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Salmonela is most commonly associated with food poisoning from
contaminated pultry and egg
poisoning from undercooked hamburger meat
E. coli O157:H7
fried rice poisoning
Bacillus cereus
food poisoning from: shellfish like clams, oysters and mussels
Vibrio parahemolyticus
food poisoning from: meats that are not refrigerated
Clostridium perfringens (C.botulinum is from canned food)
Blood in the stool in infectious diarrhea is caused by
Salmonella Shigella Yersenia E.coli (enteroivasive and enterohemorrhagic) Campylobacter
Bloody inflammatory diarrhea
Entamoeba and C. difficile
Hemolytic Uremic syndrome is associated with
E.coli O157:H7 and Shigella
Preformed toxin which leads to vomiting is common with
Bacillus cereus and Staph diarrhea is later
The best initial antibiotic tx of an invasive pathogen is with a
Fluoroquinolone such as Ciprpofloxacin
Tx for Campylobacter diarrhea
Erythromycin
Tx for Giardia
Metronidazole
Tx for C. difficile
Metronidazole or Vancomycin
Tx for Scromboid
antihistamines such as a Diphenhydramine (Benadryl)
Hepatitic C association
Cryoglobulinemia lead to membranous glomerulonelhritis leads to proetinuria
Hepatitis B association
development of Polyarteriitis nodosa (PAN)
Alkaline phosphatase and GGTP indicate damage to
biliary canalicular system or obstruction
Hep C activity can be followed up by
PCR-RNA, but do not use it for initial diagnosis
HBsAg
acute Hep B
HBeAg and Anti-HBc - IgM type core antibody
acute infection the e antigen = high levels of viral infection and is a marker for greatly incrzd infectivity
Anti-HBc - IgG type core antibody Anti-HBe
the acute infection is about to resolve and may be the only antibodies in the window period
Tx for chronic HepB
Interferon or Lamivudine
Tx for chronic HepC
interferon + Ribavirirn
Prophylaxis for needle stick from a person w/ HBsAg +
give the needle stick victim HBIg (Hep B immunoglobulin) and HepB vaccine
Gonococcus is cultured on:
Thayer-Martin media
CMT/adnexal tenderness CMT = cervical motion tenderness
PID
What is the inpatient tx for PID? (the main reason for hospitalization is a high WBC or high fever)
Doxycycline and Cefoxitin (or Cefotetan)
What is the outpatient tx for PID?
Doxycycline and Ceftriaxone for 2 weeks
condyloma lata
extremely infectious, at mucocutaneous junctions and moist areas; 2nd stage syphilis
Argyll Robertson pupil
syphilisneuro a small irregular pupil that reacts normally to accommodation but not to light
Which ones are the screening tests for syphilis
VDRL and RPR
Which ones are the specific tests for syphilis
FTA-ABS MHA-TP Darkfield exam of chancre
how long 1mary and how long 2nday syphilis are tx?
1 - ONE WEEK 2 - three weeks of i.m. therapy
Tx for tertiary syphilis?
INTRAVENOUS penicillin 10 milion units for 10 days
Allergic to Penicillin pts
Doxycycline for 1, 2, but 3-iary must receive desensitization before tx; same for pregnant pt - do desensitization
Chancroid (H. ducreyi G- bacillus) tx:
Azithromycin or Ceftriaxone - single dose for one week Erythromycin or Ciprofloxacin for 3 days
Lymphogranuloma Venereum (chalmydia trachomatis)
Doxycycline
Granuloma inguinale what is the way to diagnose it:
Giemsa or Wright stain - Donovan bodies or smear of lesions or punch bx
Tx for granuloma inguinale
Doxycycline or TMP-SMZ
Tx for uncomplicated cystitis
3 days of TMP/SMZ or any Quinolone: Cipro, Levo, Gati, Moxi, O-floxacin
Best test for Perinephric Abscess
Ultrasound is the best initial scan, but CT and MRI offers better imaging Biopsy is necessary for definitive bact. diagnosis
Tx for impetigo
1st generation Cephalosporin or semisynthetic penicillin (ox-, clox-, diclox-) for the more severe cases
tx for Erysipelas
semisynthetic penicillin or 1st gen Cephalosporin
Tx for tinea capitis, corporis and unguium
Terbinafine or Itraconazole
Tx for Scabies
lindane Permethrin same as for Pediculosis
Salmonella is most common
for osteomyelitisin Pts w/ Sickle Cell Dz
Pseudomonas is most common cause of osteomyelitis in
DM pts and with puncture wounds
Tests for osteomyelitis
Technetium Bone scan MRI both equally sensitive, but MRI is with better differentiation
The best diagnostic test for Osteomyelitis?
Bone biopsy and culture
Tx for Osteomyelitis
based on the specific organism Semisynthetic penicillin (Ox/Naf) and an Aminoglycoside or a 3rd generation Cephalosporin tx for 6 to 12 weeks
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