describe F pattern in difft types of malaria | falciparum=F constant-- oval, vivax=F q24 hr-- malarial=q 72 hr
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| which malaria can have dormant hypozoites in liver? How tx that difftly? | vivax and ovale, need to add 2 wks primaquine
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| which malaria is most life-threatening | falciparum
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| tx malaria | chloroquine, if resistance then quinine sulfate and tetracycline
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| prophylaxis malaria | chloroquine if no resistance, otherwise mefloquine
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| key finding histopath that IDs rabies | Negri bodies (eosinophilic inclusion bodies in nerve cell bodies)
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| which bug can give ulcer at site of tick bite, describe rest of presentation | tularemia, also see F, HA, painful LAD
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| which arbovirus can give isolated LAD,how dx, tx? | bartonella henslea (cat scratch dz), dxserology, clinica, no tx nec
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| which spriochete can contaminate water-- how present, how tx | leptospirosis-- anicteric=rash, LAD, incrsd LFTs-- icteric=renal or liver failure, vasculitis and vascular collapse-- tx tetracycline or doxycycline
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| describe presentation of leptospirosis | anicteric=rash, LAD, incrsd LFTs-- icteric=renal or liver failure, vasculitis and vascular collapse
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| what cutaneous lesions can Candida create | erythematous eroded patches esp in DM, obese, under skin folds
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| t/f candida esophagitis can be painless | TRUE
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| how dx candida | KOH showing yeast
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| how treat vaginal candida | miconazole or clotrimazole cream
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| how treat thrush | nystatin mouthwash (3-5x/d) or clotrimazole troches (5x/d)
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| differentiate bw Blasto, Histo, and Cocci in terms of clinical present | Blasto=constitut sympt, LAD, PNA-- Histo=flu like, erythema nodosum, hepatosplenomegaly-- Cocci=asympt or non-specific respir (if dissem will have focal CNS)
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| differentiate bw Blasto, Histo, and Cocci in terms of tx | generally oral itraonazole (or fluconazole) 6mos, if severe or immune comp IV Amph B
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| clinical present of Sporothrix Schenki (localized and dissem) | localized=hard subQ nodules that ulcerate-- dissem=PNA and meningitis
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| tx of Sporothrix Schencki | KI 1-2 mo or itraconazole 3-6mos, if dissem amph B
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| tx cryptococc | amph B w flucytosine 2 wks, + oral flucanazole-- if AIDs then continue fluconazole until CD4>100 for 1 yr
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| describe E Histolytica present, tx | (amebiasis)=bloody diarrhea, tenesmus, abd pain, +/- liver abscess-- tx iodoquinol or paramomyon + metronidazole if liver abscess
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| what is bug for round worm, what cxns, how tx | ascaris-- can cause pan duct of CBD obstruct-- tx albendazole, mebendazole, or pyrantel pamoate
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| what is bug for hook worm, how present, how tx | ancylostoma duodenale, cough, anemia, malabsorb, eos-- tx=mebendazole or pyrantel pamoate
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| what is bug for pin worm, how present, how tx | Enterobiasis, perianal pruritus, tx=mebendazole or pyrantel pamoate
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| what worm from undercooked meat, how tx | tape worm (taenia solium)-- tx praziquentel
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| what bug can cause B12 defic, how tx | tape worm (Diphyllobothrium Latum)-- tx praziquentel + B12
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| which bug can block portal vein, how tx | Schistosomiasis-- tx praziquentel
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| present of Cryptoporidiosis, tx | watery diarrhea, supportive
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| which bugs MC for intrabd infxn | Enterococc, Bacteroides, E Coli
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| bugs for endocarditis: subacute, acute IV drug, prosthetic valve | subacute: Step viridans-- , acute IV drug: Staph Aureus, prosthetic valve: Staph Epi-- if S Bovis shows up watch for GI malignancy
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| MC bugs acute sinusitus | viral, S Pneu, H Flu Moraxella
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| MC bugs chronic sinusitus | Staph Aureus, anaerobes
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| what bug causes TSS | Staph Aureus MC (also Strep Pyo)-but it’s the toxin that causes the dz
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| clinical present of TSS | rapid onset hi F, HA, myalgias, diffuse macular eryth rash, strawberry tongue and hypotension-- rash desquamates during convalescent phase
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| what lab values might see in TSS | incrsd ALT/AST, incrsd BUN or Cr and pyuria, decrsd plt, incrsd creat kinase
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| define neutropenic fever and common causes | if PMN and bands <1500 then F may be only sign for a really bad infxn-- MC septicemia, cellulitis, and PNA
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| tx of neutropenic F | isolation, broad spec Abx, if doesn't resolve add anti-fungal
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| CF and CGD are at risk for which bugs | Staph and Pseudo
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| asplenic are at risk for which bugs | encapsulated: S Pneu, Neisseria, H Flu
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| cxns of mono | decrsd plts, hemo anemia, splenic rupture
