INFECTIOUS DISEASE Flashcards

1
Q

natural penicillins

A

penicillin VK, G, G, G- gram positive

anthrax- gran positive anaerobes

indc : strep pharyngitis, syphillis

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2
Q

nafcillin, dicloxaciillin

A

gram positive- but protects against beta lactamase producing staff

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3
Q

amino-penicillins like amox, ampi

A

positive and neg coverage

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4
Q

amino-penicillin with B lactamase

A

augmenting, unasyn

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5
Q

anti-pseudomnal

A

bradest spectrum pen: zosyn

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6
Q

cephalosporin- 1st

A

skin , soft tissue

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7
Q

2nd generation cephalo

A

braoder gram neg coverage- skin, respiratory, UTI, anaerobes

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8
Q

3rd generation of ceph

A

ceftriaxone, ceftazidime, cefixime- good cns penegration, gonorrhea

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9
Q

4th generaiton of ceph

A

covers pseudo- cefepime

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10
Q

5th generation of ceph

A

broad- including mrsa and negative- ceftaroline

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11
Q

carbapenems

A

broadest of all abx- imipenem, meropenem- lowers seizures threshold

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12
Q

doxy is a tetracycline

A

rmsf, lyme disease, pid

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13
Q

tetra and minocycline

A

used for acne

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14
Q

clinda

A

anaerobes above diaphran, covers gram- may cause c. diff

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15
Q

aminoglycosides

A

GRAM NEGATIVE AEROBES ONLY!- ototoxic and nephrotox

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16
Q

flouroquinolones, dna or rna syntehsis inhibitors

A

cipro- best for gram neg- vs. pseudomonas, uti, pyelonphritis, gastroenteritis

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17
Q

levo

A

legionella

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18
Q

flagyl

A

anaerobes and protoza- c. diff,

Protozoa: e. hystolica, giardia lambia, tricho

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19
Q

bactrim

A

PCP- drug of CHOICE
not for pregnant woman
inhibits folic acid syntehsis
2nd best po coverage vs. mrsa

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20
Q

nitrofurantoin

A

only for cystitis

safe in pregnancy

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21
Q

penicillins

A

hyper sese reaction- 10% cross reactivity in patients allergic to cephalo

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22
Q

vanco

A

redman syndrome

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23
Q

macrolides

A

GI upset- caution if patient is on niacin or statins

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24
Q

flouroquinolones

A

tendor reupture- QT prolongation

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25
Q

clinda

A

c.diff

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26
Q

tetra

A

deposition in teeth- teeth coloration, not given for younger children than 8, photosensitivity

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27
Q

bactrim

A

sulfa allergy, hemolysis if G6PD deficiency

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28
Q

metronidazole- flagyl

A

avoid ETOH during and 48 hours after- disulfiram like reaction

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29
Q

chloromphenical

A

broad spectrum- good CSF penetration, gray baby syndrome

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30
Q

amphotericine b

A

antifungal of choice for invasive or life threatening fungal infections.
fevers/chills during infusion nephrotox

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31
Q

nystatin

A

vaginal & local treatment: oral cadidiasis

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32
Q

azoles

A

inhibits ergosterol synthesis

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33
Q

fluconazole

A

DOC for noninvasive candida and cryptocooccal infection

good for urine and csf infections

34
Q

intraconazole

A

extended spectrum- DOC for histoplasmosis, blastomycosis, coccidiomycosis

35
Q

keto and itraconzole

A

poor CSF penegration!!

36
Q

candidiasis

A

esophagitis: fluconazole
oral thrush: nystatin
vaginal candidasis: miconazole, clotrimazole
intertrigo: satellite lesions- clotrimazole
endocarditis fungus: IV amphotericin

37
Q

cryptococcosis

A

budding round yeast- pigion/bird droppings, mc cause of fungal meningitis
INDIA stain- encapsulated yeast
amphotericin B plus flucytosine- and then oral fluconaozle

38
Q

histoplasmosis

A

AIDS defining illness
bird/bat droppings
missisippi and ohio river valley
ITRACONZAOLE`

39
Q

pneumocystits jirovecci

A

CD4- less than 200.
bilateral diffuse interstitial infiltrates
BACTRIM is drug of choice
dapsone if sulfa allergy

40
Q

cocciodiomycosis

A

southwestern US and mexico- SOIL IN ARID/desert
*erythema nodosum
arthralgia, knee, ankle
culture most definite
FLUCONAZOLE IF CNS,- most cases self limited.

