TB

Question 1

When can a false positive TB skin test occur?

Answer 1

When a patient has received the BCG vaccine

Question 2

A TST is also called what?

Answer 2

A purified protein derivative test

Question 3

Latent TB Tx

3 possible

Answer 3

1. Isoniazid 300 mg max 900 for 9 months
2. Rifampin 4 months
3. INH + rifapentine q wk for 12 wks

Question 4

What regimen is recommend for HIV, pregnant and children? and for what?

Answer 4

INH: 300 mg per day max 900 per dose

9 months for Latent TB

Question 5

What latent TB regimen is not rec’d for HIV, children < 2 or pregnant women

Answer 5

INH and Rifapentine

Question 6

How to you confirm the Dx of Active TB?

Answer 6

Skin test likely means active but need to confirm with a sputum culture AFB stain

Definitive With PCR slow growing

Question 7

In the intensive phase how long is RIPE therapy

Answer 7

8 wks

Question 8

What is the treatment and durtation for conuation phase

Answer 8

2 drugs for 4 months

INH and RIF if susceptible

Question 9

Drugs that cause QT prolongation Abxs

Answer 9

FQs

Macrolides

Question 10

Drugs that cover atypical organisms? 3

Answer 10

Azithro

Doxy

Quinolones

Question 11

Community Associated MRSA SSTIs drugs 3

Answer 11

1. Bactrim
2. Doxy
3. Minocycline

Question 12

More Severe SSTIs needing IV abx or Hospitalization cover what 2 things? and what are the 3 main drugs?

Answer 12

1. Cover MRSA and Streptococcus
2. Vanc
3. Linezolid
4. Daptomycin

Question 13

WHen should IV abxs be admin for surgical prophylaxis?

Answer 13

Cefazolin and Cefuroxime ( 1hour before surgery)

If using quinolones or Vanc 120 minytes before

Question 14

Common Cold MCPs 2

Influenza 1

Pharyngitis 2

Sinusitis 7

Answer 14

1. Resp Virus: Rhinovirus and coronavirus
2. Infuenza
3. Resp viruses and S. Pyrogenes
4. Resp viruses, S. Pneumo, H. Flu, M. Mat, staphylococcus, anaerobes, and g (-) rods

Question 15

First line tc for sinusitis?

Answer 15

Amox/clav

Question 16

Treatmetn for Pharyngitis?

Answer 16

PCN, Amox

Question 17

Second line tx for sinusitis failure of first

Answer 17

Oral 2nd or 3rg gen cephs + clinda, doxy or Resp FQ

Question 18

Tx duration for pharyngitis?

Answer 18

10

5 days for azithro

Question 19

What patients are at risk of IE during dental procedures? 4

Answer 19

1. Prosthetic heart valve or heart valve repair with artificial material
2. Hx of endo
3. Heart transplant with abnormal heart valve function
4. Certain congenital heart defects including heart/lung valve disease

Question 20

Adult prophylaxis regimens for Pts at risk of IE during dental procedure?

3 options

Answer 20

1. Oral: amox 2 g 30-60 min before procedure
2. Cant take oral: Amp 2 g or cefazolin 1 g
3. Can take oral but PCN allergy:
   
   1. Clindamycin 600
   2. Azithro or clarithromycin 500

Question 21

Other drugs besides Ceftriaxone that can be used for primary or secondary prophylaxis of SBP?

Answer 21

1. Bactrim
2. Cipro

Question 22

Mild to moderate Peritonitis and Cholangitis

What to cover? 6

Answer 22

1. PEK
2. Anaerobes
3. Strepto
4. +- enterococcus

Question 23

Mild to Moderate Peritonitis and Cholangitis

5 possible regimens

Answer 23

1. Cefoxitin
2. Ertrapenem
3. Moxi
4. Cefazolin, cefuroxime or ceftriaxone + metro
5. Cipro or Levo + metro

Question 24

Severe ICU patients Peritonitis and Cholangitis

What pathogens to cover? 12

Answer 24

1. PEK
2. CAPES
3. Pseudomonas
4. Anaerobes
5. Strepto
6. +- enterococcus

Question 25

Impetigo Honey COmb Crust First choice If numerous lesions

Answer 25

1. Mupirocin (Bactroban) ointment 2. Cover MSSA if systemmic: Cephalexin (Keflex)

Question 26

Cellulitis Non-purulent infections

Answer 26

Cephalexin 500 mg QID

Question 27

Absess Perulent Infections Treatment 2

Answer 27

Commly caused by CA-MRSA Bactrim Doxy

Question 28

DM Foot infections G (+) Pathogens 4 G (-) 5

Answer 28

1. S. Aureus Including MRSA 2. Group A Strepto 3. Viridan group strep 4. S. Epidermidis 1. E. Coli 2. Klebsiella 3. Proteus 4. Enterobacter 5. Pseudomonas

Question 29

DM foot infections Anaerobic G(+) 2 Aaerobic G (-) 1

Answer 29

1. Peptostrepto 2. Clostridium Perfringes 1. B. Fragilis

Question 30

Duration of treatment of DM foot infections 4 total

Answer 30

1. 7-14 2. More severe: 2-4 wks 3. Bone and joint: 4-6 wks 4. Osteo longer