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| what Ab is detected in Monospot test? What would PBS show? | heterophil Abs, PBS shows large atypical lymph
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| what can trigger Herpes Zoster | break in skin at that site, immunocompromise
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| tx Herpes Zoster | antiviral + TCA (desipramine) for neuropathic pain + steroids
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| what bugs are assoc w Gullan Barre | Camp Jej MC, also CMV, EBV, and Mycoplasma
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| describe Dengue fever presentation | mosquito flavivirus, muscle/joint pain, macular rash, cervical LAD, injected conjuctiva w incrsd LFT, WBC and decrsd plts in hemorrhagic kind
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| how hairy oral leukoplakia present? Tx? | (EBV) white projections on one side of tongue, tx=acyclovir
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| tx dissem Toxo | trimethoprim and sulfadiazine (Bactrim)
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| how does Crypto meningitis present that's different | often doesn't have stiff neck, photophobia or vomitting, just F, malaise and HA
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| name 3 anti-cough meds | codeine, bextramethorphan, benzonatate
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| when need to get CXR for bronchitis | if suspect PNA, ie F, tachypnea, crackles, dullness to percussion
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| MC causes acute bac sinusitis | S Pneu, H Flu, anaerobes
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| MC causes of chronic bac sinusits and which difft from acute | same as for acute (S Pneu, H Flu, anaerobes) + Staph Aureus and GNR
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| when get imaging in acute sinusitis | if no imrpovement after 1-2 wks of Abx and decongestants
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| what Abx used for acute sinusitis (4) | 1) amoxicillin +/- clavulanate, 2) Bactrim, 3) levofloxacin or morafloxacin, 4) cefuroxime
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| what anti-His are used for acute sinusitis w allergic component (3) | 1) loratadine (Claritin), 2) fexofenadine (Allegra), 3)chlorpropamine (ChlorTrimeton)
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| what decongestants are commonly used, for how long | pseudoephedrine, oxymetazoline (<3-5d)
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| MC causes laryngitis | viral, also Moraxella and H Flu
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| Abx for strep throat | PCN for 10d (or erythromycin)
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| when do endoscopy for GERD | if wgt loss, dysphagia, anemia, persist despite tx, suspect ulcer or stricture (also monitor Barretts)
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| how monitor for Barretts in GERD | if sympt GERD 5yrs, should do endoscopy and bx q3 yrs
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| tx GERD (by phases) | 1) behavior mod and antacids after meals and at bedtime, 2) add H2 blocker, 3) switch to PPI, 4) add promotility (metoclopramide or bethanechol), 5) combo
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| promotility |
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| Rx used in GERD | metoclopramide or bethanechol
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| sx for GERD (2) | Niessen's fundoplication if esophageal motility is good, if motility isn't good do a partial fundoplication
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| when do you need to check stool sample for WBC in cases of diarrhea | if bloody stool, systemic symptoms (ie F), dehydration, abd pain, N/V
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| if no F and no blood and have diarrhea, what could be causes | viral (Rota or Norwalk), Enterotoxic E Coli (traveler's diarrhea), or food poison S Aureus, C perf)
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| if diarrhea, when need to order stool culture | WBC in stool, invasive bac suspected, hospitalized, moderate/severe illness or F
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| MC acute bac diarrhea | C Jejuni
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| name Abx used for Shigella, C Jejuni, Giardia | Shigella=Bactrim, C Jejuni=erythromycin, Giardia=metronidazole
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| generally what Abx used for mod-severe diarrhea | 5d ciprofloxacin
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| what cxn to look for w hermorrhagic E Coli 0157:H7 | HUS and TTP
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| how difft 2 MC food poisoning bugs | C Perfringens has crampy abd pain, not vomit or F-- S Aureus has N/V and assoc w mayonnaise
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| foul smelling diarrhea w bloating is assoc w ? Tx? | Giardia (tx metronidazole)
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| when should loperamide be used in diarrhea | if mild-mod w no F and no blood
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| differentiate shigella and salmonella in terms of sympt | shigella often has tenesmus and less often N/V-- salmonella can be w/o blood whereas Shigella almost always has blood
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| tx for constipation | psyllium, dietary fiber, colase, cisapride
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| what Rx can be used specifically for IBS? How does it work? | Tegaserod maleate (Zelnorm), serotonin agonist
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| what Rx can be used for N/V | prochlorperazine (Compazine) or promethazine (Phenergan)
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| key differentials for N/V | usu viral gastroenteritis or food poisoning-- also preg, metabolic (incl DKA), pancreatitis/appendicitis, Neuro/incrsd ICP, acute MI, Rx
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| some key Rx can cause N/V | chemo, esp cisplatin, Abx (ie erythromycin), digitalis toxicity
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|
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