41
Q

TX for menignitis

A

ceftriaxone and vancomycin in adults

ampcillin and cefotaxime in infants`

42
Q

chancroid

A

haemophilus DUCREYI= painful GENITAL ulcers- bubo- painful inguinal lymphadenopathy
AZITHRO!

43
Q

h.flu

A

COPD is a risk factor
AMOXICILLIN
IV ceftriaxone for epiglogtitits

44
Q

tularemia

A

rabbits- streptomycin is doc

45
Q

hot tub folliculitis

A

pseudomans aeruginosa- contaminated spa, swimming pool or hot tub
resolves spontaneously, but if needed- cipro

46
Q

NECROTIZING Fasciitis

A

MC GABHS! - penis/scrotum- impaired immunity
BLUE/HEMORRHAGIC bullae- BLISTERS AT SITE
GANGRE, then becomes septic shock
extreme pain out of proportion to physical exam

BRAOD spectrum abx: unaysyn, piperacillin, imipenam

47
Q

Diptheria

A

GRAM POSITIVE ROD!
friable gray/white membrane on pharynx that bleeds if scraped- tonsillopharygintis or laryngitis, bull neck!!- enlarged cervical lymphadenopathy

DIPTHREIA antitoxin, erythromycin or penicillin X 2 weeks!

48
Q

TETANUS

A

clostridium tetani- gram positive ROD!- blocks acetylcholinesterase!- unblocked acetylcholine so nerves keep on contracting muscles!
puncture or crush wounds
SEVERE MUSCLE SPASM!
neck/jaw stiff, trismus: lock jaw!!- dysphagia, irritable, drooling, can affect respiratory muscles- increased DEEP TENDON REFLEX!

TX: metronidazole plus IM tetanus immune gloubulines

49
Q

gas gangrene

A

clostridium perfringes- anaerobic conditions!
shock, watery exudates, crepitus/gas in the tissue
AIR IN SOFT TISSUES
IV PENICILLIN! + IV clinda, debridement

50
Q

botulism

A

gram positive, spore forming rods-
weakness, flaccid paralysis, resp arrest
canned/smoked foods
ingestion of honey or dust

DILATED , fixed pupils- dry mouth, dysphagia, dysarthria, DESCENDING DECREASED MUSCLE STRENGTH!!
floppy baby syndrome
TX: ANTITOXINS IN ALL CASES!`

51
Q

syphillis = CHANCRE

A

chancre- painless ulcer
secondary: maculopapular rash- palms/soles common
condyloma lata: highly contagious

TERIATRY: gumma! tabes dorsalis (demyelination of posterior columns- ataxia, weakness)
argyll-robertons pupil: small, irregular pupil - constricts to near accomdation but not reactive to light
aortitis

52
Q

congenital syphillis

A

HUTCHINSON TEETH!, saddle nose deformity

53
Q

DX of syphillis

A

darkfield microscopy- direct visualization of spirochete fon chancre or condyloma lata
SCREEN: RPR- confirmed by treponema testing- FTA
confirmation: FTA-ABS!flourescent treponema antibody absorption

PEN G: TX !

54
Q

lyme disease

A

borrealia burgodrferi= = tick/deer
erythema migrans- central clearing, arthritis, CN VII facial nerve palsy with lyme disease, AV block
ELISA followed by western blot!

TX: DOXY!, amoxicillin if preg, or children

55
Q

rocky mountain spotted fever

A

blancing macular rash- WRIST/ANKLES- then palms and soles- spreads centrally-

check for antibody for IGM and IGG - may develop throbocytopenia or hypnatremia

DOXY! even in children!!
chloramphenicol- 2nd line- choice in PREGNANCY!

56
Q

amebiasis

A

e.histolytica- bloody diarrhea, gi colitis- amebic liver abscess

FLAGYL!!!

