Aaron: Infectious Disease Flashcards
Bands more than 10% are what?
Sepsis or SIRS qualification
SIRS/pancreatitis criteria, what is the most common test to observe and look at outcomes?
BUN > 20 mg/dL
HIV induced hypercholosterolemia, hyperlipidemia, what is the first drug of choice?
-statin, not a fibrate, fibrates are not the first go to drug
IV drug abuser, first time new murmur, septic pulmonary emboli, what is the next best step?
Transthoracic Echo
Classic Triad of pleuritic chest pain, cough, hemoptysis, what is the most likely cause? Immunosuppressed patient with “ground glass opacity” (not PCP).
Invasive Pulmonary Aspergillious
A patient is scared to drink, hydrophobia is common in what disease?
Rabies
What is a pulmonary indication for corticosteroids?
Alveolar-arterial oxygen gradient >35 mmHg
PCP is seen with a CD4 count less than 200, if the sputum analysis is negative for PCP, can a patient still be infected with PCP?
Yes
If I have TB meningitis, what is the length of treatment?
2 months of 4 drug therapy then 9-12 months of isoniazid and Rifampin
TB meningitis, will patients have long term neurological problems?
Are intrathecal drugs helpful?
Yes, to long term neuro issues
No intrathecal drugs are helpful
Does Dexamethasone (glucocorticoid therapy) reduce morbidity and mortality in TB patients?
Yes, should be given for 8 weeks
A patient obtains C. Diff. does not want to be admitted, what is the scariest C. Diff complication?
Intestinal Perforation
All things being equal, what is a quick easy difference between Meningococcal Meningitis and Tertiary Syphilis?
Syphilis happens over weeks and months, Meningococcal Meningitis is hours to days
What are the three criteria for acute liver failure?
If a patient has 1 of 3 and an acute Hep B infection, should they be admitted?
Elevated Liver Enzymes, Encephalopathy, and INR > 1.5
No
Does antiviral Hep B treatment make a huge difference?
No
Centor Criteria of the following gets what?
Less than 3?
3-4?
Less than 3 = symp. treatment
3-4 = Streptococcal Rapid Antigen Test, if +, then get abx
Before starting HIV treatment, what should be investigated before treatment starts?
Hep B serology
Assuming I have an HIV exposure, what is a perfect timeframe that triple therapy retroviral treatment should be started?
less than 72 hours
A positive p24 HIV tests can take up to how long to be positive?
4 weeks
If a patient had a rabies vaccine one year ago, then they were bitten by a bat, what is the treatment?
Vaccine on day 0 and 3, yes despite the fact that he had it a year before, I know
Multiple Small papules with central umbilication, on face, neck, trunk, and upper thighs. Oral Thrush and HIV non-compliant, what is the most likely cause?
Cryptococcus, confirmed via biopsy
Mycotic aneurysms are what?
Infected Aneurysms
Close contact has meningococcal infection, what is the treatment of choice?
What condition makes it so that a woman cannot take Rifampin?
One dose ciprofloxacin 500 mg
OCP use
Chronic Bacterial Prostatitis can have what hallmark sign and treatment?
Treatment = 6 weeks of ciprofloxacin Sign = pain during ejaculation
HSV encephalitis will cause what problems?
Altered Mental Status, will not be able to follow commands well
26-year-old with a white lesion that can be scrapped off with a tongue depressor, is this enough to think about oral cancer? 5-year smoking history
no, think about HIV, particularly with the enlarged regional lymph nodes
How do you tell Erysipelas vs Cellulitis?
Cellulitis does not have a distinct cut off, Erysipelas does have a well demarcated line
The red rash is also elevated and raised
If a tick is engorged, does there need to be abx treatment?
If a tick has been attached less than 36-48 hours, does the patient need abx, even with a rash?
Yes
No, tick saliva can cause red rash after the fact
A patient has urethritis, given a shot of azithromycin, does not get better a few weeks later, what is the next best test?
