Block 46, 47,48 ID Flashcards
when does ventilator-associated pneumonia occur
48 hours or more after intubation
First step in management for ventilator-associated pneumonia
Chest x-ray
clinical features of Ehrlichiosis
- acute febrile illness with malaise and altered mental status
- not associated with rash
lab values for Ehrlichiosis
leukopenia
thrombocytopenia
elevated aminotransferases
treatment for Ehrlichiosis
Doxycycline
Second line treatment for Ehrlichiosis
Chloramphenicol
Enterococci species are common causes of infective endocarditis associated with
procedural manipulation of the urinary tract infection
Indications for corticosteroid use in Pneumocystis pneumonia include
PaO2 less than 70 mmHg
OR
A-a gradient greater than 35 on room air
where can one get blastomycosis
Great Lakes
Mississippi
Ohio River basin
lumbar puncture for herpes encephalitis
- elevated wbc
- lymphocytic predominance
- normal glucose
- elevated protein
what is Chlordiazepoxide used to treat
alcohol withdrawal in hospitalized patients
choice of antibiotics for immunocompromised patients with suspected bacterial meningitis
Cefepime, vancomycin, ampicillin
- corticosteroids: discontinue if an organism other than strep. pneumonia shows
When you have infective endocarditis, what is the best next step in management
- Blood cultures before initiating antibiotics
Who and what is mycobacterium avium complex
infection found in HIV patients with CD less than 50
what is a PE and lab value finding for mycobacterium avium complex
splenomegaly
alkaline phosphatase
what prophylaxis treatment should mycobacterium avium complex patients get
azithromycin
what does BCG vaccine stand for
Bacille Calmette-Guerin
common antibiotic options for anaerobic coverage include
- metronidazole with amoxicillin
- amoxicillin-clavulanate
- clindamycin
Jarisch-Herxheimer reaction
- acute, febrile reaction–> rapid destruction of spirochetes
- less than 12 hours after initial treatment of syphilis
- headache, myalgias, rigors, sweating, hypotension, worsening of syphilitic rash
what is immune reconstruction inflammatory syndrome
HIV pts initiated on highly active antiretroviral txt,
- paradoxical worsening of infectious symptoms due to immune system improvement
Cryptosporidium parvum is a major cause of what
chronic diarrhea in pts with HIV
CD count less than 180
difference between acute HIV and EBV
HIV: rash and diarrhea
EBV: tonsillar exudates
what does RPR stand for
rapid plasma reagent
highest sensitivity testing for syphillis
florescent treponemal antibody absorption
pathergy test is useful for diagnosing what
Bechet syndrome: oral ulcers and multiple, painful genital ulcers
many hospitalized patients with pyelonephritis can be transitioned to what after 48 hours of symptom improvement
culture-guided oral antibiotics
where is sporothrix schenckii
decaying vegetation and soil
treatment for sporothrix schenckii
itraconazole
infective endocarditis most likely impacts what heart valve
mitral regurgitation
antinuclear antibody can detect what
lupus
what secondary bacterial penumonia do younger people get after influenza? Describe what you see on X-ray?
Community-associated methicillin-resistant Staph. aureus
- multilobar cavitary infiltrates
what does peptostreptococcus cause
putrid sputum and abscess/empyema pulmonary infection
hilar adenopathy is more suggestive of blastomyces or histoplasmosis
histoplasmosis
characteristic of brown recluse spider bites
red plaque or papule with central clearing
how do you get cutaneous larva migrans
hookworm larvae
- barefoot on contaminated sand or soil
treatment for cutaneous larva migrans
Ivermectin
how big does a TB skin test must get to be considered positive
15mm greater
treatment guides for Penumocystis pneumonia
Trimethoprim-sulfamethoxazole
- add corticosteroids when pulse ox is less than 92%
PaO2 less 70 and aa greater than 35
most common cause of community-acquired Infective endocarditis
streptococcal infection
most common cause of healthcare-associated infective endocarditis
Staphylococcal infection
difference between Strept. bovis and Strept. sanguinis
bovis: UC of colon
Sanguinis: viridans group of strep found orally
how does Giardia physically impact the small intestines
blunts microvilli
clinical feature of viral gastroenteritis
Both vomiting and diarrhea
what lab value is increased for penumocystis jirovecii
lactate dehydrogenase is elevated
anti-cyclic citrullinated peptide antibodies are associated with what
rheumatoid factor
Anti-double-stranded DNA antibodies associated with
SLE
mixed cryoglobuliemia associated with
chronic hepatitis C
risk factors for C. diff
- hospitalization
- advanced age
- antibiotic use
paitents with plantar puncture wounds through footware are at risk for
pseudomonas aeruginosa osteomyelitis
condyloma acuminata is associated with what
papillomavirus
Ludwig angina
mandibular molar infections leading to cellulitis of the submandibular space
if you see a tick what should you do
- remove tick with tweezers
- no prophylaxis needed for lyme disease of tick is attached for less than 36 hours
name 3 bacteria that cause bloody diarrhea
- E. coli
- Shigella
- Campylobacter
who is recommended to hep A vaccine
- gay men
- countries where hep A is endemic
- chronic liver disease
when do you not give rabies postexposure prophylaxis
Domesticated animals, and animal must be observed for 10 days
patients who receive a solid organ transplant are at risk or what opportunistic infections
- pneumocystis pneumonia
2. CMV (multiple organ involvement)
unvaccinated individuals should receive what for hep B infection
Both HB vaccine and HB immune globulin
Treatment for CMV esophagitis
ganciclovir
Herpes simplex esophagitis treatment
acyclovir
difference between herpes simplex esophagitis and CMV esophagitis
herpes: small, well-circumscribed round/ovoid ulcer and intracellular inclusions
CMV: large linear ulcers and intranuclear and intracytoplasmic inclusions
second line treatment for pneumocystis pneumonia
Pentamide
treatment for cryptococcal meningoencephalitis
amphotericin B plus flucytosine followed by fluconazole
Do you usually get fever with echinococcus granulosis
no
when should one be screened for Hep C
blood transfusions before 1992
Sulfadiazine and pyrimethamine treat what
toxoplasmosis
Clarithromycina and Ethambutol is used to treat
MAC
Mycobacterium avium complex
Bright red, firm, friable, exophytic nodules in an HIV infected patient most likely ave
bacillary angiomatosis
Penumocystis may cause nodular and papular cutaneous lesions where in HIV patients
external auditory meatus
