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ITE '23 > Ch. 8 ID > Flashcards

Ch. 8 ID Flashcards

1
Q

List characteristics of Clostridium botulinum bacteria

A

Gram +
Anaerobic rod
spore-forming
prevalent in soil an marine sediment
heat and acid resistent

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2
Q

What is the mechanism of action of botulinum toxin?

A

blockage of presynaptic release of acetylcholine at the neuromuscular junction –>
flaccid descending paralysis
mydriasis, ptosis, respiratory paralysis

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3
Q

what is the primary cause of death in botulism?

A

respiratory paralysis

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4
Q

What is the treatment of botulism?

A

Botulinum Antitoxin
Adults –» trivalent antibodies to toxin (derived from horse serum)
Infants –» human-derived botulinum Ig IV (BIG-IV)

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5
Q

What toxin causes tetanus?

A

exotoxin tetanospasmin

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6
Q

List characteristics of Clostridium tetani bacteria

A

gram + Rod
anaerobe
spore-forming –> “drumstick appearance”
found in soil and animal feces

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7
Q

What is the mechanism of action of exotoxin tetanospasmin?

A

Blocks release of inhibitory neurotransmitters (glycine and GABA) at motor endplates of skeletal muscle, spinal cord, brain and sympathetic nervous system –> spastic paralysis and tetany

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8
Q

What type of poisoning can have a similar presentation to tetanus?

A

Strychnine poisoning
(found in pesticides, homeopathic meds, street drugs)
- waxing and waning intense muscle contractions, back arching, grimacing

Tx with benzos

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9
Q

How is tetanus diagnosed?

A

Clinical diagnosis
SPATULA TEST - a tongue depressor is used to touch the posterior oropharynx, will cause a patient with tetanus to uncontrollably bite down on the depressor
(reported sensitivity and specificity of > 90% for tetanus infection.)

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10
Q

What is the treatment for tetanus?

A
  1. aggressive supportive care
  2. Human Tetanus Ig (TIG) 3000-5000 units IM
  3. Tetanus immunization (opposite side)
  4. +/- Abx (Metronidazole) (questionable utility)
  5. other meds:
    • Benzos to relax muscles
    • Magnesium and labetalol for sympathetic hyperactivity

penicillin and isolated beta blockade are contraindicated

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11
Q

If you have a wound that requires debridement should you do it before or after administration of tetanus immune globulin?

A

After. Debridement can release additional toxins

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12
Q

How is gonorrhea diagnosed?

A

Nucleic acid amplification test (NAAT) of urethral/first-catch
urine, cervical, pharyngeal, or rectal specimen; sensitivity approximately
95%

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13
Q

What is the treatment for disseminated gonorrhea?

A

Ceftriaxone 1 g IV daily

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14
Q

What organism causes syphilis?

A

Treponema pallidum

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15
Q

Describe the characteristics of the organism treponema pallidum?

A

Gram negative
obligate intracellular
spirochete (corkscrew shaped)
visible with darkfield microscopy

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16
Q

What is the incubation period of syphilis?

A

2-4 weeks

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17
Q

Describe primary syphilis

A

painless genital ulcer with indurated border (chancre) that heals spontaneously over 2-6 weeks

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18
Q

What do you call a wartlike genital lesion?

A

condyloma lata (secondary syphilis)

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19
Q

What are the 4 components of tertiary syphilis?

A
  1. tabes dorsalis - myelopathy involving dorsal columns of spinal cord
  2. dementia
  3. gummatous lesions of mucous membranes
  4. Thoracic aortic aneurysms
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20
Q

What stage of syphilis does neurosyphilis occur?

A

can occur in ANY stage!

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21
Q

How is syphilis diagnosed?

A

screening test = serum rapid plasma reagin (RPR) or VDRL
confirmatory test = serum florescent treponemal antibody absorption test (FTA-ABS)

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22
Q

What is the treatment of primary or secondary syphilis?

