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NURS 518 > 526 Infectious Disease > Flashcards

526 Infectious Disease Flashcards

1
Q

what is hyperpyrexia

A

temperature over 41.5

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2
Q

what is fagets sign or sphygmothermic dissociation

A

elevated temperature with relative bradycardia

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3
Q

what are 2 common tropical diseases to be considered in a febrile patient with recent travel

A

malaria
dengue

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4
Q

what drug classes are commonly implicated in drug induced fevers

A

antihypertensives
antiarrhythmics
antibiotics
thryoid medication
antiepileptics

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5
Q

elevated lymphocytes in a febrile patient may indicate what

A

viral infection

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6
Q

elevated monocytes in a febrile patient may indicate what

A

mono

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7
Q

eosinophils in a febrile patient may indicate what

A

parasites
asthma or allergy

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8
Q

an elevated ESR >100 greatly increases possibility of what diseases in a febrile patient

A

osteomyelitis
endocarditis
temporal arteriris
rheumatological disease

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9
Q

at what temperature should fever always be aggressively treated

A

41 degrees or above

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10
Q

immunosuppressed patients should seek medical care for a fever above what

A

37.8

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11
Q

true or false: vertebral osteomyelitis with neuro symptoms can be treated as outpatient

A

false, it requires urgent hospitalization

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12
Q

what timelines define acute and chronic osteomyelitis

A

acute less than 2 weeks
chronic more than 3 months

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13
Q

what is the treatment for osteomyelitis once bone necrosis has occured

A

surgical debridement

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14
Q

what is the Cierny-Mader classification

A

to determine the extent of anatomic involvement of osteomyelitis to help determine treatment

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15
Q

which stage of osteomyelitis can be treated with antibiotics alone

A

stage 1

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16
Q

what are the 3 stages of the cierny mader classification

A

stage 1 - medullary
stage 2 - superficial
stage 3 - localized
stage 4 - diffuse

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17
Q

what symptoms would you suspect to see in osteomyelitis

A

localized pain, erythema, swelling, +/- fever

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18
Q

true or false: osteomyelitis of the hips, pelvis and spine are more likely to present as subacute with a dull persistent pain

A

true

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19
Q

what blood work should be completed for a suspected osteomyelitis

A

CBC with diff and CRP

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20
Q

when should blood cultures be obtained with osteomyelitis

A

vertebral osteomyelitis
or is febrile

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21
Q

what is used for the definitive diagnosis of osteomyelitis

A

bone biopsy

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22
Q

what is first line investigation for possible osteomyelitis? what is used if first line is inconclusive

A

first line is xray
mri if xray is unclear

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23
Q

true or false: wound biospy is just as useful as bone biopsy in determining causitive organism in osteomyelitis

A

false, bone biopsy is gold standard

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24
Q

what are the main differentials other than osteomyelitis that need to be ruled out

A

soft tissue infection
septic arthritis

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25
Q

when is surgical consultation needed for osteomyelitis

A

patient with vascular insufficiency
debridement or drainage needed

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26
Q

although ID should be consulted, what is typical first line treatment for osteomyelitis

A

vancomycin plus 3rd gen cephalosporin like ceftriaxone

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27
Q

how long are antibiotics usually given for osteomyelitis

A

6 weeks of IV abxw

28
Q

what is the difference between lymphadenitis and suppurative lymphadenitis

A

lympadenitis is tender, warm, ertyhematous nodes
suppurative includes fluctuance

29
Q

pain associated with a rapidly growing lymph node is usually a sign of what

A

infection

30
Q

what does an enlarged virchow node indicate and where is the virchow node

A

left supraclavicular node
concern for malignancy within abdominal organs

31
Q

unilateral or bilateral lymph nodes are more likely to be malignant

A

unilateral

32
Q

what abdominal assessment should be completed with any upper lymphadenopathy below the neck?

