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COMLEX infectious dz

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jmanderson's version from 2017-06-17 15:15

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Question Answer
mc cold virusrhinovirus
clindamycin moabactericidal and bacteriostatic 50S inhb
what virus: cough, ha, pharyngitis in kidsflu
rx for early Lyme's in <8 y/oamoxicillin 50 mg/kg/d tid
rx for early Lyme's in >8y/odoxycycline 4mg/kg bid
rx for advanced Lyme'sceftriaxone, pcn G
rx for partner exposed to primary syphillis with neg RPRbenzathine pcn G IM
mcc severe dehydrating gastroenteritis in kids <5y/o (esp daycare) rotavirus (non enveloped, icosahedral, dsRNA)
hosp precautions for VZV chickenpoxcontact and airborne
fever, cough, coryza, conjunctivitis, red/blue mucosal lesionsmeasles (rubeola)
periph blood smear of mono (EBV)atypical lymphocytosis
abx for gonococcal arthritisceftriaxone and azithromycin
CRAB s/sx of MMhyperCa, renal insuff, anemia, bone dz
bug group spread at NICU and daycare causing meningoencephalitis, hepatic dsyfxn, DIC, pneumonitis, hand foot mouthenterovirus (coxsackie, echo)
VZV exposure ppxacyclovir 7-9 d after
dx and w/u: painless red-purple lesion on hand s/p exposure to livestock baccilus anthracis, tissue bx (gm stain, cx, immunohist stain)
RSV ppx in high risk kidspalivizumab
abx for pna pt with pseudomonal riskzosyn (pipercillin/tazobactam)
abx for MRSA copd pt w/ pna, but allergic to zosynvanc and ceftazidime
empiric UTI delerium abxvanc (GP, MRSA) and cefapime (GNB, pseudomonas)
coverage of ceftriaxoneGNB (not psuedomonas)
abx in advance lyme dz in pregnant pt with pcn all azithromycin (doxy c/i in preg)
bacteriostatic or -cidal?: augmentin, ceph, daptomycin, fluroquinolones, metronidazole, vanc bactericidal (inh cell wall synth)
bacteriostatic or -cidal?: sulfa drugs, chloramphenicol, macrolides bacteriostatic (inh growth via intracellular)
AIDs defining illnessCMV, kaposi sarcoma, CD4<200, PCP, esophogeal candidiasis
abx for Actinomyces israellipcn
mc bug for otitis externapseudomonas (swimmer's ear)
anti-pseudomonal abxceftazidime, cefepime, meropenem, imipenem, cilastatin, piperacillin/tazolbactam, ticarcillin/clavulanate, tobramycin, gentamicin, tmp-smx, aztreonam
clindamycin anti-pseud?no
worst s/e of linezolidbone marrow suppresion (low plt, anemia)
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Question Answer
dx and w/u: severe colitis, bowel ulceration, hepatic abscess, mexicoentamoeba histolyticum, stool Ag test
triad of HSParthritis, purpura, abd pain
bug: pna in CF and COPD, GNB, lactose(-), oxidase(+)pseudomonas
bug: unvaccinated, URI s/sx (fever, runny nose, cough, malaise), progress to emesis, spasmswhooping cough, bordatella pertussis (aerobic, GNC)
whooping cough ppx to contactsazithromycin 5d
dx: severe meningitis s/p swimming in pondamebic meningoencephalitis (naegleria fowleri)
bug: meningitis with low grad efever, ha, photophobia, neck stiffness, india ink, buddingcryptococcus
bug: GPC in chains, beta hemolytic, catalase (-)strep pyogenes
bug: ingestion of undercooked pork or wild game, dx by muscle bxtrichinella spiralis
doc for strongyloides infxnivermectin
bug: kid, h/o recent uri, tonsillar exudates (dense, grey), cervical LAD, swollen mucosa, gm(+), granules, methylene blue corynebacterium diphtheriae
corynebacterium diphtheriae virulenceAB exotoxin (ADP ribosylation of EF2, inh protein synth)
bug: pt with pna and cold agglutinin +mycoplasma pneumo
cold agglutinin hemolyytic anemia d/o (3)mycoplasma pneumo, EBV, idopathic
bug: too thin for gm stain, seen on silver stain, immunofluorescence, dark field microscopytreponema pallidum (syphillis)
2nd mcc UTIstaph saprophyticius
uti bug: gm+, catalase +, coagulase negstaph saprophyticus
tx of PCP pna if sulfa allpentamidine
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Question Answer
bact: abd pain, watery diarrhea, w/in 24 hr eating, seafood/oystersvibrio parahaemolyticus
bact: copious watery diarrhea, s/sx dehydration, water or seafood, tx with hydration, tetracycline/doxyvibrio cholera
bact: abd pain, bloody diarrhea, RLQ pain, fever, pork, fresh produceyersinia enterocolitica
parasite: mild/severe bloody diarrhea, abd pain, cysts/trophozoites in stool, water, poor sanitationentamoeba histolytica
rx entameobametronidazole, paromomycin
parasite: watery diarrhea, abd pain, malaise, acid fast, food/water, immunocompromisedcryptosporidium parvum
rx crryptosporidumctrl immune suppression, nitazoxanide
parasite: fever, myalgias, periorbital edema, eosinophilia, undercooked porktrichinella spiralis
rx trichinellaalbendazole, mebendazole if CNS or cardiac sx
parasite: mild diarrhea, CNS sx (neurocysticercosis), undercooked porktaenia solium
rx taenia soliumpraziquantel for intestinal, albendazole + steroids for neurocysticercosis
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Question Answer
rx malaria P ovale and P vivax (tertian fever cycle, latency, dormant liver hypnozoite)primaquine
1st line antimalarialschloroquine, primaquine, quinine
antimalarials for chlorquine-resistent P falciparum proguanil or mefloquine
MRSA abxvanc, clindamycin, bactrim
dx- non vacc, 3 cs (cough, conjuctivitis, coryza), posterior cervical LADmeasels (rubeola)
dx- blueberry muffin rashgerman measles (rubella)
dx- 5d fever followed by trunk to head diffuse rashHHV-6 (roseola)
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