A

Benzathine penicillin 2.4 million U IM (alternative = doxycycline × 14 days)

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23
Q

What is the treatment of latent or tertiary syphilis?

A

Benzathine penicillin 2.4 million U IM weekly × 3 (alternative = doxycycline PO × 28 days)

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24
Q

What is the treatment of neurosyphilis?

A

Aqueous penicillin G 3-4 million units IV q4h × 10-14 days
or
benzathine penicillin 2.4 million units IM qd plus probenecid PO qid × 10-14 days

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25
Q

Describe a Jarisch-Herxheimer reaction and when does it typically occur?

A

Acute fevers, headaches, myalgias, sweating within 24 hours of initial treatment of spirochete infections;

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26
Q

What is the treatment of Jarisch-Herxheimer reaction?

A

self-limited
supportive treatment

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27
Q

Describe the microbiology of the influenza virus.

A

single-stranded RNA
Orthomyxoviridae virus

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28
Q

How is EBV typically transmitted?

A

bodily secretions

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29
Q

What lab finding is common in those with mono?

A

transaminitis

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30
Q

How is Mono diagnosed?

A

Heterophil antibody tests, eg, Monospot (viral capsid immunoglobulin M [IgM])

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31
Q

What organism causes rabies?

A

Lyssavirus (specifically genotype 1)

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32
Q

What are the symptoms of encephilitic form of rabies?

A
  • periodic episodes of hyperactivity
  • hypersalivation
  • periodic spasms, including inspiratory (aerophobia) and (pharyngeal) hydrophobia
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33
Q

What organism causes sporotrichosis?

A

fungus – Sporothrix schenckii

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34
Q

How is sporotrichosis diagnosed?

A

biopsy/fungal cultures
however, treat based on clinical suspicion

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35
Q

What is the treatment for sporotrichosis?

A

Intraconazole for 3-6 MONTH

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36
Q

What should you consider in travelers, immigrants or patients with unexplained fever, abdominal pain, diarrhea, or eosinophilia?

A

parasitic helminths

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37
Q

What is the most common helminth infection in the US?

A

Pinworm (Enterobius vermicularis)

which is a type of nematode aka roundworm

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38
Q

How is pinworms diagnosed?

A

via scotch-tape swab of anal verge and direct visualization of worms

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39
Q

How is Pinworms/Enterobius vermicularis treated?

A

Albendazole or mebendazole

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40
Q

Which parasite hatches eggs in the small intestine, mature in the lungs and ascend the bronchial tree to be swallowed?

A

Common Roundworm
(Ascaris Lumbricoides)

Hookworm and strongyloides also ascends bronchial tree but eggs hatch into larvae in soil and travels via blood to lungs (rather than eggs hatching in intestine)

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41
Q

What do you call the dry cough, chest pain, and low grade fever due to eosinophilic pneumonitis during migration through lungs associated with ascaris lumbricoides?

A

Loeffler Syndrome

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42
Q

How is Common Roundworm (Ascaris Lumbricoides) diagnosed?

A

stool microscopy (Ova and parasites)

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43
Q

How is Common Roundworm (Ascaris Lumbricoides) treated?

A

albendazole or mebendazole

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44
Q

How does Hookworm cause anemia?

A
  1. chronic blood loss from attaching to intestinal mucosa
  2. iron deficiency anemia and nutritional deficiencies
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45
Q

Which parasite is known to occasionally cause rectal prolapse?

A

whipworm (trichuris triciura)

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46
Q

How is Strongyloides (Strongyloides stercoralis) treated?

A

Ivermectin or albendazole

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47
Q

Which parasite commonly causes muscle pain and tenderness, fever, and periorbital swelling?

A

Trichinella (Trichinella spiralis)

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48
Q

Which nematode uses mosquitos as its vector?

