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PANCE > 12. Infectious disease > Flashcards

12. Infectious disease Flashcards

1
Q

HIV infected + surrounded by bird/pigeon

Name/Transmission/2 type presentation/Dx/Tx

A

Name: Cryptococcosis

Transmission: inhalation of bird/pigeon dropping

2 type of presentation: fungal meningitis(MC cause of fungal menigitis) and PNA

Dx: lumbar punture (india ink stain)

Tx: Amphotericin B + Flucytosin

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2
Q
  • Esophagitis - appearance/Tx
  • Oral thrush - appearance/Tx
  • Vaginal candidiasis - appearance/Tx
  • Intertrigo(cutanous infection)- appearance/Tx
  • Fungemia - cause/Tx

Pathogen/Dx

A
  • white liner plaques - Tx: fluconazole PO
  • friable white plaque able to scrap off - Tx: nystatin
  • white thick curd like - Tx: Clotrimazole
  • beefy red erthema (satellite lesions - underbreast) - Tx: clotrimazole
  • Cause - indwelling catheters - Tx: IV Amp B

Pathoge: candida albican (MC opportunistic organism)

Dx: KOH

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3
Q

hx of living mississippi & ohio river valleys (IL, Missouri) + PNA like sx + X-ray BB-sized calcifications and hilar adenopathy

Name/Transmission/Dx/Tx

A

Name: histoplasmosis

Transmission: inhalation

Dx: CXR, culture

Tx: itraconazole, if severe amphotericin B

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4
Q

hx of HIV + PNA like sx + CD4 less than 200

Name/Transmission/Pathogen/Dx/Tx

A

Name: Pneumocystis Pneumonia

Transmission: inhalation

Pathogen: Pnemocystitis jirovecii

Dx: CD4 less than 200, X-ray shows bilateral interstitial

Tx: Bactram (TMX-SMX), add prednison if CO2 less than 70

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5
Q

hx of garden and houseplant soil work + chronic sinuses

Name/transmission/Pathogen/Dx/Tx

Hemoptysis + fungal ball on CXR

Name/Dx/Tx

A

Name: aspergillosis

Transmission: inhalation

Pathogen: aspergillus

Dx: biopsy - dusky, necrotic tissue (nose)

Tx: Voriconazole

Name: aspergilloma

Dx: biopsy

Tx: surgical remove

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6
Q

Black eschars on nose + hx of DM or HIV

Name/Dx/Tx

A

Name: Mucormycosis

Dx: biopsy

Tx: IV Amphotericin B

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7
Q

hx of immunosupressant + outdoor activities (soils or decaying wood) + PNA sx

Name/Transmission/Dx/Tx

A

Name: blastomycosis

Transmission: inhalation

Dx: culture

Tx: itraconazole, severe Amphotericin B

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8
Q

Hx of southwestern US or Mexico + Fever + arthralgias + EM

Name/Transmission/Dx/Tx

A

Name: coccidioidomycosis (valley fever)

Transmission: inhalation

Dx: IgM & IgG 1st, Culture Definitive

Tx: self limit

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9
Q

pruritus + purulent discharge + sexually active + PAINFUL

Name/Pahogen/type3/Dx/Tx/After care

A

Name: Chlamydia

Pathogen: Chlamydia trachomatis

Type 3

  • Urethritis
  • PID
  • Reiter’s dz - urethritis, uveitis, arthritis

Dx: Nucleic acid amplification

Tx: AZA 1g x 1 dose or doxy 100mg bid x 10 days

Also tx for gonorrhea Ceftx IM 250mg x 1 dose

After care: retest in 3 weeks to make sure, treat sex partner as well

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10
Q

hx of cat scratch

Name/Pathogen/Tx

A

Name: Cat scratch

Pathogen: bartonella henselae

Tx: AZA

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11
Q

Purpuric rash + neck rigidity + fever

Name/2 PE sign/Dx/Tx/Prophylaxis

A

Name: Neisseria meningitidis (meningococcemia)

