-
Physician exam for bacterial meningitis
- Brudzinski sign
- kernig sign
-
Empiric treatment for meningitis
Antiviral and cefotoxime (add ampicillin for neonates)
-
Cerebrospinal fluid findings for bacterial meningitis
- Low glucose and pH
- increased protein, WBC, lactic acid
-
Bloodwork findings for bacterial meningitis
- leukocytosis with left shift
- elevated CRP
-
Prophylactic treatment for patient’s contacts for n. meningitidis
Rifampin
-
s/s bacterial meningitis
- Fever
- chills
- headache
- nausea / vomiting
- petechiae
-
treatment for tetanus
- Antitoxin
- immune globulin
- penicillin or metronidazole
-
early signs of tetanus
- pain, tingling at site
- nucal rigidity
- dysphagea
-
treat purulent cellulitis
- drain
- if abx needed outpatient Bactrim
- if severe, Vanco & admit
-
treat non purulent cellulitis
Clindamycin P.O. or IV
-
Pain on eye movement DDx
- Preseptal cellulitis
- rubella
-
s/s rubella
- Headache, runny nose
- occipital lymphadenopathy
- eye pain on movement
- arthralgias, esp in females
- petechiae on uvula and soft palate
- low fever concurrent with diffuse pink pruritic rash spreading from face to trunk
-
Forcheimer’s sign
petechiae on soft palate and uvula, indicative of rubella
-
Treat preseptal cellulitis
Bactrim
-
treat orbital cellulitis
Pip/tazo
-
What is curtis fitzhugh syndrome, and which illness is it a complication of
- RUQ pain, inflammation of the liver capsule, normal LFT.
- complication of chlamydia
-
DDx syphilis vs gonorrhea in women
- Syphilis has adenopathy and possibly rash
- chlamydia has cervical motion tenderness and red lesion on cervix
-
Gray membrane in pharynx
nasal discharge
hoarse voice / dysphonia
fever
sore throat
malaise
Diphtheria
-
DDx sore throat
- diphtheria: gray membrane on pharynx
- Rhinovirus: rinorrhea and sneezing
- Adenovirus: conjunctivitis
- Influenza A and B: cough, myalgia
- EBV: fatigue, lymphadenopathy, fever, sweat/chills
- CMV: no exudate or lymphadenopathy
- GABHS: sudden onset, without cough, coryza or rhinorrhea
- Mycoplasma pneumoniae: wheezing, rales, dry cough
-
Modified Centor score for strep pharyngitis
- 1 point for each of the following findings:
- tonsillar exudates,
- swollen tender anterior cervical nodes,
- absence of cough,
- history of fever and
- age < 15 years.
- One point is subtracted for age over 45 and older.
-
Treatment of strep pharyngitis
Penicillin 500 bid x 10 days
-
Treatment of diphtheria
Penicillin 250 qid x 14 days
-
Painful red bulging bullous spots on legs or face with discrete margins
Erysipelas
-
erythema infectosium is caused by what
Parvovirus B19
-
Erythema infectosum before the rash starts
- fever, coryza, conjunctivitis
- headache, arthralgia, nausea, diarrhea
-
progression of rash in erythema infectosum
- Starts 2-5 days after fever
- circular, well defined with surrounding pallor
- ”slapped cheek”
- several days later, lacy pattern on trunk
-
adults with persistent polyarthralgia should be tested for what
Erythema infectosum
-
treat gonorrhea
- ceftriaxone 250 mg IM x 1
- also treat for chlamydia: azithromycin 1 g x 1
-
symptoms of gonorrhea in women
- Purulent vaginal discharge
- dysuria
-
s/s of malaria
- Cyclic presentation: cold, hot, wet
- continuous rigors 20-60 min
- Temp rises over 3-8 hours
- final temp 104-107
- then falls with profuse sweating
-
Progression of measles
- Malaise, anorexia, high fever, then
- cough, coryza, conjunctivitis
- koplik’s spots
- ~48 hrs later patchy rash starts on face and spreads to trunk
-
Roseola progression of illness
Very high fever, followed within a week by a pink diffuse rash
-
Triad of shigella
- Cramps/abdominal tenderness
- tenesmus
- frequent small volume bloody mucoid feces
-
3 drugs to treat shigella
- ciprofloxacin
- ceftriaxone
Azithromycin
-
Triad of shigella
- Cramps
- TEnderness
- frequent, small volume bloody mucoid feces
-
Fulminant colitis
- Abdominal distension hypovolemia fever
- 40k+ leukocytosis
- elevated creatinine
- Lactic acidosis
- hypoalbuminemia
- diarrhea or no stool
-
C. diff s/s
- Low fever
- nausea, anorexia
- lower abdominal pain and cramping
- significant leukocytosis
- watery diarrhea, possibly with mucous or blood
-
Sign of c diff on endoscopy
pseudomembrane
-
Follow up care for osteomyelitis
- ESR and CRP weekly
- Targeted antibiotics 6-12 weeks
-
Saddle paresthesias
bowel or bladder dysfunction
new motor weakness
focal back pain with electric shooting to extremities
Red flags for spinal epidural abscess
-
Clinical presentationof septic arthritis
- Restricted ROM
- acute onset
- one red, warm, swollen, painful joint
-
treat Candidiasis: thrush, esophageal, cutaneous, vulvovaginal
- Thrush: clotrimazole troches
- esophageal: fluconazole tablets
- Cutaneous: topical azole
- vulvovaginal: oral fluconazole
-
-
Treat candida
fluconazole
-
Treat impetigo
Topical mupirocin
-
treat preseptal cellulitis
Bactrim
-
Treat cryptococcus
AmphotericinB
-
Treat malaria
chloroquine
-
treat UTI
Bactrim or nutrofurantoin
-
treat shigella
ciprofloxacin
-
treat diphtheria
Penicillin
-
treat pertussis
Azithromycin
-
Treat anthrax
Ciprofloxacin and meropenem
-
Treat cholera
Only if very ill. Tetracycline
-
Treat salmonella
Only if very ill. Bactrim
-
treat tetanus
- Antitoxin,
- immune globulin
- penicillin
-
treat enteric fever
ceftriaxone
-
treat pinworms
Albendazole
-
treat hookworm
mebendazole
-
Treat histoplasmosis
Itraconazole
-
treat trichomonas
Metronidazole
-
treat syphilis
Benzathine Penicillin
-
-
Gram negative organisms
- Chlamydia
- e. Coli
- gonorrhea
- h. Influenzae
- klebsiella
- legionella
- meningococcus
- pertussis
- pseudomonas
- rickettsiae
- salmonella
- shigella
- vibrio
-
Gram positive organisms
- Bacillus anthracis
- botulism
- clostridium
- corynebacteria
- diphtheria
- Enterocci
- listeria
- staph
- strep
- Tetanus
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