Clin Med ID Flashcards
1
Q
Gram-positive bacteria have a _________ peptidoglycan layer
A
Thick
2
Q
Do gram positive bacteria retain or not retain crystal violet stain?
A
Retain
3
Q
What color do gram negative bacteria stain?
A
Pink
4
Q
Do gram negative bacteria have an outer lipid membrane?
A
Yes
5
Q
In microbiology lab, serology includes
A
Antibody testing
antigen testing
6
Q
What is a culture used to identify?
A
Susceptibility
7
Q
How long to get species identification in culture
A
Within 24 hours
8
Q
How long to get susceptibilities of a culture
A
Within 48 hours
9
Q
What is prevalence?
A
The number of cases of an illness overall, whether new or chronic
10
Q
What is incidence?
A
Number of new cases
11
Q
5 families of gram + bacteria (broad) we discussed
A
Staphylococcus
Streptococcus
Enterococcus
Clostridium
Corynebacterium
12
Q
Families of gram - bacteria (broad) we discussed
A
Campylobacter
Salmonella
Vibrio
Shigella
Bordetella
13
Q
What are the two non cell wall organisms mentioned in lecture?
A
Chlamydia
Mycoplasma
14
Q
Morphology of streptococcus
A
Gram + clusters
15
Q
Staphylococcus catalase positive result indicates what specific bacteria
A
Staph aureus
16
Q
Staphylococcus catalase negative result indicates what possible bacteria?
A
S. epidermis
S. saprophyticus
S. lugdunensis
17
Q
S. aureus found where
A
Also common on skin, found in moist areas, nasal carriage 30% of people
18
Q
Most common portal of entry for s. aureus is
A
Skin
19
Q
Staph saprophyticus is a common cause of
A
Urinary tract infections
20
Q
S. aureus is a ________ mediated disease
A
Toxin
21
Q
Scalded skin syndrome caused by
A
S. aureus
22
Q
Purulent drainage in a wound would indicate what bacteria
A
S. aureus
23
Q
Erythematous wound with no purulent drainage would indicate what bacteria
A
Strep
24
Q
MSSA
A
Methicillin Sensitive Staph Aureus
25
Methicillin is what type of antibiotic?
Beta-lactam
26
Frontline oral ABx choice for MSSA?
Cephalexin
27
Frontline IV ABx choice for MSSA?
Nafcillin or cefazolin if needed
28
What are the two types of MRSA?
Community acquired
Hospital acquired
29
Frontline ABx for community acquired MRSA?
Doxycycline, bactrim
30
Why is clindamycin not recommended empirically for MRSA?
Resistance is common
31
Frontline ABx for hospital acquired MRSA
Vancomycin, daptomycin, ceftaroline
32
Empiric coverage of severe infections is always what ABx?
Vancomycin
33
Once sensitivities are available, what can you do to ABx regimen?
De-escalate
34
Why is source control important?
If possible, drainage and removal of infected source can lead to better outcomes
35
S. saprophyticus treatment
Bactrim, augmentin (amox), cipro
36
Alpha hemolysis
Partial hemolysis (green)
37
Beta hemolysis
Complete lysis of red blood cells (no green on blood agar)
38
Group A strep, also known as
Strep pyogenes
39
Strep pyogenes found where?
Skin
40
Common syndromes caused by strep pyogenes?
Pharyngitis
Skin/soft tissue infections (non purulent cellulitis)
41
Two possible severe syndromes caused by strep pyogenes?
Scarlet fever
Toxic shock syndrome
42
Two POST infectious syndromes caused by strep pyogenes?
Rheumatic fever
Glomerulonephritis
43
Most common presentation of rheumatic fever is ______________
Carditis/valvitis (mid systolic murmur)
44
Syndenham’s chorea
Associated with strep pyogenes
causes involuntary rapid movement of limbs, trunk, face, neck
45
Erythema marginatum in rheumatic fever
The skin manifestations associated with acute rheumatic fever include a rash that usually appears early in the course of the disease (non pruritic pink/red rings on trunk)
46
Group B strep, also known as
Strep. Agalactiae
47
Group B strep often causes
Neonatal sepsis, bacteremia, soft tissue infections
48
Group D strep associated with what malignancy?
GI - colon cancer
49
Virdans streptococci
Alpha hemolytic strep found in oral/GI flora that can be a contaminant
Common in IV drug users (licking needle), can cause wound, bacteremia w/ endocarditis
50
Strep pneumoniae morphology
Gram positive diplococcus
51
Common syndromes of strep pneumoniae
Otitis media
Pneumonia
Sinusitis
Meningitis
Conjunctivitis
52
Name of vaccine for strep pneumoniae?
Prevnar (peds)
Pneumovax (adults)
53
Treatment of choice for group A strep?
Penicillin and amoxicillin
Others: Cephalexin
Clindamycin
54
Why is azithromycin not recommended for treating group A strep?
Increasing resistance
55
Strep pneumoniae have an increasing resistance to what
Beta lactam ABx
56
Drug of choice for strep pneumoniae?
IV or oral 2nd or 3rd gen cephalosporin (ceftriaxone IV or cefdinir oral)
57
Alternatives to beta lactam ABx for strep pneumoniae?
Levofloxacin
Vancomycin
Linezolid
58
Enterococcus morphology
Gram positive short chains
59
Why does male foley catheter make more susceptible to enterococcal infection?