PE

  • Kernig(hip flexed leg can’t straighten)
  • Brudzinski (neck flexion cause hip/knee flexion)

Tx

  • Adult: Ceftx + Vanco, Infant: Amp + cefo (empiric first)
  • Drug of choice - Pen G

Prophylaxis - exposed - cipro 500mg 1 dose

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12
Q

PAINFUL Ulcer first + later inguinal lymph pain

Name/Pathogen/Tx

A

Name: Chancroid

Pathogen: Hemophilus Ducreyi

Tx: AZA 1g x 1 dose

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13
Q

Eschar + hx of around rabbits

Name/Related/transmission/Dx/Tx

A

Name: Tularemia

Related: Rabbits

Trasmission: by tick/insect or touching animal

Dx: serology

Tx: Streptomycin

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14
Q

hx of eating cheese and milk in Mexico + low grade fever

Name/Related/Dx/Tx

A

Name: Brucellosis

Related: goat/sheep/cattle hog

Dx: serology

Tx: rifampin + doxy

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15
Q

hx of use spa, hot tub which made of wood, or swimming pool + small pink to red bump

Name/Tx

A

Name: hot tub folliculitis

Tx: None, resolve in 7-14 days w/o tx

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16
Q

hx of exposure to sheep, cattle, and goat + flu like sx

Name/Dx/Tx

A

Name: Q fever

Dx: immunofluorescence IFA

Tx: Doxy

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17
Q

Acutely swollen extremely warm painful at groin, axilla, cervical region(neck)

Name/Pathogen/Dx/Tx

A

Name: Plague

Pathogen: yarsinia

Dx: Gram stain (safety pin appearance)

Tx: Streptomycin -> prophylaxis doxy or tetra

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18
Q

Pain out of proportion + develop grangrene + hemorrhagix bullae

Name/Pathogen/Tx

A

Name: Necrotizing fasciitis (flesh eating disease)

Pathogen: GABHS

Tx: Surgical debridement + broad spectrum abx

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19
Q

Friable gray/white membrane(pseudomembrane) on pharynx that bleed if scraped + bull neck + myocarditis

Name/Tx/Prevention/Prophylaxis for close contact

A

Name: Diphtheria

Tx: Diphtheria antitoxin + Penicillian or erythromycin x 2 weeks (airway protection)

Prevention: Dtap 5 dose 7 year old less, 11 yr with booster

Prophylaxis: erythomycin 7-10 days (No school)

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20
Q

hx of puncture wound from rawfish, shellfish + purplish erythema

Name/Tx

A

Name: Erysipeloid

Tx: Pen V

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21
Q

hx of puncture or crush wound + severe muscle spasm (neck stiffness, Trismus)

Name/Tx/Prophylaxis

A

Name: Tetanus

Tx: Metronidazole

Prophylaxis: Tdap Q10yrs

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22
Q

Sudden on set of pain & edema + gas in the tissue palpated on PE

Name/Dx/Tx

A

Name: Gas gangrene

Dx: X-ray - soft tissue air pocket

Tx: IV Pen + IV Clinda

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23
Q

hx of eating can/smoked/vacumm-packed food + dilated fixed pupil + descending decreased muscle strength

Name/MC/infant case/Occur time/Tx

A

Name: Botulism

MC type: infentile

Infant: ingested honey or dust

Occur time: 1-2 days

Tx: Antitoxin

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24
Q

hx of eating cold deli & unpasterized cheese, milk

Name/Risk/Tx

A

Name: listeriosis

Risk: infant <2month & elderly - bacteremia, Pregnancy - premature labor & stillbirth

Tx: IV Ampicilin

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25
Q

Painless black eschar

Name/Dx/Tx

A

Name: Anthrax

Dx: Clinical - if seen black eschar, X-ray widen midiastinum on CXR - inhalation case

