-
Gram + cocci in chains
streptococci
-
gram-neg cocci in pairs (diplococci)
Strep pneumoniae
-
gram-neg diplococci
Neisseria or Morazella
-
gram-neg rod, plump, thick capsule
Klebsiella
-
gram-pos rods that form spores
Clostridium, Bacillus
-
Acid-fast organisms
Mycobacterium tuberculosis, Norcardia
-
gram-pos with sulfur granules
Actinomyces (PID with intrauterine device, neck mass and cerv adenitis)
-
silver-staining
PCP and cat-scratch dis
-
positive India ink prep
Cryptococcus
-
spirochetes
Treponema, Leptospira (both dark field microscope), Borrelia
-
gardener stuck with thorn, TX?
Sporothrix schenckii (fungus), tx itraconazole, fluconazole, oral K iodide
-
Bronchitis organisms
virus, H influenzae, Moraxella
-
Bronchitis emperic treatment
amoxicillin, erythromycin
-
Cellulitis org
strep, staph
-
Cellulitis emperic treatment
antistaph PCN (methicillin, dicloxacillin)
-
Endocarditis orgs
staph, strep
-
Endocarditis emperic treatment
antistaph (methicillin, dicloxacillin) + aminoglycoside
-
Meningitis child/adult
Strep pneumoniae, Neisseria meningtiids (or H influ in child w/no vaccine)
-
Meningitis emperic treatment
3rd gen ceph, OR meropenum + vanco
-
Meningitis neonate and TX
Strep B (amoxicillin, ampicillin), E coli, Listeria
-
Meningitis neonate emperic treatment
Ampicillin + aminoglycoside, 3rd gen ceph
-
Osteomyelitis
staph aureus, Salmonella
-
Osteomyelitis emperic treatment
Antistaph PCN (methicillin, dicloxacillin), vanco
-
Pneumonia atypical
Mycoplasma, Chlamydia
-
Pneumonia atypical emperic treatment
Macrolide, doxyclycline
-
Pneumonia classic
Strep pneumoniae, H influenzae
-
Tx for endometritis or puerperal fever
amoxicillin or ampicillin
-
Pneumonia classic emperic treatment
3rd gen ceph, azithromycin
-
3 Macrolides
erythromycin, azithromycin, clarithromycin
-
Septic arthritis
Staph aureus or Gonocci(younger/sexually active)
-
Septic arthritis emperic treatment
Antistaph PCN (methicillin, dicloxacillin), vanco... gono: Ceftriazone, fluoroquin, spectinomycin
-
Sepsis
gram-neg orgs, strep, staph
-
Sepsis emperic treatment
3rd gen PCN or ceph + aminoglycoside, imipenem
-
-
UTI emperic treatment
TMP-SMX, nitrofurantoin, amoxicillin, quinolones
-
Tx bacteroides
metronidazole... clindamycin
-
Tx borrelia
doxycycline, amoxicillin... erythromycin
-
Tx Chlamydia
Azithromycin, doxycycline
-
Tx Enterococci
PCN or ampicillin + aminoglycoside
-
Tx E coli
3rd gen ceph, fluroquinolone... aminoglycoside
-
Tx Gonocci
ceftriazone or fluroquinolone... spectinomycin
-
Tx Haemophilus (gram neg coccobacilli)
2nd or 3rd gen ceph... ampicillin
-
Tx Klebsiella
3rd gen ceph, fluoroquinolone... 3rd gen PCN + aminoglycoside
-
Tx Meningococcus
Ampicillin... cefotaxime, chloramphenicol
-
Tx Mycobacterum TB
Isoniazid-rifampin... ethambutol, pyrazinamide
-
Tx Mycoplasma
Azithromycin, fluoroquinolone... doxycycline
-
Tx Pseudomonas
ext spectrum PCN + aminoglycoside
-
Tx Streptococcus A or B
PCN, ecphazolin... erythromycin
-
Tx Treponema
PCN... doxycycline
-
Tx Strep pneumoniae
3rd gen cephalosporin, fluoroquinolone... fluoroquinolone
-
Tx staphylococci
antistaph PCN (methicillin, dicloxacillin)... vanco (MRSA)
-
sickle cell pt in aplastic crisis or other hemoglobinopathy
parvovirus B19
-
sepsis after splenectomy or sickle cell autosplenectomy
S. pneumoniae, H influezae, N meningtidis (all encapsulated)
-
Pneumonia in southwest (Ca or Az) AND tx
Coccidioides immitis... itraconazole, flucanozole, amphotericin B (severe)
-
Pneumonia in cave, exp to bird droppins on OH or MS River valleys
Histoplasma capsulatum
-
Pneumonia after exocitic bird or parrot exp
Chlamydia psittaci
-
Fungus ball or hemoptysis ater TB cavitary lesion
