Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
ID Tx 1
Infectious Disease
| Question | Answer |
|---|---|
| Lyme dz tx | Adult: doxy or amox (ceftin if allergic). Kids: ceftriaxone |
| Empiric treatment for bacterial meningitis | begin Abx immediately (ceftriaxone or cefotaxime 2 g IV and vanc; add ampicillin for pts <3months & >55 and/or immunocomp |
| Meningitis: add to empiric therapy if HSV is suspected: | acyclovir |
| Bacterial meningitis: give concurrently with empiric Abx: | dexamethasone, continue for 4 days |
| supportive care for bacterial meningitis | hydration, pain meds, anticonv, antiemetics |
| meningitis bugs: >50 yo / EtOH | SP, listeria; tx = amp + rocephin + vanc + dex |
| meningitis tx: 1 - 3 mos | Amp + (rocephin or cefotaxime) + Dex |
| meningitis tx: 3 mos - 50 yo | (rocephin or cefotaxime) + vanc (if >1 mo. old) + Dex (add Amp for listeria) |
| Meningitis: EtOH / impaired immune | Amp |
| post exposure prophylaxis for meningitis | PEP = rifampin for household contacts/droplet exp only; alts = cipro or rocephin |
| meningitis tx: hosp-acquired (or post-neurosurg) or immunocompromised: | amp + ceftazidime + vanc |
| brain abscess tx | PCN +/- chloramphenicol +/- flagyl; if SA suspected, add nafcillin |
| Furuncle/carbuncle tx | mild: oral dicloxacillin or ceph; severe: IV ceph |
| Mastitis: No MRSA | Dicloxacillin or Keflex |
| Mastitis: MRSA possible | TMP-SMX or clinda |
| Otitis externa | drops (polymyxin B + neomycin + hydrocortisone) + Se sulfide shampoo |
| Otitis media | Amox; if Abx in past month: Aug or cefdinir/cefpodoxime |
| Internal hordeolum | Dicloxacillin; TMP-SMX-DS if MRSA-CA |
| Orbital cellulitis | nafcillin 2 gm IV; if MRSA: vanco 1 gm IV + Rocephin 2 gm IV + Flagyl 1 gm IV |
| Advanced generation macrolide | azithromycin or clarithromycin |
| 1st gen Ceph | Duracef, Keflex, cephalothin, cephazolin |
| 2nd gen Ceph | cefuroxime |
| 3rd gen Ceph | Omnicef, Suprax, Rocephin, fortaz, cefotaxime, cefpodoxime |
| 4th gen Ceph | Cefclidine, Cefepime (Maxipime), Cefrom |
| 1st gen Ceph efficacy: | GP: MSSA/MSS strep; not vs MRSA/strep; GN: PEcK (Prot, e coli, Klebs) |
| Cefuroxime efficacy: | No GP; GN: HEN (H flu, Enterobacter aerogenes, some Neisseria )+ PEcK; >Gen1 |
| 3rd gen Ceph efficacy: | GN: Broad spectrum, esp hosp acquired; meningitis (pneumococci, meningococci, H flu, some E coli/Klebs); ceftriaxone / cefixime for NG |
| 4th gen Ceph efficacy: | GP: MSSA/MSS strep; not vs MRSA/strep; GN: exp beta-lactamase, meningitis, pseudomonas |
| 5th gen Ceph (Ceftobiprole, Ceftaroline) efficacy: | Antipseudomonal |
| tetanus tx | IM IG; post recovery, full tetanus toxoid; PCN; DTaP/TDaP booster q 10 yrs (if clean wound; 5 yrs if dirty wound) |
| Tetanus IG: give if: | pt has dirty wound & imms hx unknown, OR not fully immunized (ie, received <3 doses) |
| Tetanus toxoid: give if: | 1) pt’s tetanus imms hx unknown or got <3 doses; 2) wound is >24 hrs old; 3) pt’s last booster was >5 yrs (if dirty wound) or >10 yrs (if clean wound) |
| Diphtheria tx | serum antitoxin; airway (poss membrane removal via laryngoscopy); PCN or erythro/zithro; test of cure |
| HSV tx | antivirals (acyclovir, valcyclovir); trifluridine for HSV keratitis; Foscarnet for immunocompromised pts |
| CMV tx | ganciclovir, valganciclovir, foscarnet, cidofovir |
| Severe Rhinosinusitis tx | Augmentin; macro or ceph |
| Monobactams w/antipseudomonal action = | Imipenem & meropenem |
| PCNs MOA: | inhibit peptidoglycan cross linking |