A

check for splenomegaly and enlarged liver

33
Q

how long should lymphadenopathy with no known cause by left for a period of observation

A

3-4 weeks

34
Q

what is the acronym CHICAGO and what is it used for

A

Cancers
hypersensitivities
infections
connective tissue disease
atypical lymphoproliferative disorders
granulomatous lesions
other unusual causes

framework for differential for lymphadenopathy

35
Q

right sided supraclavicular lymph nodes suggest pathology in the ____ and left sided suggest pathology in the ____

A

right - thoracic/lungs
left - abdominal/peritoneal

36
Q

what is a sister mary joseph sign and what does it indicate

A

palpable nodes around the umbilicus. Sign of significant intra-abdominal lymphadenopathy, usually malignant

37
Q

what conditions present with generalized lymphadenopathy, fever, fatigue, weight loss and night sweats

A

lymphoma and TB

38
Q

what are shotty nodes, what do they indicate, when would you find them

A

inguinal nodes that are firm, not fixed and less than 1 cm
they are common in adults as a result of recurrent infection or injury in the feet and legs

39
Q

what other organs are part of the lymph system and should be assessed with generalized lymphadenopathy

A

spleen and tonsils

40
Q

true or false: sarcoidosis is an allergic reaction

A

false, it is an inflamatory

41
Q

erythema nordosum, lymphadenopathy, and respiratory symptoms is indicative of what condition

A

sarcoidosis

42
Q

a 20-30 year old black female patient with dry cough, shortness of breath and nodules on the shins is indicative of what disease

A

sarcoidosis

43
Q

what are lupus pernio and when are they seen

A

raised purple lesions on tip of nose and across cheeks
with sarcoidosis

44
Q

true or false: sarcoidosis only affects the lungs and skin

A

false, it can affect all systems throughout the body causing multiple different sequela

45
Q

what is lofgrens syndrome

A

caused by sarcoidosis
includes: erythema nodosum, bilateral hilar lymphadenopathy, and polyarthralgia

46
Q

what condition would cause an increased serum ACE and increased CA

A

sarcoidosis

47
Q

how is sarcoidosis diagnosed

A

histology with skin biopsy or bronchoscopy

48
Q

what is the difference between primary and post primary TB

A

primary is first occurence of TB and is usually not symptomatic
post primary is when TB is reactivated from not being treated and is usually symptomatic

49
Q

how long after being infected with TB before a TST will be reactive

A

2-8 weeks

50
Q

when measuring a TST test, what is measured?

A

mm of induration, not erythema

51
Q

does a negative TST conclusively rule out TB

A

no, there are many causes for a false negative

52
Q

true or false: having HIV or AIDs means you are more likely to have a false negative on the TST test

A

true

53
Q

what is the two step method for a TST

A

if first reaction is + = infected
if first reaction is -, repeat test in 1-3 weeks

54
Q

true or false, history of the BCG vaccine will not affect your TST result

A

false, it is variable and may or may not affect the result

55
Q

is history of BCG vaccine a contraindication for the TST test

A

no

56
Q

what is another diagnostic way to test for TB other than the TST

A

serum IGRAs

57
Q

TST or IGRA is perferred testing method for children under 5

A

TST, there is little evidence on the IGRA for children under 5

58
Q

true or false: IGRA or TST play a role in diagnosing active TB

A

false, they are screening test

59
Q

true or false: CXR results may suggest TB but cannot be diagnostic

A

true

60
Q

true or false: a positive AFB is diagnostic of TB

A

false, although strongly suggestive, it is not diagnostic

61
Q

what is the test that is diagnostic for TB

A

positive culture

62
Q

what are the most potent first line drugs in TB treatment

A

INH and rifampin

63
Q

what is the major side effect associated with INH

A

hepatitis

64
Q

what influenza type symptoms would warrant emergency referral

A

new onset confusion
CP
difficulty breathing
abdo pain
persistent vomiting
worsening symptoms
suspicion of epiglottis

65
Q

how long does a fever associated with influenza usually last

A

2-3 days but can last as long as 8 days

66
Q

amantadine and rimantadine are effective against what strain of influenza

A

influenza A

67
Q

at what age can people start to recieve an annual influenza vaccine?

A

6 months or older

NURS 518 (15 decks)

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