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Cin Med - Infectious diseases > Bacterial Diseases 1 > Flashcards

Bacterial Diseases 1 Flashcards

1
Q

Pertussis

A
  1. June→September
  2. No lifelong immunity→protection wanes after 3-5 yrs
  3. Transmission→Face to face
  4. Incubation 3-12 days
  5. Stage 1: Catarrhal→looks like URI
  6. Stage 2: Paroxysmal phase
  7. Stage 3: Convalescent→chronic cough
  8. paroxysmal cough >14 days that ends w/ post tussive vomiting or whoop→
  9. PCR>CX for DX CX (culture)
  10. < 6 months=hospitalization
  11. TX > 1 mo old→macrolides→azithromycin
  12. TX > 2 mo old→trimethoprim sulfamethoxazole
  13. Erythromycin and clarithromycin NOT for < 1 mo d/t risk IHPS (infantile hypertrophic pyloric stenosis)
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2
Q

Acute Rheumatic Fever

A
  1. Heavily capsulated strain w/ group A Strep w/ rich M protein
  2. Causes myriad of dz w/ cross rxn of bacterial antigens: migratory arthritis→Syndeham chorea (not initially present)→carditis
  3. Latent period: 18 days after strep throat→usually resolve in 12 weeks
  4. Jones criteria: 2 Majors or 1 maj & 2 minors
    a. Majors: carditis, polyarthritis, chorea, EM, subQ nodules
    b. Minors: Arthralgias & fever
  5. 60% involve mitral valve→suspicion is high w/ new or changing murmurs, cardiomegaly, CHF, pericarditis
  6. Labs: +ASO supports DX/ CRP & ESR elevated
  7. Imaging: ECHO→detects regurgitant lesions
  8. Primary goal: Eradicate strep & antigens
  9. TX: PCN # 1→does NOT alter cardiac dz→reduces reactive antigen exposure
  10. Severe TX: corticosteroids & Digoxin
  11. Syndeham chorea: Haloperidol
  12. AHA: Benzathine benzylPCN
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3
Q

Botulism

A
  1. Acute neuroparalysis d/t neurotoxin from clostridium botulism→binds irreversibly to presynaptic membranes of peripheral NM jct→blocks AcH
  2. Cure: Sprouting of new nerve terminals
  3. FBB: 12-36 hrs post prandial (foodborne botulism)
  4. WB: 4-14 days of incubation (wound borne)
  5. GI sxs: paralytic ileus & urinary retention→ precede neuro
  6. Labs: Mouse neutralization bioassay/ Wound CX/ EMG/ Edrophonium Cl to r/o MG
  7. TX: Supportive
  8. Prevention: Pressure cook at 250 for 30 min for at home canning
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4
Q

C. Trachoma

A
  1. Risk factors: Poor SES/ Male foster kids/
  2. Female presentation: Discharge/ vaginal bleeding/dyspareunia/proctitis/ PID/ fever
  3. Male presentation: Urethral discharge→scarring in men/proctitis/rectal discharge/ unilateral scrotal swelling
  4. Newborns: Conjunctivitis at 1-2 weeks/ PNA at 1-3 months
  5. Fitz-Hugh-Curtis syndrome 5 X more likely
  6. 6.5 x greater chance of cervical CA
  7. Infertility/ Miscarriage/ preterm delivery
  8. Screen all prego/sexually and/or high risk females <25
  9. General TX: Tetracycline and Macrolides
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5
Q

C. Trachomatis

A
  1. Genital specimens more sensitive than urine for women→same sensitivity in men
  2. Labs: HIV/Pap/APTIMA/sexual partners/ DFA/ELISA/DNA probes/ PCR &LCR
  3. TX: Azithromycin & Doxycycline
  4. TX for Lower GU infection: Single dose
  5. TX for Upper GU infection: 10 days of a cephalosporin to treat gonorrhea
  6. Abstain from sex for 7 days
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6
Q

C. Trachomatis-Trachoma

A
  1. Chronic keratoconjunctivitis
  2. Transmission is care giver←→children
  3. TX: PO Azithromycine/ Tetracycline eye ointment
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7
Q

C. PNA. PNA.

A
  1. 7-40 y/o males
  2. Incubation 3-4 wks
  3. Hoarseness common
  4. Prolonged symptoms for wks→months despite ABX
  5. Labs: IgM titer by MIF/ PCR Assay
  6. Imaging Finding: Single subsegmental infiltrate in lower lobe
  7. TX: Empiric Doxy for 10-14 days after defervescence d/t lack of rapid testing
  8. ALT TX: Erythromycin/ azithromycin/ clarithromycin
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8
Q

C. psittaci PNA

A
  1. RARE→acquired d/t bird exposure
  2. Incubation 5-14 days
  3. Fever 103-105 is MC sx
  4. Labs: Paired acute and convalescent sera/ serological test preferred/ MIF&PCR assays
  5. Imaging Finding: Single lower lobe infiltrate in lower lobes
  6. TX: Tetracyclines or Doxy for 10-21 days
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9
Q

C. Trachomatis PNA

A
  1. 12,000 infants each year→conjuntivitis/nasopharyngitis/symptomatic PNA
  2. MOST AFEBRILE
  3. Labs: DX confirmed by chlamydial inclusion bodies on Giemsa stained smears/ CBC w/ peripheral eosinophilia
  4. Imaging: Bilateral infiltrates w/ hyperinflation
  5. TX: Erythromycin
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10
Q