| Aminoglycoside MOA | prevent mRNA translation into proteins |
| Glycopeptides (vancomycin, daptomycin) MOA | inhibit peptidoglycan cross linking (Gram pos orgs only) |
| FQs MOA | inhibit bacterial DNA gyrase |
| macrolides MOA | bind to 50S ribosome (interfere w/protein synthesis) |
| Oxazolidinones MOA | inhibit protein synthesis at 50S ribosomal subunit |
| macrolides: effective against: | GPC, some anaerobes (NOT Bacteroides), mycoplasma, chlamydia |
| Flagyl MOA | accepts electrons under anaerobic conditions => metabolite toxic to bac DNA |
| tetracyclines MOA | locking tRNA to septal site of mRNA (thus interfere w/pro synthesis) |
| SMX-TMP MOA | inhibit synthesis of tetrahydrofolate |
| MRSA (cellulitis) tx | Vanco +/- rifampin, gentamicin, linezolid |
| Non-gono arthritis: gram neg: tx | ceftazidime or genta; IV 2wks & po 4 wks |
| 3 major types of HIV tx | Nucleoside & nucleotide reverse transcriptase inhibitors (zidovudine, abacavir, tenofovir). Protease inhibitors (ritonavir). Nonnucleoside reverse transcriptase inhibitors (efavirenz). Entry inhibitors. Integrase inhibitors (raltegravir). |
| EBV / mono tx | Supportive. No contact sports >1 month. Avoid amoxicillin for strep co-infection (increases rash from 15% to 90%) |
| Rabies mgmt. | Rabies IG infiltrated around wound. Inactivated rabies vax on days 0, 3, 7, 14, 28 post exposure. Milwaukee protocol (coma). |
| RSV tx | O2 support PRN. Corticosteroids, bronchodilators, ribavirin (poor evidence of benefit). High-risk infants (heart dz) get palivizumab. |
| West Nile virus tx | Intensive supportive easures. IVIG or interferon alpha. |
| Anthrax tx | Cipro or doxy. (second: amox, Pen G, clinda, clarithro, vanco, imipenem. |
| In anthrax outbreak, prophylaxis is: | Cipro or doxy x 100 days (or vax w/investigational agent + 40 days of Abx) |
| Botulism mgmt. | Admit to ICU => intubation. Antitoxin from CDC to neutralize unabsorbed toxin. |
| Brucellosis tx | Doxy plus rifampin +/- streptomycin +/- gentamicin |
| Campylobacter mgmt. | Tx may shorten dz course. Azithromycin or Cipro (FQ resistance rising). Fluid & lyte replacement |
| Role of vax in cholera | Provides only short term protection; not useful in managing outbreaks |
| Cholera mgmt. | PO or IV fluid replacement. Abx may shorten course, but there is often resistance |
| Diphteria mgmt. | Diphtheria antitoxin (from CDC). Remove membrane. Erythromycin or PCN eliminate organism (secondline: other macrolides) |
| Hospitalization & isolation for diphtheria are needed until: | 3 cultures document elimination of organism |
| MAC mgmt. | TOC: clarithromycin and ethambutol +/- rifabutin. Possibly azithromycin. |
| Additional mgmt. for MAC in HIV+ patients with CD4 <50 cells/microliter | Single-drug prophylaxis |
| Erysipeloid mgmt. | Usually self limiting in 3-4 weeks. Pen G, imipenem, cephalosporins, clinda, cipro. |
| Hansen disease mgmt. | Lepromatous: combo tx with dapsone rifampin, & clofazimine x2-3 years (due to single-drug resistance). Tuberculoid: dapsone & rifampin x6-12 months, then dapson x2 years |
| Salmonella tx | Cipro, Bactrim, or ampicillin (if severe or HIV or SCD). Enteric fever: IV cipro, Levaquin, CTX, or per C&S. |
| Shigella tx | Hydration / lyte repletion. Bactrim or FQ is TOC. Azithro in MDR. |
| Mgmt. of Lyme complications | CNS/cardiac dz: IV Pen G, CTX, or cefotaxime x2-4 weeks. Arthritis: PO doxy or amox up to 60 days (vs Pen G or cefotaxime up to 4 weeks) |
Created by:
Abarnard
Popular Medical sets