A

Lymphatic Filariasis/Elephantiasis (Wuchereria bancrofti and Brugia malayi )

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49
Q

How is Lymphatic Filariasis/Elephantiasis (Wuchereria bancrofti and Brugia malayi) treated?

A

diethylcarbamazine (DEC) or ivermectin

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50
Q

What vector does Onchocerciasis/River Blindness (Onchocerca volvulus) use?

A

Blackfly (simulium) - found near fast-flowing rivers and streams

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51
Q

How do you treat Onchocerciasis/River Blindness (Onchocerca volvulus)?

A

Ivermectin

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52
Q

What vector does Loa loa use?

A

deerfly

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53
Q

How does loa loa present and how do you treat Loa Loa?

A

worm can be visible on conjunctival exam of eye
tx: DEC

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54
Q

Which tapeworm can cause a megaloblastic anemia due to B12 deficiency?

A

Diphyllobothrium latum

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55
Q

How is Diphyllobothrium latum ingested?

A

undercooked fish

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56
Q

How is Echinococcus species ingested?

A

Feces of sheepdogs, cattle,
wolves, foxes

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57
Q

Which parasite causes larval cysticerci in brain, striated muscle, and liver (aka cysticercosis)?

A

T. solium

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58
Q

How is T. Solium treated?

A

Praziquantel

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59
Q

How long does HIV seroconversion take?

A

3-12 weeks after exposure

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60
Q

What is the treatment for AIDS patient with Histoplasmosis?

A

Severe –> IV amphotericin
mild –> itraconazole

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61
Q

What is the treatment of coccidiomycosis in AIDS patient?

A

Same as Histoplasmosis

Severe –> IV amphotericin
mild –> itraconazole

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62
Q

What organism causes PCP (pneumocystis) pneumonia?

A

P. jirovecii – a yeast-like FUNGUS

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63
Q

What lab finding is common in PCP pneumonia?

A

elevated LDH
(also elevated A-a gradient)

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64
Q

What is the treatment for PCP pneumonia?

A

TMP-SMX
(in sulfa allergy, treat with clindamycin + primaquine)
■ Prednisone if A-a gradient > 35 or Pao2 < 70 mm Hg

■ Prophylaxis with TMP-SMX, 1 DS tab daily is indicated for CD4 < 200 cells/
mm3 and greatly decreases the incidence of PCP.

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65
Q

Cryptococcal meningitis is most commonly in patients with CD4 <_____ cells/mm3

A

100

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66
Q

How is cryptococcal meningitis diagnosed?

A

LP – fungal cultures is definitive

CSF cryptococcal antigen – is highly sensitive and specific
(India ink stain of CSF is only positive 75% of time)

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67
Q

What is the treatment for cryptococcal meningitis?

A

Admit for IV amphotericin and PO flucytosine, then requires lifelong tx with fluconazole

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68
Q

Describe microbiology of toxoplasma gondii

A

Protozoan parasite
Obligates intracellular
Found worldwide
Felines are host

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69
Q

What is the treatment for toxoplasmosis?

A

Pyrimethamine + sulfadiazine (+ folinic acid)
■ Steroids are indicated for significant edema/mass effect.

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70
Q

Primary CNS lymphoma occurs most commonly with CD4 < ___ cells/mm3

A

50

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71
Q

What is the CT appearance of Primary CNS lymphoma?

A

Focal lesion (usually solitary) that enhances with contrast. Hyperdense/ isodense periventricular enhancement is often seen.

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72
Q

What is the treatment for Primary CNS lymphoma?

A

Chemotherapy + radiation
(median survival <1 month)

73
Q

How does Progressive Multifocal Leukoencephalopathy (PML) appear on CT?

A

Single or multiple NON-enhancing white-matter lesions

74
Q

What is the treatment for PML?

A

Highly active antiretroviral therapy (HAART)
prognosis is poor

75
Q

What is the treatment of thrush?