Cholera

A
  1. Hallmark: profuse secretory diarrhea
  2. Transmission: Fecal→oral
  3. ABX are NOT essential
  4. NOT acid resistant
  5. Increased Risk: Gastrectomy/ H Pylori/ antacids/ H2 blockers/ PPIs increase risk
  6. 24-48 hrs incubation
  7. Hypoglycemia: MC lethal complication in kids
  8. Labs: Stool sample→Gram stain/ CX/ Dark field exam/ Serotyping w/ specific antisera
  9. TX: Doxycycline and Tetracycline
  10. Manage dehydryation!!!
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11
Q

Diptheria

A
  1. Manifests as a URI or cutaneous infection caused by: C. Diptheria→exotoxins cause tissue destruction and necrosis→Cardiac toxicity & Neuro toxicity
  2. Spring or winter
  3. Communicable for 2-6 weeks w/o ABX
  4. Incubation 2-5 days
  5. MC cause of death: Suffocation
  6. TX: PCN or erythromycin→ Most effective in early stages
  7. Horse serum anti-toxin→most efficacious early tx given to anyone suspected to have diphtheria
  8. High mortality rates 40 y/o
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12
Q

Gonorrhea

A
  1. 2nd MC notifiable dz in US
  2. Purulent infection of mucous membrane
  3. Spread through sexual contact→ Male to female: 50-70% →Female to Male: 20%
  4. Neonates: ophthalmia neonatorum & systemic infection
  5. Women: Cervix/ endocervicitis/ urethritis/rectum/pharynx
  6. Men: Urethritis/rectum/pharynx
  7. Prognosis: PID/ectopic pregnancies/infertility/ epididymitis/ epididymorchitis
  8. Complication: Achilles tneosynovitis
  9. Labs: NAAT, NAPSA
  10. TX: Ceftriaxone 1st line…several other options
  11. NO Fluroquinolones or Tetracycline
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13
Q

Salmonellosis

A
  1. Transmitted via consumption of MC foods: beef/poultry/eggs
  2. Incubation 6-72 hrs
  3. Fever progression→persistent and high grade by end of 2nd week
  4. Loose/bloodless stool
  5. Labs: Blood CX/ Stool CX from freshly passed stool
  6. Complications: Malaise and lethargy for months→Typhoid Fever→Splenectomy
  7. Treatment: ABX ONLY for pts w/ severe dz or at high risk→Quinilone/Macrolide/ Cephalosporin/Fluroquinolone
  8. Prognosis: 50% of CNS infections are fatal
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14
Q

Shigella

A
  1. Fecal-oral transmission
  2. Incubation 2-4 days
  3. Shiga toxin→contributes to severity of dysentery
  4. Host response: Acute inflammation→PMN cell infiltration→massive destruction of the colonic mucosa
  5. Risk factors: Peds/ Homosexual men/ inadequate clean water
  6. Manifestations: Seizure/Diarrhea w/ frank blood/ CNS symptoms
  7. Labs : Blood CX/ Stool CX/ Enzyme immunoassay
  8. TX: Fluids/ Vit A/ Zinc/ ABX for 5 days→Beta lactams/ Quinolones/Macrolides
  9. AVOID Antidiarrheals
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15
Q

E. Coli

A
  1. Causitive bacteria in : UTI/ Choleycystitis/Cholangitis/Traveller’s DZ
  2. TX for traveller’s DZ : Doxy/ TMP/SMZ/ fluroquinolones & rifampin
  3. ABX will shorten diarrhea by 24-36 hrs
  4. AVOID antidiarrheals
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16
Q

Tetanus

A
  1. C. Tetani: mobile, spore forming in soil
  2. Sxs 8 days after infection → typically in a open wound
  3. Major cause of infant mortality in underdeveloped countries→Infection umbilical cord contamination during unsanitary birth
  4. Presents w/ lockjaw/ nuchal rigidity/dysphagia
  5. Muscular rigidity: flexion above midline/ extension below midline
  6. Intact sensorium w/ severe pain
  7. TX: ICU→ TIG shortens course of dz→benzodiazepines→MgSO for muscle spasms
17
Q

Cellulitis

A
  1. Majority causes by S. pyogenes and Staph Aureus
  2. Borders are NOT elevated or sharply demarcated
  3. Treatment: Beta Lactam ABX
  4. Alt TX for allergies: Clindamycin
  5. Severe TX: IV Ceftriaxone or Vancomycin
18
Q

Erysipelas

A
  1. Strep, skin in upper dermis that extends into the superficial lymphatics
  2. fiery red, indurated and shiny plaques w/ well demarcated borders
  3. Pre-Existing lymphadema→big risk factor
  4. Non-PK Treatment: Elevation/Rest/Saline Dressings in necrotic areas
  5. PCN PO or IM for 10-20 days
19
Q

Impetigo

A
  1. Non-Bullous→GABHS
  2. Bullous→SAU
  3. Topical TX: Mupiricin x 7 days for single lesion
  4. Systemic TX: Beta Lactamase resistant ABX
  5. Anti-Histamine for pruritis
  6. Pedi TX: Cephalexin
  7. ALT TX: Erythromycin or clindamycin

Cin Med - Infectious diseases (7 decks)

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