57
Q

malaria

A

falciparum most dangerous type!! cyclical fever, hemolytical anemia, thromboycopenia, giemsa stain
CHLORoquine- 1st line- quinidine

58
Q

babesia

A

attacks red blood cells- hemolytic aemia and jaundice
maltese cross
ATOVAQUONE plus azithro

59
Q

enterobiasis- pinworm

A

sctoch tape test- perianal itch, albendazole

60
Q

MAC

A

less than 50 HIV
pulmonary infection- bronchiectasis, disseminated, lymphadenitis in children-
clarithromycin and ethambutol

61
Q

HSV esophagitis

A

small, deep ulcers on EGD

62
Q

cytomegalovirus- HHV 5

A
- immunocompromised people
congenital CMV: hearing loss, petechia 
TORCH : toxoplasmosis (ring enhancing lesions from cat)
syphillis, rubella, CMV, HSV
retinitis- if cd4 less than 50
esophagitis: LARGE superficial ulcers on upper endoscopy
owl's eye appearnce- biopsy 
GANCICLOVIR TOC
63
Q

vARICELLA - hhv 3

A

chicken pox- vesciles on erythematous base- dew drops on a rose petal- diff stages- begins on face, trunk and then extremities

SHINGLES: one dermatome
opthalmicus: hutchinson’s sign- ocular involvement
trigeminal NERVE!- 1st division- dendritic lesions
ramsay-hunt syndrome- CN VII - facial palsy- otalgia- HEREPES OTICUS is ramsay

64
Q

EBV- HHV 4

A

posterior cervical lyphadenopathy, splenomegaly- rash if given ampicillin- heterophile monospot- atypical lymphocytes
supportive therapy, avoid trauma/contact sports

65
Q

opportunitistic infections in HIV

A
500-200- TB, kaposi sarcoma, thrush, zoter, lymphoma
200- pcp
150- histo
100- TOXO- bactrim
crypto: fluconazole
MAC- azithryo or clarithyro
CMV retinitis- ganciclovir
66
Q

HAART regimens for HIV

A

NNRTI plus 2 NRTI
PI +2 NRTI
insti +2 NRTI

67
Q

NRTI (DINE, VIR, BINE)

A

(zidovudine, bine, abacavir, lamivudine, didanosine, stavudine, tenoforvir)
inbhitis viral rep- interferes with hiv viral rna dependent -
TRUVADA is one of them! (2 combined)
peripheral neuropathy, pancreatitis- SIDE EFFECTS!

68
Q

NNRTI- (VIRINE)

A

viren! -efavirenz, delaviridne, etravirine, nevirapine-

69
Q

PI : protease inbhitor: navir

A

lipodystrophy, hyperlipidemia- main side effect along with N/v/ d
indinavir- renal stones

70
Q

INSTI: gravir

A

hyperlipidemia- prevents insertion of DNA copy of viral genome

71
Q

varizella- chicken pox

A

rash in diff stages at same time- face first then etremities- erythematous base dew drops on a rose petal

72
Q

rubeola (MEASLES)

A

COUGH, coryza, conjunctivits- BRICK RED RASH!!!- begins at hairline and then face and extremities after- koplik spots on buccal mucosa

73
Q

RUBELLA (GERMAN measles)

A

URI prodrome, PINK-light red- spotted rash on FACE then extremities- lasts 3 days
ARTHRALGIA AND PHOTOSENSITIVITY: part of TORCH!

74
Q

ROSEOLA

A

ONLY ONE THAT STARTS ON TRUNK/exTREMITIES AND THEN GOES TO FACE!-
3 DAYS OF HIGH FEVER!- HIGH HIGH FEVERS!
blanchable pink rash!!

75
Q

erythema infectiosum- PARVOVIRUS!

A

SLAPPED CHEEK appearnce with circumoral pallor- LACY reticular rash on the BODY!
parvovirus!

76
Q

kawasakai

A

strawberry tongue- desquamation of palms and soles- mi and coronary artery invovelment

77
Q

SCARLET fever

A

strawberry tongue, SAND PAPER RASH!- circumoral pallor with facial flush- small red spots on the soft palate- forchheimer spots.

78
Q

bartonella h.

A

cat scratch fever- painful lymphadenopathy

79
Q

rabies

A

at the bite site = fasciculations and paresthesia

80
Q

lymphogranuloma venerum

A

CLAmydia- painful lymph nodes but painless lesions on penis!

81
Q

enterobiasis

A

is pinworm!- scotch tape test