Aspergillus
-
Pneumonia in pt with silicosis
TB
-
Diarrhea after hiking or drinking from stream AND tx
Giardia Lamblia... metronidazole
-
Pregnant women with cats
Toxoplasma gondii
-
B12 def and abdominal sx
Diphyllobothrium latum
-
Seizures from ring-enhancing brain lesion on CT
Taenia solium (cysticercosis)
-
Bladder ca (squamous) from Middle East, Africa
Schistosoma haematobium
-
Worm infx in children w/perianal itching
Enterobius
-
Fever, mm pain, eosinophilia, periorbital edema after eating raw meat
Trichinella spiralis (trichonosis)
-
Gastroenteritis in young child
rotavirus
-
food poisoning after reheated rice
Bacillus cereus
-
food poisoning after raw seafood
Vibrio parahaemolyitucus
-
travelors diarrhea (after Mexico)
E coli
-
diarrhea after antibx AND tx
C diff... oral metronidazole
-
genital lesions in child, no sex abuse or activity
molluscum contagiosum
-
cellulitis after cat/dog bite AND prophylactic tx
Pasteurella multocida... ampicillin 1st, doxycycline alternative
-
Slaughterhouse worker with fever
Brucella
-
Pneumonia after hotel, near AC or water tower AND tx
Legionella pneumophilia... azithromycin, fluoroquinolone
-
Burn wound infx with blue/green color
Pseudomonas (no green color-- Staph aureus)
-
most common cause of pneumonia and TX
Strep pneumoniae (rapid onset, productive couph, lobar consolidation)... tx 3rd gen ceph or fluoroquinolone
-
2nd most common cause of pneumonia and TX
H influenzae (same as strep, but gram-NEG coccobacilli, more common in child)... ampicillin, amoxicillin,2nd/3rd ceph
-
Cause of hospital pneumonia and TX
staph aureus, common to have empyema and lung abscess... meropenam + gentamicin + vanco
-
Pneumonia in CF pt
Pseudomonas
-
Pneumonia in alcoholic or homeless
Klebsiella
-
Pneumonia with aspiration, neutropenia or hosp acquired
enteric gram neg (E coli)
-
Pneumonia in adolescents, young adults AND tx
Mycloplasma (atypical, slow onset, bad CXR but feels ok), + cold-agglutinin Antibdy titers... tx macrolides
-
2nd to mycoplasma in young adults/adolescents
Chlamyida pneumoniae (presents same, but NEGATIVE cold-agglutinin)
-
Pneumonia in HIV pt
PCP (silver stain, treat TMP-SMX or pentamidine) or CMV (intracellular includsion bodies, tx ganciclovor)
-
Tx for Kawasaki
aspirin and IVIG to reduce cardiac lesions
-
Tx for Rocky Mountain spotted fever (Rickettsia Rickettsii infx)
doxycycline or chloramphenicol
-
possible causes of aseptic meningitis
mumps or measles (best to prevent)
-
herpes encephalitis (lesions in temporal lobe) TX
acyclovir
-
Tx for bronchiolitis
supportive (O2, mist tent, IV fluids, bronchodilators)
-
Tx for croup
supportive (mist tent or racemic epi)
-
Tx for epiglottitis
establish airway first, then 3rd gen ceph
-
Rabies prophylaxis
rabies immunoglobulin and vaccine
-
3 tetracyclines
Doxycycline, minocycline, demeclocycline
-
Some fluoroquinolones
Norfloxacin, ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin
-
Extended spectrum PCN
ampicillin, amoxicillin, pipericillin, ticarcillin
-
1st gen Cephalosporins
cefazolin, cephalexin
-
2nd gen cephalosporins
cefotetan, cefoxitin, cefamondole, cefuroxime, cefaclor
-
3rd gen cephalosporins
cefoperazone, ceftazidime, cefotazime, cefixime, ceftriaxone, ceftizoxime
-
4th gen cephalosporin
Cefepime
-
Some aminoglycosides
gentamycin, amikacin, tobramycin, streptomycin, neomycin, spectinomycin, netilmicin
-
Triple therapy for H Pylori infx
Amoxicillin, clarithromycin, omeprazole
-
Bugs that cause bloody diarrhea
Salmonella, Shigella, E coli, Campylobacter
-
Most common cause of infectious diarrhea... TX
Campylobacter... Erythromycin
-
Ingested contaminated food or water in developing country, long incubation period (up to 3 m) and TX
