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