Bugs and Drugs
Gram Slam
Take My Breath Away
Cough It Up
100
This antibiotic is the preferred treatment of PVL-MRSA to target toxin production
Linezolid
OR
Vancomycin+Clinda
100
This serum biomarker helps distinguish bacterial sepsis from non-infectious systemic inflammation.
Procalcitonin
100
Pulmonary Hypertension is defined hemodynamically as a mean pulmonary pressure greater than this value
>20mmHg
100
This is the formula for calculation of driving pressure
Plateau pressure-PEEP
200
A 55-year-old woman is admitted to the ICU for septic shock requiring initiation of norepinephrine. The patient is diagnosed with C.diff colitis. This is the recommended antibiotic regimen.
Oral Vancomycin AND IV Metronidazole
Fulminant C.diff criteria: shock, toxic megacolon, ileus. You can also include Vanc enemas in treatment of fulminant C.diff
200
A 59-year-old man is evaluated for fever, a 6.8-kg (15-lb) weight loss over the past 7 weeks, fatigue, malaise, and productive cough, occasionally with blood. The stain below is shown. This is the treatment for this organism
Voriconazole
Organism is Aspergillus
200
Pirfenidone, nerandomilast, and nintedanib have shown benefit in slowing disease progression in select persons with this disease.
Idiopathic Pulmonary Fibrosis
200
In a patient with a pleural effusion, a pleural fluid LDH greater than two-thirds the upper limit of normal for serum LDH is one of the three Light's criteria. These are the other two.
Pleural fluid protein-to-serum protein ratio > 0.5
Pleural fluid LDH-to-serum LDH ratio> 0.6?
300
A 34-year-old male with HIV with a last known CD4 count of 38cells/microL presents with a week of fever, malaise, abdominal cramping, and diarrhea. Colonoscopy performed with biopsy reveals this pathology. The following is the treatment.
Gancyclovir
CMV colitis -present in immunosuppressed patients. Owl's-eye intracellular inclusions are present in tissue biopsy. Treatment with ganciclovir OR valganciclovir is indicated in tissue-invasive disease.
300
Perform this test in patients with Streptococcus gallolyticus endocarditis.
Colonoscopy
Isolation of S. gallolyticus from blood cultures is associated with colon cancer in 60% to 80% of patients and can be associated with other gastrointestinal malignancies.
300
During an SBT on a ventilator, a resident calculates the RSBI. A value above this threshold indicates a high probability of extubation failure.
105 (breaths/l/min)
Rapid shallow breathing index: RR/Tidal vol (L)
300
Add-on therapy for severe COPD (bronchitis variant) to prevent recurrent exacerbations.
Roflumilast
400
A 38-year-old woman is evaluated in the emergency department in a New Hampshire hospital for a 2-day history of new fatigue and exercise intolerance. She has no other medical history and takes no medications. EKG is shown below. This is the appropriate treatment.
IV Ceftriaxone for 14-21 days
Treatment for Lyme carditis as evidenced by 2nd degree AV block
400
A 45-year-old man with HIV and a CD4 cell count of 100/μL has had 3 weeks of dry cough and progressive dyspnea on exertion, now present at rest. On examination, his temperature is 38.3 °C (100.9 °F), and PaO2 is 67 mm Hg on ambient air. His chest X-ray shows diffuse bilateral infiltrates. This is the stain used to identify the organism.
Giemsa Stain/Silver stain
The organism is Pneumocystis Jirovecii
400
The picture below is a cutaneous manifestation of this disease.
Sarcoidosis
Waxy papular lesions on the nose are consistent with Sarcoidosis.
400
This diameter is the threshold for further imaging of a pure ground-glass subsolid solitary pulmonary nodule found incidentally on CXR.
6mm
< 6 mm: no follow-up
= or > 6mm: CT at 6-12 months to confirm persistence, then CT every 2 years until 5 years
500
A 25-year-old man has epistaxis managed by nasal packing. The next day, he is confused; his temperature is 39.0 °C (102.2 °F), and his BP is 90/82 mm Hg. Erythema of his face, shoulders, and palms is present. MRSA screening of the nares is positive. This is the recommended antibiotic regimen.
Vancomycin AND Clindamycin
Clindamycin is essential in TSS to stop toxin production
500
A 45-year-old man with a 10-month history of shortness of breath presents to the emergency department with fever and cough. The patient reports that he works in a stone quarry and was recently diagnosed with a lung disease. The patient is at increased risk for this pathogen.
Mycobacterium Tuberculosis
The patient most likely has Silicosis- patients with silicosis are at an increased risk for TB and must be tested when presenting with fever and cough.
500
A 32-year-old woman with no significant PMH presents to the emergency department with shortness of breath for the past 40 minutes. CXR is shown below. This is the etiology.
LAM (lymphangioleiomyomatosis)
Spontaneous pneumothorax and lung disease in a premenopausal woman suggest pulmonary lymphangioleiomyomatosis (LAM).
500
Spasmodic Dysphonia related to Inducible Laryngeal Obstruction can be treated with this.
Onabotulinum toxin A injections