
Infectious Diseases
During this rotation, resident is expected to:
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learn how to order, and interpret the results of immunologic, serologic and microbiologic testing including:
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Serologic antigen and antibody testing
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Cultures and sensitivities
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Gram stains, fungal stains, acid-fast stains
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Antimicrobial drug levels
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Demonstrate understanding of the major antibiotic classes, their use & common side effects.
Helpful Links:
Central nervous system infection
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Microbiology of bacterial meningitis
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Diagnostic work up. When to consider CT head before LP.
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Understand how to properly interpret the CSF analysis
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What are the antibiotics used for empiric treatment of bacterial meningitis and why?
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What are the common causes of aspetic meningitis
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Definition of encephalitis, what are the common viruses, how to diagnose and treat.
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Diagnosis and treatment of focal CNS infections ( brain and spinal epidural abscess).
Pneumonia:
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Differentiate between CAP and HCAP
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What are the common organisms causing CAP ( including atypical: Legionella and coccidioides)
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Know the diagnostic work up that should be performed for CAP, HCAP, and VAP
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Understand the choice for Antibiotic therapy for each.
Urinary tract infections:
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Definition of uncomplicated UTI ( acute cystitis ) – everything else is complicated.
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Microbiology, diagnosis and antibiotic therapy for uncomplicated vs complicated UTIs.
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Definition and treatment options for recurrent UTIs.
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Microbiology and treatment of prostatitis.
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Indications for treating asymptomatic bacteruria.
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Diagnosis and treatment of catheter associated urinary tract infections.
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Differential diagnosis of sterile pyruia ( TB, Legionella, leptospirosis).
Week One
Skin and soft tissue infections:
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Know the microbiology of cellulitis, including community acquired MRSA, common presentation and treatment.
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Know the microbiology, common presentation and treatment of necrotizing fasciitis.
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Know the microbiology and treatment of diabetic foot infections.
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Know the clinical presentation, diagnosis and treatment of toxic shock syndrome.
Osteomyelitis:
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Classification and microbiology of Osteomyelitis.
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What are the diagnostic methods and treatment options for Osteomyelitis.
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Evaluation and Management of Diabetes–Associated Osteomyelitis
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Evaluation and Management of Vertebral Osteomyelitis
Infectious arthritis:
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Know how to interpret synovial fluid analysis
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Know your different etiologies of infectious arthritis including gram positive, non gonococcal gram negative and disseminated gonococcal, lyme and viral arthritis. Understand the diagnostic and therapeutic measures.
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Diagnosis and pharmacologic and surgical management of prosthetic joint infections.
Infectious Diarrhea and C- diff colitis:
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What organisms causes diarrhea with and without fever
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What organisms causes pseudo appendicitis ( yersinia, Capmylobacter and RMSF).
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When should you send for stool culture and O&P.
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Recognize the clinical spectrum of C-diff and diagnosis tests
How to treat initial, first and subsequent recurrences of C-diff infections.
Week Two
Week Three
Blood stream infections:
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When must you remove central venous line in documented blood stream infections.
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What is the significance of Staph aureus isolated in blood culture.
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When to get an Echocardiogram.
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What is the significance and how to treat of Gram negative bacteremia including ESBL.
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What is the significance of candida isolated in blood stream and what are the risk factors of developing candidemia in ICU and non-ICU patients.
Infective endocarditits:
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Know the microbiology of native and prosthetic valve endocarditis.
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How to diagnose and treat endocarditis.
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What are the HACEK organisms and how are they isolated.
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What are the indications for surgical valve replacement.
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What are the indications for prophylactic antibiotics.
Neutropenic fever:
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What is the definition of chemotherapy induced neutropenic fever.
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Understand the gram negative bacterial translocation mechanism of acquiring the infection.
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What are your antibiotic coverage options.
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What are the indications to start Vanc.
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When to consider antifungal.
Sexually transmitted diseases:
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What is the differential diagnosis of sexually transmitted genital ulcers?
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Recognize the different phases of syphilis, and definition of latent infection.
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How to diagnose syphilis, difference between specific and non specific antibody testing, and in which phase each are expected to be positive.
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What is the treatment of primary, secondary, latent and neurosyphilis.
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When to treat genital syphilis and when to give prophylactic therapy.
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Know the common etiology, diagnosis and treatment of urethritis, cervcitis and PID.
HIV:
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Understand the serologic testing for HIV, and who should be screened.
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Recognize the clinical presentation and method of diagnosis for acute retroviral syndrome.
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What are the indications for initiation HAART. And what are the indications for immediate cessation of HAART.
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What are the indications for prophylaxis, what antibiotics and at what CD4 level.
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Recognize the clinical presentation, diagnostic methods and treatment for PJP, MAC, Toxoplasmosis and cryptococcal meningitis.
Tuberculosis:
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Criteria for diagnosing latent TB in various risk groups.
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How to treat latent TB.
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Who should be placed in respiratory isolation and Criteria for diagnosis of active TB
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What is Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis.