ID FC 1.txt

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gm1147
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169354
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ID FC 1.txt
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2012-09-06 20:39:46
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ID step2 FC set1
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kaplan
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  1. Diarrhea with blood and WBCs
    Salmonella, Campylobacter, EHEC, Shigella, Vibrio parahaemolyticus, Vibriovulnificus, Yerisinia, C dif
  2. Most common cause of bloody diarrhea
    Campylobacter
  3. HUS associated diarrheas
    • Ecoli 0157: H7
    • Shigella
  4. Source of Vibrio
    • V parahaemolyticus: shellfish and cruise ships
    • V vulnificus: shellfish, hx of liver disease, skin lesions
  5. Yersinia diarrhea risks
    High affinity for iron, so hemochromatosis and blood transfusions
  6. Stool lactoferrin
    Better sens and spec than stool leukocytes. Not as accurate as stool culture
  7. Diarrhea with no blood or WBCs
    • Viral
    • Giardia: camping, fresh water
    • Cryptosporidiosis: CD4 <100, modified acid fast
    • Bacillus cereus: with vomitting
    • Staph: with vomitting
  8. Scrombroid
    Fish food poisoning with allergic symptoms. Most rapid, wheezing, flushing, rash. Tx with antihistamines
  9. Diarrhea tx
    • Fluids
    • Severe: Ciprofloxacin
    • Giardia: metro, tinidazole
    • Cryptosporidiosis: tx AIDs, nitazoxanide
  10. Severe diarrhea
    • hypotension
    • tachycardia
    • fever
    • abd pain
    • bloody
    • met acidosis
  11. Hepatitis B DNA polymerase
    Quantatative form of e-antigen test
  12. Acute viral hepatitis tx
    Only tx hepC (rarely acute) with interferon and ribavirin
  13. Chronic HepB tx
    Entecavir, adefovir, lamivudine, telbivudine, interferon, or tenofivir. Interferon is not first choice bc injection and sides.
  14. Interferon sides
    • Arthralgias/myalgias
    • Leukopenia and thrombocytopenia
    • Depression
    • Flu like
  15. Chronic Hep C tx
    • If high PCR-RNA, interferon and ribavirin
    • Especially if fibrosis on bx
  16. Ribavirin sides
    Anemia
  17. Urethritis initial test and most accurate test, and others
    • -Urethral swab with gram stain: shows inc WBCs and intraceullar gram neg diplococci for N gonorrhea
    • -urethral cx, DNA probe, or nucleic acid amplification test for both.
    • -Urine testing for nucleic aci amplicfication for both
  18. Causes of urethritis
    • Gonorrhea
    • Chlamydia
    • Mycoplasma genitalium
    • Ureaplasma
  19. urethritis tx
    Cefixime or Ceftriaxone for gonorrhrea + azithromycin or doxycycline for chlamydia
  20. PID initial test and most accurate test
    • Cervical swab with culture, DNA probe, or nucleid acid amp
    • Laparoscopy
  21. PID tx
    • Inpt: Cefoxitin or cefotetan + doxy
    • Outpt: Ceftriaxone + doxy, +/- metro
    • Anaphylactic all to pen: inpt clinda+gent and outpt levofloxacin + metro
  22. Gential ulcer with:
    • Painless
    • Painful
    • Tener LN and suppurative
    • Syphilis
    • Chancroud/Haemophilus ducreyi or HSV (vesicles)
    • LGV
  23. Dx test for genital ulcers:
    • Syphilis
    • H ducreyi
    • LGV
    • HSV
    • Dark field, vDRL, PRP, FTA or MHA-TP(confirmatory)
    • Stain and cx in special media
    • Blood complement fixation titers or swab nucleic acid amp
    • Tzanck is best initial. Cx is most accurate
  24. Tx for genital ulcers:
    • Syphilis
    • H ducreyi
    • LGV
    • HSV
    • 1 dose of IM benzathine pen or doxy if allergic
    • 1 dose azithro
    • Doxy
    • Acyclovir, valacyclovir, famciclovir. if resistant foscarnet
  25. False+ VDRL/RPR
    Infection, older, IVDU, AIDS, malaria, APL syndrome, endocarditis
  26. Tertiary syph tx
    IV pen. If allergic, desensitize.
  27. Imiquimod
    Local immunostimulant for condylomata acuminata which leads to sloughing off of the lesion
  28. Pediculosis
    • Crabs
    • Tx with permethrine. Lindane has same efficacy but more toxicity
  29. Scabies tx
    • permethrin
    • Ivermectin if widespread
  30. Beta lactams in pregnancy
    All are safe
  31. Cystitis tx
    • Bactrim (3 days if uncomplicated, 7 if anatomic)
    • Ciprofloxacin
    • Cephalexin
    • Nitrofurantoin esp if pregnant
  32. Pyelonephritis tx
    • Amp and gent
    • Cirpofloxacin
  33. Prostatitis tx
    • Acute: amp and gent
    • Chronic: 6-8wks of bactrim

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