Tx: cipro + exposure

26
Q

Painless ulcer + sexually active

Name/Pathogen/3 types/Dx/Tx/Cotransmission

A

Name: syphilis

Pathogen: Treponema pallidum

Type

  • Primary - painless ulcer
  • Secondary - maculopapular rash (palms/soles), condyloma lata (wart like legion)
  • Tertiary - argill-robertson pupil (doesn’t react to light)

Dx: Darkfield microscopy, RPR, VDAL, FTA ABS (confirming test)

Tx: Pen G IM 2.4 million dose, if tertiary or late latent - x 3 dose, if neuro IV 4 million dose

Allegic to Pen G then use doxy

Cotransmission: high rate of cotransmission with HIV infection

27
Q

Central clearing or bull’s eye

Name/Pathogen/Early/disseminated/Dx/Tx(pregnancy, severe)/Prophylaxis

A

Name: Lyme disease

Pathogen: borrelia burgdorferi (tick)

Early: bulls eye (erythema migrans)

Disseminated: CN7/facialy nerve palsy

Dx: Elisa, if Disseminated: lumbar punture

Tx

  • Doxy
  • Pregnancy (amox)
  • Late/severe - IV ceftx
  • Prophylaxis - doxy 200mg x 1 dose in 72 hours
28
Q

hx of camping + blaching erythematous rash wrist and ankles (lower extremities)

Name/Pathogen/Dx/Tx/Pregnancy

A

Name: Rocky Mountain Spotted fever

Pathogen: Rickettsia Ricketsii (tick)

Dx: clinical

Tx

  • Doxy (even children) x 5- 14 days
  • Pregnancy - chloramphenicol
29
Q

Amebic liver abscess + fecal contamination

Name/Dx/Tx

A

Name: Amebiasis

Dx: Stool O&P

Tx: Metronidazole

30
Q

hx of swimming with contact lens + keratitis

Name/PE

A

Name: Acanthamoeba Keratitis

PE: Corneal stromal ring infiltrate

31
Q

Cold stage(chilld), Hot stage(fever), sweating stage every other or 3rd days

Name/Most dangerous type/Dx/Tx

A

Name: Malaria

Most dangerous: Malaria falciparum

Dx: Giemsa stain peripheral smear (thick and thin smear)

Tx: Chloroquine

32
Q

hx of tick bite + smear appears pathognomonic tetrads

Name/Dx/Tx

A

Name: Babesiosis

Dx: Peripheral smear

Tx: Atovaquone + AZA

33
Q

hx of cat owner + encephalitis + CD4 less than 100 + MRI shows ring enhancing lesion

Name/Dx/Tx/Prophylaxis

A

Name: Toxoplasmosis

Dx: MRI

Tx: Sulfadiazene + pyrimethamine

Prophylaxis: TMX-SMX

34
Q

Perianal itching at night

Name/Dx/Tx

A

Name: Enterobiasis (pinworm)

Dx: Scotch tape

Tx: Albendazole

35
Q

Fever + unilateral periorbital edema + CHF + Leading cause of latin america

Name/Risk/Dx/Tx

A

Name: Chagas disease

Risk: MC children

Dx: Echo for heart, Blood smear or culture

Tx: Benznidazole

36
Q

hx of bite (Tsetse fly) + hx of visit afrian and south/central america + painless chancre

Name/Dx/Tx

A

Name: African trypanosomiasis

Dx: blood smear

Tx: infectious disease control

37
Q

hx of eating raw pork + myositis

Name/Dx/Tx

A

Name: Trichonosis

Dx: Serology - eosinophilia

Tx: self limited, severe albendazole

38
Q

eggs in feces or large worm coughed, vomited

Name/Tx/other possible

A

Name: Ascariasis

Tx: Albendazole, Pyrantel (if pregnant)