Do another gram stain and urethral swab
Assuming a patient has active TB, what is the next best step?
Sputum Acid Fast Culture and smear, IFN gamma and TB skin test do not have distinguish an active infection
P. Aeruginosa has what skin disease?
IBD has what skin disease?
Ecthyma Gangrenosum
Pyoderma Gangrenosum
Bartonella has what specific disease characteristic?
Very tender lymphadenopathy
Bacteremia in a cancer patient, what is the first treatment step?
Empiric IV abx, Pseudomonas abx should get Beta Lactam and Aminoglycoside
After fungal meningitis treatment, how long should patients wait for HIV treatment initiation?
2-10 weeks after meningitis treatment start
Fluconazole treatment, CD4 count must be over _____ to stop?
100
Cryptococcal Meningoencephalitis can clog up the arachnoid villi, and what treatment needs to be done?
Look out for continued symptom headaches, nausea, vomiting, and lethargy
Serial Lumbar Punctures
MCV lesions Elevated opening pressure low leukocyte count, lymphocytic predominance Elevated protein and glucose Meningitis symptoms, what am I?
Cryptococcal Meningitis
Positive India Ink preparation
Shingles in an 82 year old patient, what is the best treatment?
Oral Valacyclovir, if under 72 hours
Shingles patient is admitted for pain control, what are the necessary PPE precautions?
Airborne and Contact
Can a Jarisch-Herxheimer Reaction be prevented with anti-histamines or steroids?
No
A new HIV diagnosed patient, +RPR, +FTA, headaches, nausea, vomiting, dizziness, what is the next step?
LP, the symptoms may be tertiary syphilis
Recurrent C. diff infection is seen based on what patient history contribution?
Is a +PCR stool antigen test enough to diagnose
3 loose, watery stools in 24 hours, look out for elevated white count and fever, too
No to +PCR test only
Best way to prevent C. Diff?
Stop gastric acid suppression
Bladder cancer will have blood when during micturation?
Through out urination
Schistosomiasis will have blood when during micturation?
Terminal part of urination
Schistosomiasis in a Ghana Man, dysuria, increased urinary frequency, and anemia, what is a good next step?
Urine Sediment microscopy
Dengue Fever is seen via what test?
Petechiae after blood pressure cuff inflation
Osteomyelitis in a diabetic patient, what is the best radiography test?
MRI
What is a common Isoniazid side effect besides nerve damage?
Drug induced hepatitis
If a patient’s airway is about to close off, what is the best immediate treatment besides intubation?
Corticosteroids
Does EBV or Strept infection more likely cause hepatosplenomegaly?
EBV
EBV treatment is what?
Supportive care, no anti-viral medications are helpful
If I have necrotizing fasciitis, what is the most common culprit?
Group A strep, not C. Perfringens (also a cause, but not #1) from uworld
If an elderly woman is brought from a nursing home, cloudy urine, +urine culture, but no burning during urination, no increased urinary frequency, and no other symptoms. What is the next best step?
Leave alone, if UTIs are asymptomatic, do not treat, the only time to treat if not symptomatic is if +culture/results and pregnant
Oseltamivir is best used in Flu patients via what time table?
Less than 48 hour onset
How long after infection does it take for a Giardia infection to take place?
At least one week
How long after infection does it take for an E. Coli infection to take place?
A few days
Do you treat E. Histolytica if the patient has stool cysts but no symptoms?
Yes, paromomycin
If a patient had unprotected sex with a known HIV positive partner, and they present within 72 hours after the sexual encounter, what can be done?
Triple Therapy anti-viral medications for 28 days
Can Thiazide diuretics cause pancreatitis?
Yes
Fever
AMS
Late spring, summer, or early autumn
Flaccid paralysis –> transverse myelitis
Extrapyramidal symptoms
What am I? Treatment?
West Nile Encephalitis
Tx: Fluids, supportive care