A

mild –> nystatin or clotrimazole topical therapy
recurrent/refractory or severe disease –> fluconazole

76
Q

What are the three most common causes of esophagitis in HIV-positive patients?

A

candida albicans (especially if with thrush)
HSV
CMV

77
Q

What is the treatment for esophagitis in HIV patient?

A

Presence of thrush: Empiric trial of fluconazole
Absence of thrush or no response to fluconazole: Endoscopy and biopsy to guide treatment

78
Q

What is the treatment for Mycobacterium avium-intracellulare (MAI) infection?

A

Clarithromycin or Azithromycin +Ethambutol

79
Q

What do you call the angioproliferative disease occurring in HIV patients with prior HHV-8 infection?

A

Kaposi sarcoma

80
Q

What are the signs and symptoms of Kaposis Sarcoma?

A

■ Papules or nodules that are pink, red, or purple in color
■ Painless/nonblanching
■ Commonly on lower limbs, face, mouth, and genitals
■ Respiratory and GI involvement can occur

81
Q

What is the treatment for Kaposi Sarcoma?

A

antiretroviral therapy – disease may regress as CD4 counts rise
Palliation:cryotherapy, radiotherapy, systemic chemo

82
Q

What is the #1 cause of AIDS -associated blindness?

A

CMV retinitis (occurs with CD4 <100)
causes a severe necrotic vasculitis and retinitis

83
Q

Describe the eye / retinal exam of CMV retinitis

A

Retina: Fluffy white perivascular lesions (“cotton-wool spots”)

84
Q

What is the treatment for CMV retinitis?

A

Ganciclovir

85
Q

What is a common complication of treatment with NRTIs? (eg, stavudine, zidovudine, didanosine, and lamivudine)

A

Lactic acidosis – untreated mortality rate of 50%

86
Q

How is Hantavirus spread?

A

inhalation of feces/urine or direct bite from rodents (primarily deer mouse)
majority occur in southwestern united states

87
Q

What is Hantavirus Pulmonary Syndrome?

A

characterized by a flulike prodrome for
3-4 days, followed by noncardiogenic pulmonary edema and hypotension

88
Q

What is Hantavirus hemorrhagic fever?

A

fever,
hemorrhage, hypotension, and renal failure

89
Q

What are common lab findings in Hantavirus infections?

A

Thrombocytopenia and marked leukocytosis

90
Q

How is Hantavirus definitively diagnosed?

A

Immunofluorescent or immunoblot assays

91
Q

What is the treatment for Hantavirus infections?

A

Supportive care

92
Q

What type of virus is west nile virus?

A

Flavivirus

93
Q

What are the symptoms of West Nile fever?

A

fever, flu-like illness with URI
and maculopapular central rash
symptoms last about 3-6 days

94
Q

What are CSF findings of meningoencephalitis?

A

increased lymphocytes and protein,
normal glucose

95
Q

How is meningoencephalitis diagnosed?

A

IgM antibody in CSF or serum.

96
Q

What is the treatment for west nile virus?

A

supportive

97
Q

What organism causes Lyme disease?

A

Borrelia burgdorferi

98
Q

What is the microbiology of Borrelia burgdorferi?

A

Gram-negative bacterium
Spirochete (helical shape)
Extracellular
Tick transmitted

99
Q

What are the three stages of lyme disease?

A

Early localized
early disseminated
late disseminated

100
Q

How is Lyme Disease diagnosed?

A

Screening test: ELISA (89% sensitive, 72% specific, false positives common)
Confirmatory test: Western blot assay

101
Q

What is the treatment for Lyme Disease?

A

Depends on the stage
1. early localized –> doxycycline PO x 21d
2. Early disseminated with arthritis –> Doxycycline PO x30d

  1. Early disseminated with neuro or cardiac sx
    - if isolated CN palsy or first degree AV block –> Doxycycline PO × 21 d
    OR
    –> Ceftriaxone IV at meningitic doses (all other presentations)
102
Q

When is Lyme Disease prophylaxis indicated? Dose?

