1. prosthetic heart valve and suspecting IE, rx
    vancomycin, gentamicin, rifampin
  2. 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
  3. native valve or IVDU, rx initially
    vancomycin + gentamicin
  4. native valve or IVDU and MSSA
    PCN sens
    PCN rest
    • nafc
    • vancomycin¬†
    • naf
    • ceft+gent
  5. indication for surgery in IE
    • heart block
    • late vegetation
    • fungal etiology
    • persistent bacterermia
    • CHF
    • EMBOLI
  6. can daptomycin be used in right sided endocarditis with emboli
  7. enterococcal IE affects what valve
  8. what ab do you not give for enterococcus
  9. 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
  10. pt with tricuspid vegetation and MRSA, rx
    • daptomycin or
    • vancomycin +rifampin+gentamycin
  11. meningitis with listeria, rx
    ampicillin + gentamicin
  12. earliest sign of bacterial meningitis
    CSF to serum glucose <0.4
  13. causes of meningitis
    nsaids, bactrim
  14. recurrent meningitis
    dx, and caused by?
    • Mollaret's meningitis by HSV2
    • Rx is supportive
  15. how do you diagnose west nile virus
    IgM for WNV ab
  16. WNV presents how
    rash, muscle weakness, decreased DTR's
  17. meningitis + choreiform movements
    NMDA encephalitis, do U/S pelvis to rule out malignancy
  18. rx for naegleria fowler
  19. meningitis ppx with?
    rifampin or cipro
  20. what vaccine do you give with Eculizumab
    • meningococcal
    • Zoster
  21. when do you culture for UTI
    if symptoms + after 3 days of Rx
  22. rx for recurrent UTI in post menopausal woman
    vaginal estrogen
  23. how long do you do droplet isolation for meningitis
    24 hrs
  24. asymptomatic bacteria post transplant
  25. rx for uti in pregnancy
    amoxicillin or nitrofurantoin
  26. how do you treat recurrent cystitis in woman
    daily bactrim
  27. how long do you treat acute prostatis
    4-6 weeks with cipro or bactrim
  28. which of the vaginitis you treat partener
    only trichomonoas
  29. strawberry cervix, dx
  30. pt treated with ceftiaxone and azithro, but still has discharge, dx
    • mycoplasma genitalium
    • moxifloxacin
  31. do you need to tap joint in disseminated gonococcal disease
  32. more than 4 episodes of HSV in 1 year, wtd
    HSV ppx
  33. painful ulcers and LAD, miscoscopy shows box car, dx
    • H. ducreyi
    • ceftriaxone, azithromcyin
  34. painless ulcer, disappears reappears with scarring, fistulae
    LGV, rx is doxycycline
  35. painless ulcer +LAD
    Granuloma inguinale, rx is doxycycline
  36. how is granuloma inguinale diff from LGV
    • LGV occurs then disappears
    • Granuloma inguinale has +LAD and does not disappear
  37. 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
  38. what 3 infections give you rash on palms
    • RMSF
    • Meningococcemia
    • syphils
  39. treatment for syphils, titer decreased 4 fold, wtd
    titer goes up
    nothin, rx is successful

    rule out Neurosyphilis, do LP
  40. you suspect neurosyphilis, but VDRL is neg but many WBC, wtd
    treat and repeat LP until WBC normal
  41. jarisch herxheimer rxn
    hypotension, hA, fever after starting rx for pcn
  42. rx for RMSF
  43. tick borne infections
    • lyme
    • RMSF
    • anaplasmosis(ehrlichia)
    • Babesia
    • TUlaremia
    • Stari
  44. how does anaplasmosis presents
    leukopenia, thrombocytopenia, hepatitis
  45. anaplasmosis vs babeisa
    babes will have hemolysis but anaplasmosis will have leukopenia, thrombocytopenia, ast/alt
  46. maltese cross
  47. rx for babesia
    • severe quinine
    • moderate- azithromycin + atovaquone
  48. rx for lyme
    RX for lyme involving CNS(besides CN VII) and carditis

  49. IgG and 5 band +, seen with
    lyme disease
  50. can foot drop occur 2.2 lyme
  51. when do you treat for lyme, with the tick
    after 36 hrs
  52. ramsay hunt syndrome
    facial palsy and zoster
  53. paralysis after tick, wed
    remove it
  54. fr what 2 bacteria you need to do colonoscpy if you have IE
    • clostridium septicum
    • streptococcus bovis
  55. IE of what valve gives you conduction defects
    aortic valve
  56. when do you continue genta for IE
    • if MRSA, MSSA with prosthetic HV
    • PCN resistant native valve
  57. what meds can cause aseptic menintitis
    nsaids, bactrim, OKT3
  58. do you treat candida in female partener is she has vaginitis
    only if he has balanitis
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