Other possible: Hookworm (Necator americanus) - egg in stool same tx as ascariasis

Difference

  • Hookworm - infect upper intestine which lead to anemia
  • Ascariasis - cough up large worm, do not lead anemia
39
Q

hx of bite of a female sand fly

Name/Dx/Tx

A

Name: Leishmaniasis

Dx: Culture

Tx: Infectious disease consult

40
Q

Grouped painful vesicles

Name/Resided/Related dz/Dx/Tx/Prevention

A

Name: Herpe simplex virus HHV1,2 (1 Oral, 2 genital)

Resided: doral root ganglion

Related dz: bell’s palsy, encephalitis

Dx: PCR

Tx: Acyclovir (IV for encephalitis)

Prevention:

41
Q

vesicle on an erythematous base (dew drops on a rose pedal) in different stages

Name/Tx

A

Name: Varicella Zoster Virus (HHV3) (chicken pox)

Tx: Surppotive tx

42
Q

Follow dermatome with painful legion

Name/Related spread to other organ/Special PE sign/Complication/Tx

A

Name: VZV HHV3 (Shingles)

Related spread to other organ: Eye - opthalmicus, Ear - oticus (Ramsay Hunt syndrome)

Special PE sign: Hutchinson’s sign - VZV on tip of nose possible eye infection

Complication: Herpetic nuerralgia

Tx: Acyclovir, Neuro pain - gabapentin

43
Q

Fever + throat swelling + posterior cervical lymphadenopathy + splenomegaly

Name/Drug interaction/Dx/Tx/Prevention/complication

A

Name: Epstein-barr virus (mono,, kissing)

Drug interaction: Rash after Amox given (mono)

Dx: Monospot (heterophile) test

Tx: supportive but no aspirin

Prevention: no contact sport due to possible spleen rupture

Complication: Guillian barr

44
Q

Fundus exam shows pizza pie legion (retinite) + CD4 less than 50

Name/Type/Dx/Tx

A

Name: Cytomegalovirus HHV-5

Type

  • Congenital CMV - sensorineuro hearing loss
  • CMV reactivation - retinitis (CD4<50), esophagitis

Dx: Fundus exam - pizza pie legion (scrambled egg/ketchup appearance), problem at esophagitis - endoscopy (large superfical ulcer)

Tx: ginciclovir

45
Q

Sudden high fever + after few days fever gones rash start from trunk to neck and head

Name/Tx

A

Name: Roseola HHV 6-7

Tx: Supportive

46
Q

Rash start from head to downward + usually goes away in 3 days

Name/Tx/Teratogenic

A

Name: Rubella

Tx: supportive

Teratogenic: 1st trimaster congenital syndrome occur - PDA, small head(microcephaly), loss hearing, cataract

47
Q

Fever + cough + coryza + conjunctivitis

Name/PE/Tx/Complication

A

Name: Measles (Robeola)

PE: Koplik’s spot(red surround w/ white/blue centered), Rash starts from head to downward

Tx: supportive

Complication: diarrhea, OM

48
Q

Coryza, fever + slapped cheek + age <10

Name/Pathogen/Tx/Complication

A

Name: erythema infectiosum (fifth disease)

Pathogen: paravovirus B19

Tx: supportive

Complication - aplastic crisis in pt with sickle cell disease

49
Q

Parotid gland pain & swelling

NAme/Pathogen/Tx/Complication

A

Name: Mumps

Pathogen: Paramyxovirus

Tx: Supportive

Complication: Orchitis

50
Q

Severe sudden on set of fever + severe arthalgia + non productive cough

Name/MC motality/Tx/Prevention/Post exposure

A

Name: Influenza

MC mortality: secondary to PNA (young or older population)

