ID FC 3.txt

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Author:
gm1147
ID:
169355
Filename:
ID FC 3.txt
Updated:
2012-09-06 20:40:20
Tags:
ID FC step2 set3
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kaplan
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  1. Aztreonam
    • Monobactam.
    • For gram neg incl pseudo.
    • No cross rxn with pen.
  2. meningitis bugs
    • Strep pneumo,
    • group b strep,
    • h flu,
    • neisseria,
    • listeria.
    • Staph if recent surgery
  3. Meningitis in cd4 <100
    Cryptococcus
  4. Csf cell count
    • Bacterial 1000s neutrophils.
    • Fungal and parasite, tb, and viral: 10-100s lymphocyte
  5. Latex agglutination test of csf
    • good specificity.
    • Add if got Abx before LP
  6. Highest csf protein
    Tb
  7. Meningitis initial tx
    • Cedtriaxone, vancomycin, steroids.
    • Steroids are effective in s pneumo.
    • Add ampicillin for listeria if baby, old, steroids, hiv, immunocomp, etoh, pregnant.
    • Add respiratory isolation if neisseria plus rifampin or ciprofloxacin to close contacts.
  8. Herpes encephalitis tx
    • Iv acyclovir.
    • If resistant foscarnet.
    • Foscarnet has more renal toxicity
  9. Otitis media tx
    • Amox.
    • Amox/clav.
    • Azithro or clarithromycin.
    • Cefuroxime or loracef.
    • Levofloxin.
    • If recurrences, also cx
  10. When to bx for sinusitis
    • Recurrent, no response.
    • Is the most accurate Dx test.
  11. Sinusitis first line
    • Amoxicillin, doxy, bactrim.
    • Also decongestant.
  12. Pharyngitis with membranous exudate
    • Diphtheria,
    • Vincent angina,
    • ebv
  13. Step pharyngitis tx
    • Amoxicillin or pen.
    • If all, cephalexin if rash and clindamycin or macrolide if anaphylaxis.
  14. Flu management
    • Within 48hrs: swab for antigen, oseltamivir or zanamivir.
    • Longer: symptomatic
  15. Aminoglycosides
    • Gentamicin
    • Tobramycin
    • Amikacin
  16. Aminoglycosides uses
    • Gram neg bacilli - bowel, urine, bacteremia
    • Synergy with beta lactam for enterococci and staph
    • No effect against anaerobes
  17. Aminoglycoside sides
    • Nephrotoxic
    • ototoxic
  18. Doxycycline uses
    • Chlamydia
    • lyme
    • Rickettsia
    • prim and sec syphilis
    • Borrelia, Ehrlichia, Mycoplasma
  19. Doxy sides
    • Tooth discoloration
    • Fanconi syndrome/Type 2 RTA
    • Photosens
    • Esophagitits
  20. Nitrofurantoin uses
    Cystitis in pregnant
  21. bactrim uses
    • Cystitis
    • PCP tx and ppx
    • MRSA skin, cellulitis
  22. bactrim sides
    • rash
    • G6PD def hemolysis
    • bone marrow supprression (bc folate antagonist)
  23. Beta lactamase
    adds coverage of MSSA
  24. MRSA tx
    • Vanc
    • Linezolid
    • Daptomycin
    • Tifecycline
    • Minor on skin: bactrim, clinda, doxy
  25. Linezolid side
    bone marrow toxicity
  26. Daptomycin sides
    elevated CPK
  27. Anaerobe tx
    • Above diaphragm: Pen, amp, amox, clinda
    • Below: metro
    • Also piperacillin, carbapenems, 2nd gen ceph
  28. Gram neg locals and tx
    • Bowel, URI, Liver
    • Quinolones
    • Aminoglycosides
    • Carbapenems
    • Piperacillin, ticarcillin
    • Aztreonam
    • cephalosporins

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