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レジデントノート

米国にて内科修行中。何ができるか模索している過程を記録していく

Infectious disease (memo from NEJM knowledge plus and MKSAP)

・ABX for extensively drug-resistant pseudomonal infection (resistant to fluoroquinolone, carbapenem, aminoglycoside)

intravenous colistin (polymyxin E)

 

・first recurrance of mild to moderate C.difficile colitis

metronidazole for 14 days

 

・Tx for tuberculous pericarditis

4-drug antituberculous Tx + prednisone

 

・positive result of PPD

> 15mm: normal populatoin,  > 10mm: IV drug abuse, etc,  > 5mm: HIV, etc

 

・flu-like symptoms, pulmonary symptms, pancytopenia, in Ohio

histoplasmosis

 

・GNR bacteremia associated with tunneled central venous catheter 

removal of catheter and 7-14 days of ABX

 

・management of suspected brain abscess (> 2.5cm in imaging study)

CT-guided aspiration

 

・beta-lactam ABX covering MRSA

ceftraroline

 

・Dx of patient with acute symmetric polyarthritis and faint maculopapular rash on chest and extremities associated with recent flu-like symptom

parvovirus B19 (classic slapped cheek appearance usually not occur in adults)

 

・self-limited shigellosis confirmed by microbiologic diagnosis

still require 3 day of ciprofloxacin

 

・fever, chills, asymmetric flaccid paralysis

West Nile virus myeltiis

 

・diarrhea associated with uncooked poultry

campylobacter jejuni 

 

・coinfection with Lyme disease, causing hemolysis 

 Babesia microti

 

・management of mild histoplasmosis

observation without ABX

 

・cough, fever, erythema nodosum in Arizona

coccidiodomycosis

 

・Dx and Tx for broad-based budding yeast from hyperkaratonic skin lesion

blastomycosis /  itraconazole

 

・Tx for clinically stable patient with bacteremic pneumococcal pneumonia susceptible to penicillin 

7 days course of oral amoxicillin

 

・recurrent cystitis treated with trimethoprim-sulfamethoxazole 5 months ago

nitrofurantoin

 

・flu-like symptoms, widened mediastinum in patient exposed to crop dusting

bacillus anthracis

 

・infection after transplantation

CMV infection during middle period (the first few months)

 

・first choice for immunocompromised patients with invasive pulmonary aspergillosis

voriconazole

 

・invasive group A β hemolytic streptococcal (streptococcus pyogenes) infection (necrotizing fasciitis, toxic shock syndrome)

require contact precaution (not only standard precaution)

 

・ABX for cat-scratch fever

azithromycin

 

・choice of statin for HIV patients on ART

no simvastatin 

 

・Tx for syphilis

primary / secondary / early latent: IM benzathin penicillin G x 1

tertiary / late latent: IM benzathin penicillin G x 3 weekly

neurosyphilis: IV aquaous crystalline penicillin G x 10 days

 

・fever, productive cough, gram negative bipolar-staining bacilli, in New mexico

Yersinia pestis (Plague)

 

・Sx of typhoid fever (Salmonella enterica)

constipation followed by diarrhea, salmon-colored rash, relative bradycardia, splenomegaly, hyponatremia

 

・recurrent erysipelas rash and fever

FMF

 

・shaving of hair prior to surgery 

risk factor for surgical site infection (not protective factor)