Entamoeba histolytica (can mimic IBD).... metronidazole (if use steroids can cause fatal perf)
-
Extremely contagious diarrhea, young children and institutionalized, severe dehydration and febrile seizures in young... TX
Shigella... TMP-SMX to decrease spread
-
Which diarrheal infx would you NOT want to tx with antibiotics or antidiarrheals
E coli... increases HUS risk
-
Diarrhea where sepsis is concern, sickle cell pts are susceptible (can lead to osteomyelitis)...TX
Salmonella... quinolone or TMP-SMX
-
Tx for HBV infx
IFN-alpha, lamivudine (3TC) or adefovir
-
Tx for HCV infx
peginterferon, ribavarin
-
TORCH infections in pregnancy
Toxo, Rubella, Other, CMV, HIV/HSV, Syphillis
-
Tx for toxoplasmosis exposure in pregnancy
Spiramycin prophlaxis 3rd trimester
-
Tx for syphillis in pregnant pt
Penicillin if test +
-
Pt with DKA then nectrotic nasal turbinate.. dx and tx
rhinocerebral mucormycosis... amphotericin B
-
Most common SE of using high dose amphotericin B?
nephrotoxicity
-
Corneal abrasion (such as after surgery) tx:
broad spectrum coverage with trimethroprim/polymycin B drops
-
Pseudomonas coverage
meropenam + gentamicin
-
Lung abscess or aspiration pneumonia (to cover moth flora) tx:
Clindamycin
-
Pt with prolonged appendicitis, which antibx tx?
Cefotetan (3rd gen cephalosporing) or good gram neg coverage or flouroqu+metronidazole
-
Cat bite, bug and TX
Pasteurella multicoda... amoxicicllin/clavulanate
-
Encapsulated yeast seen in HIV pt CSF... and TX
Cryptococcus... amphotericin IV + flucytosine po
-
Malignant externa otitis seen in diabetic pt or immuno pt.. bug and TX
pseudomonas... ciprofloxacin
-
Older man with fever, cough, chills and b/l infiltrates on CXR in Jan... bug and TX
influenza... oseltamivir or zanamavir
-
Febrile neutropenia (absolute neutrophils <1500), what bug should you cover for and TX
Pseudomonas aeruginosa... ceftazidime, imipenem, cefipime, meropenum OR aminoglycoside + pseudomonas b-lactam
-
Emperic therapy for septic arthitis
IV nafcillin or IV cefazolin
-
Lung infection + skin in Great Lakes, WI, OH, or MS River valley
Blastomycosis
-
Lung infection + skin in southwest US
coccidiomycosis
-
Lung infection + skin in southwest US with exposure to birds
Histoplasmosis
-
Epididymitis < 40 years old, TX?
for gon and chlamydia (Gon: ceftriaxone IM or cefepime PO x 1... Chlam: doxycycline PO bid x 7 or erythromycine in pregn pt)
-
Epididymitis > 40 years old, TX?
for UTI (TMP-SMX or ciprofloxacin)
-
Tx for cavernous sinus thrombosis
penicillinase-resistant penicillin (nafcillin or oxacillin) + 3rd/4th gen cephalosporin (ceftriazone or cefepime) OR mentronidazole of anaerobic infx suspected (tooth or sinus infx)
-
HIV pt with Histoplasmosis, tx?
IV amphotericin B + lifelong tx with itraconozole to prevent relapse
-
HIV pt with CD4 < 50, prophylaxis for MAC
azithromycin
-
HIV pt treatment and prophylaxis for CMV (CD4 < 200)
ganciclovir
-
HIV pt prophylaxis for PCP (CD4 < 200)
TMP-SMX (1st line), dapsone
-
5 year old child with tick bit, central central clearing surrounds original bit mark that has expanded. Dx and Tx?
Lyme Dis.. amoxicillin 21 days (only doxycycline if child >9yrs old)
-
HIV prophylaxis for toxoplasmosis vs treatment
prophylaxis-- TMP-SMX, treatment is sulfadiazine and pyrimethamine (remember CD4 <100, ring enhancing cerebral lesion)
-
What is dermatitis herpetiformis associated with? Tx?
celiac sprue (eat gluten free diet), tx with Dapsone
-
Treatment of low-risk community aquired pneumonia (no other risk factors) on outpatient basis
azithromycin of doxycycline
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