Tx: Oseltamivir (tamiflu) - must given within 48 hours

Prevention: vaccination yearly

Post Exposure: must provide tamiflu if within 48 hours

51
Q

HIV explain

Virus type/transmission/Infected site/AIDS definition/Dx/Tx/Opportunistic dz

A

Virus type: Retrovirus

Transmission: Sex, IV drug

Infected site: HIV target T4 due deplete

AIDS definition: CD4 less than 200 or defining illness (see below)

Dx: Fourth generation combination HIV-1/2 immunoassay (1st), Western blot (confirmatory)

  • Serum viral load is for monitor therapy status

Tx: HAART (NRTI 2 + 1 PI or NNRTI)

Opportunistic dz defined as AIDS

  • CD4 <200 - PCP
  • CD4 <100 - toxoplasmosis, cryptococcus
  • CD4 <50 - MAC(GI sx), CMV(eye sx)
52
Q

hx of bite of bats + hydrophbia (painful throat after drink H2O) + Paresthesias and fasciculations

Name/Related/Dx/Tx/Prior vaccinated with new bite

A

Name: Rabies

Related: bat, dog, racoon, skunks, foxes, wolves

Dx: Dead animal biposy - negri bodies

Tx: Rabies vaccine day 0,3,7,14 + Rabbies immune globulin 1/2 wound site, 1/2 IM at glut

*if immunisupressant person - need extra care 28 days of rabies vaccine

Prior vaccination with new bite: Immuno globin for once, Vaccination everytime new bite occur.

53
Q

Small pox vs chicken pox

A

Small pox - one stage

Chicken pox - all different stage

54
Q

inital fever 3-7 days + gone for 2 days + 1-2 days of fever again + break bone or joint pain

Name/Tx

A

Name: Dengue fever

Tx: acetaminophen

55
Q

history of pain, tenderness, and itching of his glans penis and foreskin + curd-like exudate in the sulcus between the glans and foreskin

Name/Related/Tx

A

Name: Candidal balanitis

Related: DM - poorly controlled glucose lead infection candida

Tx: antifunfal (clotrimazole)

56
Q

pruritus + mucopurulent discharge + sexually active + PAINFUL

Name/Pahogen/Disseminated/Dx/Tx/After care

A

Name: Gonorrhea

Pathogen: Neisseria Gonorrhea

Disseminated: arthrities + dermatitis (necrotic or hemorrhagic center at palm)

Dx: Nucleic acid amplification

Tx: AZA 1g x 1 dose or doxy 100mg bid x 10 days

Also tx for gonorrhea Ceftx IM 250mg x 1 dose

If disseminated gonorrhea Ceftx x 7 days

After care: retest in 3 weeks to make sure, treat sex partner as well

57
Q

Fever 7-10 days gets btter after + bradycardia + rash + pea soup diarrhea

Name/Tx

A

Name: typhoid fever

Tx: Ceftx + quinolone x 2weeks

58
Q

hx of picnic + on set 8 - 48 hours abd pain + diarrhea 3-5 days with fever

Name/Pathogen/Dx/Tx

A

Name: Gastrogenteritis

Pathogen: MC form of salmonella (caused by food)

Dx: stool culture

Tx: self-limited

59
Q

severe rice water diarrhea + third world country visit

Name/Pathogen/Patho/Tx

A

Name: Cholera

Pathogen: Vibrio cholerae

Patho: toxin cause hypersecretion of water in small intestine

Tx: Oral rehydration + cipro

Prevention: Clean water and food supply for prevention

60
Q

hx of food intake + sudden onset diarrhea + fever + loose stool with blood

Name/Dx/Tx

A

Name: Shigellosis

Dx: Fecal test, stool culture

Tx: bactram(TMP/SMX)

61
Q

Painless ulcer + painful inguinal

Name/Pathogen/Travel site/Risk/Tx

A

Name: Lymphogranuloma venerum

Pathoge: Chlamydia trachomatis

Travel site: recent travel to tropical and subtropical areas of the world

Risk: homosexual

Tx: Doxy 100mg bid 21days

PANCE (12 decks)

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