A

Ixodes tick bite and only if tick is attached > 36 hours
Single 200-mg dose doxycycline within 72 hours of tick removal

103
Q

Which ticks are responsible for the spread of Rickettsia ricketsii (RMSF)?

A

Dermacentor variabilis (dog tick) and Dermacentor andersoni (wood tick)

104
Q

Describe the pathogenesis of RMSF?

A

Tick bite and transmission → invasion and proliferation of organism within
capillary and precapillary endothelial cells → perivascular inflammation →
platelet and fibrin occlusion of vessels and multisystem disease

105
Q

Describe the rash of Rocky Mountain Spotted Fever.

A

Maculopapular → petechial/purpuric
■ Starts on wrists/ankles
■ Spreads centripetally (extremities → trunk)
■ Classically involves palms and soles (50%)

106
Q

How is Rocky Mountain Spotted Fever diagnosed?

A

based on clinical suspicion
Serology can be done but takes 6-10 days

107
Q

Which lab findings are common in RMSF?

A

Hyponatremia and thrombocytopenia (in advanced disease)

108
Q

What is the treatment for RMSF?

A

■ Treat empirically for clinical suspicion due to high mortality rates (roughly
3%-5% despite treatment, 25% if untreated).
■ Supportive therapy, low threshold for admission
■ Antibiotics: Doxycycline, tetracycline, or chloramphenicol

109
Q

What are common complications of RMSF?

A

ARDS
myocarditis, CHF
DIC
seizures, encephalitis

110
Q

What are the two types of ehrlichiosis?

A

human monocyte ehrlichiosis
human granulocytic ehrlichiosis
(depends on which immune cell is invaded)

111
Q

What organism causes human monocyte ehrlichiosis?

A

Ehrlichia chaffeensis

112
Q

What organism causes human granulocytic ehrlichiosis?

A

Anaplasma
phagocytophilum.

113
Q

Describe the microbiology of Ehrlichia chaffeensis and Anaplasma phagocytophilum.

A

Gram-negative coccobacilli
Obligates intracellular (monocyte or
granulocyte)
Tick transmitted

114
Q

What lab findings are commonly seen in Erhlichiosis?

A

Leukopenia, thrombocytopenia, transaminitis (50%-90%)

115
Q

How is Erlichiosis diagnosed?

A

IgG antibody titers or culture/biopsy
■ Definitive: PCR

116
Q

What is the treatment for Erlichiosis?

A

Doxycycline, tetracycline, or rifampin

117
Q

What organism causes Babesiosis?

A

Babesia genus;
Parasitic protozoan
Pleomorphic
Intraerythrocytic
Transmitted by ticks

118
Q

what is the vector for babesiosis? reservoir?

A

Ixodes ticks with a reservoir in deer and mice

119
Q

How does babesiosis present?

A

Mild –> flu-like illness +/- splenomegaly
Severe –> hemolytic anemia, jaundice, renal insufficiency, ARDS

120
Q

How is Babesiosis diagnosed?

A

Thick and thin Giemsa-stained smears
■ Erythrocytes show budding tetrad in “Maltese cross” formation.

121
Q

What is the treatment for Babesiosis?

A

■ Mild disease → no treatment
■ Severe disease or postsplenectomy → quinine + clindamycin
■ Exchange transfusion if fulminant

122
Q

What pathogen causes Q fever?

A

Coxiella burnetii

123
Q

Describe the microbiology of Coxiella burnetii

A

Gram-negative bacterium
Obligates intracellular
Transmitted by ticks, exposure to animal
products or raw milk
Highly infectious

124
Q

What are the symptoms of Q Fever?

A

flulike symptoms, pneumonia, hepatitis

125
Q

How is Q fever diagnosed?

