CCFP 2012.txt

Card Set Information

Author:
KEECH
ID:
150359
Filename:
CCFP 2012.txt
Updated:
2012-04-26 18:49:00
Tags:
CCFP KEECH
Folders:

Description:
CCFP 2012 study cards
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user KEECH on FreezingBlue Flashcards. What would you like to do?


  1. 7 situations to give abx in AOM
    • <6mos old
    • Fever >39
    • Congenital
    • Craniofacial
    • Heart/Lung
    • Downs
    • SADMIST
    • Hx OM complications
    • Mastoiditis
    • Meningitis/Brain Abcess
  2. What microbes in perfed AOM
    • S aureus,
    • P aeuriginosa
    • Strep Viridans
  3. What is watchful waiting in AOM
    • 48-72hrs with analgesia
    • 84% vs 93% spont recovery compared to abx

    • >6mos reassess in 24hrs
    • if not better 2-3 days 10 days Amox 80mg/kg/div TID

    • >2yrs
    • return if sx worse
    • Amox 5 days if symptoms dont improve
  4. What bugs in chronic rhino-sinusitis
    • S aureus
    • GAS
    • Enterobacteracea
    • Anaerobes
  5. what are non abx options for rhino-sinusitis
    Saline rinse, decongestants, hydration, intranasal steroids

    No anti-histamines, no topical decongestants
  6. What should you look for in chronic sinusitis
    • polyps/anatomic abnormalities
    • Xray, CT
  7. Who is at high risk for pseudomonal bronchitis
    • FEV <35%
    • FEV1 <50% with frequent AECB
    • chronic po steroid
    • constant purulent sputum
  8. Which macrolides have higher levels of resistance
    • Azithro>Clarithro>Erythro
    • OD/BID/QID dosing
  9. What are the components of McIsaac Score
    When does it not apply?
    • Fever >38
    • Absent cough
    • Swollen tender anterior LN
    • Tonsillar swelling with exudate
    • Age 3-14
    • Age 15-44 (zero pt)
    • Age >44 (-1pt)

    not for endemic popln, hx rheumatic fever, valvular HD, SADMIST
  10. What are suppurative complications of GAS
    • PTA
    • RPA
    • OM
    • Sinusitis
    • Nec Fasc
  11. What are non suppuratice complications of GAS
    • Scarlet Fever
    • Strep Toxic Shock
    • Acute GN
    • Rheumatic fever
    • PANDAS
  12. What are the Jones criteria
    2+ major or 1 major and 2+ minor

    • Major
    • Heart: carditis/valvulitis
    • MSK: Migratory arthritis
    • Neuro: Syndehams chorea
    • Skin: Erythema marginatum, subcutaneous nodules
    • Minor
    • Clinical: Arthralgia, Fever
    • Labs: ESR/CRP elevated, Prolonged PR
  13. What are 8 emergent conditions that may present as sore throat
    • PTA
    • RPA
    • Ludwigs angina
    • Lemiere's Dz
    • Thyroiditis
    • Epiglotitis
    • Croup
    • Bacterial
    • Diptheria
  14. What P/E findings are suggestive of emergenc sore throat cuases
    • Epiglottitis (drooling, sniff)
    • PTA (trismus, hot potatoe voice)
    • RPA (nuchal rigidity)
    • Ludwigs angina (high riding tongue, tender under jaw)
    • Thyroiditis (thyroid tender to palpation)
    • Lemiere's (fever, rigors, resp distress, tender jug vein, pharyngeal ulcers)
    • Diptheria (pseudomembrane)
  15. What are the typical pneumonia organisms
    S pneumo, H flu
  16. What are the atypical in pneumonia
    MC LIRP

    • Mycoplasma
    • Chlamydophilla
    • Legionella
    • Influenza
    • RSV
    • Parainfluenza
  17. What are anti-pseudomonal abx
    • Flouro: cipro
    • Ceph: Ceftaz
    • Penicillins: Piperacillin, Ticaracillin
    • AG: Gentamycin, Tobramycin
    • Penems: Meropenem+cilastin, Imepenem
  18. How do you sub-classify pneumonias
    • CAP
    • Adult: mild/mod
    • No comorbidities: amoxicl, Clarithro, Doxy
    • Comorbidities/LTC: Amoxil/Amox/clav, Cefuroxime + Macrolide/Doxy OR Resp Flouro
    • Adult: severe
    • Admit to H: Ceftriazone + Clarithro/Doxy
    • Admit to ICU Ceftriaxone + Resp Flouro
    • Admit to ICU ? pseudomonas: Cipro + Cefipime/Ceftazadime/Pip-Tazo/Imipenem/Gent
    • Peds
    • Outpt: Amox 80, Clarithro 15/kg Div BID
    • Admit to H: Cefuroxime 150/kg div TID
  19. When should aspiration be tx with abx
    • LOC,
    • Etoh/Overdose,
    • Szr
    • Esophageal dismotility
    • Gingival Dz

    Not in ADENTULOUS
  20. Who is at risk for MRSA
    • I AM An IVDU
    • Inmate
    • Aboriginal
    • Military
    • Athletes
    • IVDU
  21. Who is at risk for pseudomonas
    HIS Hottub

