-
prosthetic heart valve and suspecting IE, rx
vancomycin, gentamicin, rifampin
-
prosthetic heart valve with MSSA
prosthetic heart valve with MRSA
Prosthetic heart valve with pen sens. strep
prosthetic heart valve with pen, res. strep
- gentamicin, rifampin, nafcillin
- gentmaycin, rifampin, vancomyin
- nafcillin
- ceftriaxone + gentamicin
-
native valve or IVDU, rx initially
vancomycin + gentamicin
-
native valve or IVDU and MSSA
MRSA
PCN sens
PCN rest
- nafc
- vancomycin
- naf
- ceft+gent
-
indication for surgery in IE
- heart block
- late vegetation
- fungal etiology
- persistent bacterermia
- CHF
- EMBOLI
-
can daptomycin be used in right sided endocarditis with emboli
yes
-
enterococcal IE affects what valve
aortic
-
what ab do you not give for enterococcus
ceftriaxone
-
pt with staph aureus on vancomycin, repeat bc neg <72 hrs
repeat bc + >72hrs or immunocomprimsied or prosthetic heart valve
- vancomycin for 2 weeks
- vancomycin for 4 weeks
-
pt with tricuspid vegetation and MRSA, rx
- daptomycin or
- vancomycin +rifampin+gentamycin
-
meningitis with listeria, rx
ampicillin + gentamicin
-
earliest sign of bacterial meningitis
CSF to serum glucose <0.4
-
causes of meningitis
nsaids, bactrim
-
recurrent meningitis
dx, and caused by?
- Mollaret's meningitis by HSV2
- Rx is supportive
-
how do you diagnose west nile virus
IgM for WNV ab
-
WNV presents how
rash, muscle weakness, decreased DTR's
-
meningitis + choreiform movements
NMDA encephalitis, do U/S pelvis to rule out malignancy
-
rx for naegleria fowler
miltefosine
-
meningitis ppx with?
rifampin or cipro
-
what vaccine do you give with Eculizumab
Dortezemib?
-
when do you culture for UTI
if symptoms + after 3 days of Rx
-
rx for recurrent UTI in post menopausal woman
vaginal estrogen
-
how long do you do droplet isolation for meningitis
24 hrs
-
asymptomatic bacteria post transplant
treat
-
rx for uti in pregnancy
amoxicillin or nitrofurantoin
-
how do you treat recurrent cystitis in woman
daily bactrim
-
how long do you treat acute prostatis
4-6 weeks with cipro or bactrim
-
which of the vaginitis you treat partener
only trichomonoas
-
strawberry cervix, dx
trichomonad
-
pt treated with ceftiaxone and azithro, but still has discharge, dx
rx
- mycoplasma genitalium
- moxifloxacin
-
do you need to tap joint in disseminated gonococcal disease
no
-
more than 4 episodes of HSV in 1 year, wtd
HSV ppx
-
painful ulcers and LAD, miscoscopy shows box car, dx
Rx
- H. ducreyi
- ceftriaxone, azithromcyin
-
painless ulcer, disappears reappears with scarring, fistulae
LGV, rx is doxycycline
-
painless ulcer +LAD
Granuloma inguinale, rx is doxycycline
-
how is granuloma inguinale diff from LGV
- LGV occurs then disappears
- Granuloma inguinale has +LAD and does not disappear
-
early latent syphilis vs late latent syphilis
- early is neg syphilis 1 year ago rx pcn once
- late is neg sophist more than 1 year ago rx is 3 weeks
-
what 3 infections give you rash on palms
- RMSF
- Meningococcemia
- syphils
-
treatment for syphils, titer decreased 4 fold, wtd
titer goes up
nothin, rx is successful
rule out Neurosyphilis, do LP
-
you suspect neurosyphilis, but VDRL is neg but many WBC, wtd
treat and repeat LP until WBC normal
-
jarisch herxheimer rxn
hypotension, hA, fever after starting rx for pcn
-
-
tick borne infections
- lyme
- RMSF
- anaplasmosis(ehrlichia)
- Babesia
- TUlaremia
- Stari
-
how does anaplasmosis presents
leukopenia, thrombocytopenia, hepatitis
-
anaplasmosis vs babeisa
babes will have hemolysis but anaplasmosis will have leukopenia, thrombocytopenia, ast/alt
-
-
rx for babesia
- severe quinine
- moderate- azithromycin + atovaquone
-
rx for lyme
RX for lyme involving CNS(besides CN VII) and carditis
doxy
ceftriaxone
-
IgG and 5 band +, seen with
lyme disease
-
can foot drop occur 2.2 lyme
yes
-
when do you treat for lyme, with the tick
after 36 hrs
-
ramsay hunt syndrome
facial palsy and zoster
-
paralysis after tick, wed
remove it
-
fr what 2 bacteria you need to do colonoscpy if you have IE
- clostridium septicum
- streptococcus bovis
-
IE of what valve gives you conduction defects
aortic valve
-
when do you continue genta for IE
- if MRSA, MSSA with prosthetic HV
- PCN resistant native valve
-
what meds can cause aseptic menintitis
nsaids, bactrim, OKT3
-
do you treat candida in female partener is she has vaginitis
only if he has balanitis
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