A

■ Often clinical
■ Definitive: PCR, serologies (positive 2-3 weeks after infection)

126
Q

How is Q fever treated?

A

Doxycycline, tetracycline, or chloramphenicol

127
Q

What are 3 common complications of Babesiosis?

A

Endocarditis (up to 68%), granulomatous hepatitis, osteomyelitis (peds)

128
Q

What pathogen causes Colorado tick fever?

A

Colorado tick fever virus

129
Q

How is Colorado tick fever virus transmitted?

A

D. andersoni
(wood tick)

130
Q

What are the symptoms of Colorado Tick Fever?

A

Classic biphasic fever and flulike symptoms, each lasting for a few days

rarely can cause meningoencephalitis

131
Q

How is Colorado Tick Fever diagnosed?

A

clinically

132
Q

What is the treatment for Colorado Tick Fever?

A

supportive

133
Q

Malaria is spread by the ____ mosquito.

134
Q

Describe the lifecycle of plasmodium species

A

Mosquito transmits asexual haploid form of Plasmodium → migrates to liver
and matures to produce merozoites → released from liver and invade RBCs →
mature in 48-72 hours causing RBC lysis and release of additional merozoites
→ invade more RBCs → hemolytic anemia

135
Q

What are the symptoms of uncomplicated malaria?

A

flulike illness, mild jaundice, and splenomegaly (after several days of illness)

136
Q

What is the presentation of severe or complicated malaria?

A

toxic/septic appearance
acute lung injury

137
Q

What is the treatment for uncomplicated malaria in adults (Central American and Caribbean)?

A

Chloroquine phosphate

138
Q

What is the treatment for uncomplicated malaria in PEDIATRICS (Central American and Caribbean)?

A

Chloroquine Phosphate

139
Q

What is the treatment for uncomplicated malaria in adults (South American, South Asia, Africa – chloroquine resistant)?

A

Quinine Sulfate (PO) + Doxycycline
OR
Atovaquone/proguanil
OR
Mefloquine

140
Q

What is the treatment for uncomplicated malaria in PEDIATRICS (South American, South Asia, Africa – chloroquine resistant)?

A

Quinine Sulfate (PO) + PYRAMETHAMINE SULFADOXINE
OR
Atovaquone/proguanil
OR
Mefloquine

141
Q

What is the treatment for complicated malaria in adults?

A

Quinidine Gluconate (IV) +Doxycycline

142
Q

What is the treatment for complicated malaria in pediatrics?

A

Quinidine Gluconate (IV)

143
Q

What species typically causes complicated/severe malaria?

A

Plasmodium falciparum

144
Q

How is malaria definitively diagnosed?

A

Plasmodial parasites on Giemsa-stained thick and thin smears

145
Q

For P. vivax, P. ovale, which have a dormant hepatic phase, add ______ to prevent relapse, but FIRST test for _______.

A

primaquine
G6PD

146
Q

What are the signs and symptoms of Ebola?

A

fever, headache, myalgias
n/v/d
rash
unexplained easy bruising/bleeding

causes a viral hemorrhagic fever

147
Q

What is the treatment for ebola virus?

A

isolation precautions
supportive care

148
Q

How is ebola spread?

A

bodily fluids

149
Q

_____ presents with fever and dramatic bone pain in the traveler

150
Q

What virus causes Dengue?

A

Flavivirus

151
Q

Flavivirus is transmitted to humans by the ______ mosquito.

A

Aedes – bites during the day (in contrast to Anopheles which causes malaria, bites at night or dusk)

152
Q

What is the incubation period for malaria?

153
Q

What is the incubation period for Dengue?

154
Q

What are the signs & symptoms of Dengue?

A

high fever, n/v, severe bone pain/myalgias/arthralgias
“Dengue facies” = classic facial edema
Pale morbilliform rash develops following defervescence; starts on trunk,
spreads to extremities/face

155
Q

How is Dengue diagnosed?