    • HIV
    • ICU
    • Structural Lung Dz (bronchiectasis, COPD, CF)
    • Hot Tub
  22. How long should we treat UTI with
    TMP SMX, Nitrofurantoin,
    when should Cipro be used
    • 3
    • 5
    • 7
    • (reserve for suspected psuedomonas/pyelo!!!!
  23. Who should be treated for Asx bacteruria?
    • Pregnacy (screen at 12wks, if confirmed by culture x 2 treat and culture q 1month x rest of P
    • Pro-op for GU instrumentation
  24. How do we prophlylax UTI
    • Non pharma: Cranberry juice
    • Pharma:
    • TMP SMX 1DS tab Q every other HS or post coital
    • Nitrofurantoin: 100 QHS/post coital
    • Keflex 125 QHS/post coital
  25. What are McIsaac for UTI
    • Dysuria
    • Leuks (>trace)
    • NItrites (any including trace)

    • 0-1 do UC Tx empirically if severe sx otherwise wait for UC
    • 2-3 Treat empirically dont wait for UC
  26. What are categories of UTI recurrence
    • Re-infection
    • >2wks after complete Abx
    • different organism
    • most common
    • Relapse
    • <2wks after complete Abx
    • same pathogen
    • <10% women
  27. What Abx are safe in Pregnancy
    • Keflex
    • Amoxil
    • Ceftriaxone for pyelo

    • Nitrofurantoin CI >36wks (hemolysis)
    • TMP SMX CI T1 and T3 (folic acid and kernicterus)
  28. What are CI to Nitrofurantoin
    • ALlergy
    • Pregnancy T3
    • G6PD
    • CrCL
    • Pyelo (no penetration of kidney parenchyma)
  29. Who do you urine culture
    • Recurrent cystitis
    • Pyelo
    • Pregnancy
    • SADMIST
    • Complicated UTI
    • COMSS (catheter, Obstruction, Men, Structural, SCI
  30. How do you manage a <28 day old with Rectal temp >38
    • FSWU =
    • Culture: Blood, Urine, CSF +/- Stool
    • CXR, UA, CBC, Lytes
    • Treatment
    • Ampicillin 50mg/kg and 1 of
    • Cefotaxime 50mg/kg
    • Gentamicin 2.5mg/kg
    • Acyclovir 10mg/kg if vesicles, neuro changes, Szr, Tpenia, High CSF WBCs
  31. How do you manage a 29-90 day old with rectal temp >38
    • Investigations
    • Culture: Blood, Urine, CSF, Stool
    • CXR, UA, CBC, Lytes
    • Most in US do LP until 60 days old
    • Criteria to avoid admission/LP = Rochester/Boston/Philadelphia
    • Treatmente
    • Ceftriaxone 50mg/kg
    • Vancomycin 20mg/kg
    • Consider Dex if >6wks to prevent deafness, give within 1 hr of Abx
  32. Who do you need to get a cath'ed your sample on
    • Febrile
    • Girls <24months
    • Boys Uncirc <12
    • Boys Circ <6
  33. What is a febrile Szr
    • 6mos-6yrs old
    • <15mins
    • 1/24hrs
    • Generalized
    • Return to Baseline neuro status
  34. What are 3 microbes affecting neonates
    • GBS
    • E coli
    • Listeria
  35. What are 3 deadly bugs in 29-90 days old
    • S pneumo
    • H flu
    • N menigitides
  36. What are 4 non-infectious cuases of fever
    • Inflammation: SLE, RA, Sarcoid, Corhns
    • Malignancy: leukemia, lymphoma
    • Endocrine: T4, AI
    • Environmental: Heat stroke
    • Drugs:
    • Drug fever: NSAIDS, ABX, Anti-Epileptic
    • Withdrawal: Etoh, Opiod
    • Intoxication:
    • Sympathomimetics: Cocaine, Crystal
    • Anticholinergics: pesticide
    • Overdose: ASA
    • Drug Rection: NMS, Serotonin sx
  37. Investigations in FUO
    • Neuro:
    • ENdo: TSH
    • Cardio Resp: CXR, sputum for AFB
    • Heme: Blood culture/CBC, HIV, VDRL
    • Liver: LFT's, Viral Hep serology,
    • Pancreas: AMylase/Lipase
    • GU: Urine culture/UA, TVUS, Cervical swabs
    • MSK: CK, ESR/CRP, RF, ANA, ANCA, antidsDNA, SPEP

    CT chest/abdo
  38. What classes of Rx commonly cause drug fever
    • NSAIDS
    • Abx
    • Heparin
    • ANti-convulsants
    • Allopurinol
  39. What are Duke Criteria for Endocarditis
    • 2 major, 1 major 3 minor or 5 minor
    • Major:
    • +ve culture for S viridan/bovis or S aureus, enterococcus, HACEK (haemophilus, actinobacillus, cardiobacter, Eikenella, Kingella kingae
    • Echo with Veg
    • Minor:
    • Fever >38.5
    • Vascular phenomena: Janesway, Splinter hemorrhage, arterial emboli
    • Immunologic: Oslers, Roths, RF factor, GN,
    • Positive BC with other organism
    • Abnormal echo but no Veg
  40. What characterizes NMS
    • FARM
    • Fever
    • Autonomic instability
    • Rigidity
    • Mental status changes
  41. What are Well's criteria for DVT
    • Virchows + 3Us CTAngio
    • Endothelial injury
    • Surgery/Trauma <12wks
    • Stasis
    • Paralysis, Plaster, Paresis
    • Hypercoag
    • Prev DVT, Active Ca
    • Unilateral
    • entire leg swell
    • calf swell 3cm > then other
    • pitting edema
    • Collateral superficial veins
    • Tenderness over DV
    • Alt Dx less likely
  42. What are Well's criteria for PE
    • DO (3pts) HIP (1.5pt) CHeck (1pt)
    • DVT signs and symptoms
    • Other Dx less likely
    • HR >100
    • Immobility
    • PmHx: VTE
    • Cancer
    • Hemoptysis

What would you like to do?

Home > Flashcards > Print Preview