A

clinically, but rule out malaria
Definitive Dx by ELISA

156
Q

What is the treatment for Dengue?

A

supportive

157
Q

What is a risk factor for Dengue hemorrhagic fever?

A

most often occurs following exposure to second serotype

158
Q

Describe the course of Dengue Hemorrhagic fever.

A

Initial clinical course is similar to classic dengue.
Second phase of illness begins as initial symptoms are resolving

Fatigue
shock
bleeding diathesis with hemorrhagic pleural effusions
thrombocytopenia

mortality = 50% without care (<5% with care)

159
Q

What pathogen causes Leptospirosis?

A

bacterial spirochete Leptospira interrogans

160
Q

How is leptospirosis transmitted?

A

percutaneous or mucus membrane contact with
FRESHwater contaminated by the urine of infected rodents, livestock, or domestic animals

161
Q

Describe the signs and symptoms of the Acute bacteremic phase of leptospirosis?

A

range from mild illness to abrupt high fever/chills, intense headache (often worst of life) and severe myalgias
Conjunctive suffusion (redness without exudates) = pathognomonic

162
Q

What are the signs and symptoms of Weil syndrome caused by Leptospira?

A

severe icterus
renal failure
hemorrhage
acute lung injury/ARDS

163
Q

What lab abnormalities are seen with Leptospirosis?

A

increased WBC and bilirubin (relative mild increase in alk phos and transaminases)

164
Q

How is leptospirosis diagnosed?

A

acute phase –> clinical dx
definitive: isolation of leptospires in urine or CSF

165
Q

How is Leptospirosis treated?

A

mild disease: Doxycycline/Amoxicillin
severe disease: penicillin/ampicillin/ceftriaxone

(treatment is most effective without first 4 days and may prevent Weil syndrome)
treat empirically if suspicion is high

166
Q

What pathogen causes Chagas disease?

A

Trypanosoma cruzi

167
Q

How is trypanosoma cruzi transmitted?

A

by contact with feces of the blood-sucking triatomine type of reduviid bugs (“kissing” bugs)

168
Q

What are the signs and symptoms and timing of the acute phase of Chagas disease?

A

2-30 days after infection
weeks-months duration

edema at the inoculation site (often the eyelid)
malaise, fever, anorexia, myalgias
hepatosplenomegaly, lymphadenopathy

169
Q

What are the signs and symptoms and timing of the chronic phase of Chagas disease?

A

10-20 years postinfection

Cardiomyopathy
Megaesophagus
Megacolon

170
Q

How is Chagas disease diagnosed?

A

acute phase –> observe parasite on thick and thin blood smears
chronic disease –> serologic testing

171
Q

What is the treatment for Chagas disease?

A

Nifurtimox

172
Q

What medications are used for HIV post-exposure prophylaxis?

A

Tenofovir-emtricitabine (Truvada) + raltegravir (Isentress)

Recommended in known HIV+ or at high risk of HIV

173
Q

What medications are used for Hep B post-exposure prophylaxis?

A

Hepatitis B immunoglobulin (HBIG)
Hepatitis B vaccination: Usually given as three doses over 4-6 months with first dose given with HBIG in different site

recommended for any blood or bodily fluid exposure if not fully vaccinated or known nonresponder

174
Q

What is the only vaccine given at birth?

175
Q

Which 6 vaccines are given at 2 months old?

A

Hep B - second dose
RV (rotavirus)
DTaP (diptheria, tetanus, and pertussis)
Hib (h. influenzae type b)
PCV (pneumococcus)
IPV (polio)

176
Q

What is the youngest age you can begin getting an annual influenza vaccine?

177
Q

When are MMR and Varicella vaccines administered

178
Q

In Lyme meningitis, what CSF finding is most sensitive?

A

Borrelia Burgdorferi Antibody
(PCR is positive in less than half of patients)

ITE '23 (20 decks)

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