Insertion can take away natural defense mechanism and introduce bacteria into urethra
60
VRE
Vancomycin resistant enterococcus
61
Treatment for VRE
Daptomycin, linezolid
62
Treatment for enterococcus
Ampicillin IV or Amoxicillin oral (if susceptible)
Vancomycin if resistant or have beta-lactam allergy
63
Enterococcus are always resistant to __________ and ___________
Bactrim
Cephalosporins
64
Clostridium tetani morphology
Gram positive bacillus, forms spores (important)
65
Clostridium tetani found where
Soil and feces
66
Clostridium tetani can cause
“Lock jaw”
Possible death from autonomic instability and respiratory arrest
67
Treatment for clostridium tetani
Prevention! Vaccination
Metronidazole for soft tissue infection
68
Clostridium botulinum morphology
Gram + bacillus, spore former, obligate anaerobe
69
Source for clostridium botulinum?
Food borne (amongst other things)
70
Symptoms of botulism
( The 4 Ds)
-Diplopia
-Dysarthria
-Dysphagia
-*Descending paralysis
71
Clostridium difficile morphology
Gram + bacillus
Spore former
Obligate anaerobe
72
Treatment of clostridium difficile
Oral vancomycin
IV metronidazole
Vancomycin enema if unable to tolerate PO
73
Clostridium perfringens, septicum, sordelli
Gram + obligate anaerobe
74
Clostridium perfringens, septicum, sordelli can rapidly progress into
Fever, shock, pain, (sepsis)
75
Treatment for clostridium perfringens, septicum, sordelli
Surgery
Clindamycin
Penicillin
76
Corynebacterium morphology
Gram + bacillus
Club shaped
Facultative anaerobe
77
Disease in corynebacterium caused by
Exotoxin
78
Mortality cases of corynebacterium
Airway obstruction (remember bull neck and pseudomembrane on back of pharynx)
79
Treatment for corynebacterium
Vaccine (diphtheria)
Antitoxin
Penicillin or erythromycin
80
Campylobacter jejuni morphology
Gram negative curved bacillus
81
Most common bacteria causing food poisoning?
Campylobacter jejuni
82
How long for onset of campylobacter infection symptoms?
2-5 days
83
Guillian barre syndrome has associated with what
Campylobacter jejuni
84
Diagnosis of campylobacter jejuni
Stool culture
85
Campylobacter treatment
Azithromycin
Increasing resistance to cipro
86
Salmonella morphology
Gram negative rods, aerobic
87
Salmonella responsible for what syndromes
Acute gastroenteritis
Non blood diarrhea, cramps potential for renters syndrome
Reactive arthritis
Conjunctivitis
Urethritis
Bacteremia
Osteomyelitis
Septic arthritis
88
Treatment for salmonella
Mild: rehydration, no ABx
Severe: Oral/IV ABx
Ceftriaxone
Cipro
Azithromycin
Bactrim
89
Vibrio morphology
Gram negative coccobacillus, aerobic
90
Vibrio is _______ borne
Water
91
Main clinical feature of vibrio
Profound, acute watery diarrhea (looks like rice water, literally)
92
Treatment for vibrio
Rehydration
Doxycycline
Azithromycin
Bactrim
Cipro
93
Shigella dysenteriae morphology
Gram negative rod
94
Clinical manifestation of shigella?
“Dysentary picture”
Fever, cramps, tenesmus
Bloody diarrhea
95
Shigella treatment
Fluid
Azithromycin, cipro, bactrim, ceftriaxone
96
Bordetella Pertussis is also known as
Whooping cough
97
Bordetella morphology
Gram - coccobaccli, aerobic
98
Stages of Bordetella infection
Catarrhal
Paroxysmal
Convalescent
99
Treatment for pertussis (Bordetella)
Vaccination
Azithromycin
Bactrim
Consider prophylaxis
100
8 year old with fever, sore throat, no coryza symptoms, anterior lymph nodes.
Likely bacteria and treatment?
Group A strep
Penicillin, amoxicillin
101
24 year old with swollen, red left arm.
Febrile 3x3 abscess with pointing and erythema
Likely bacteria? Treatment?
S. aureus
Bactrim or doxycycline
102
37 y/o with abdominal cramping and soft diarrhea
n/a, afebrile
Likely bacteria?
Treatment?
Campylobacter/salmonella
Hydration and supportive care
103
14 year old with fever, knee pain and rash
sore throat week prior febrile
erythematous rash painless nodules over shin and forearms
knee warm to touch
mid systolic murmur on auscultation
diagnosis?
treatment?
Rheumatic fever
Supportive care
Get rid of the strep!
104
E. coli morphology
Aerobic gram negative rod
Spore forming
105
Name 2 virulence factors for E. coli
Lipopolysaccharides
Shiga toxin
106
E. coli is the most common cause of
Urinary tract infections
107
Enterotoxigenic E. coli (ETEC)
penetrate the intestinal epithelium and produce a toxin that causes gastroenteritis
Traveler’s diarrhea
108
Shiga toxin producing E. coli (STEC)
This group contains E. coli O157:H7 and other virulent strains that cause hemolytic uremic syndrome and other debilitating effects
109
Enteropathogenic E. coli (EPEC)
Person to person spread, causes watery diarrhea, adhesion to intestinal lining
110
Enteroinvasive E. coli (EIEC)
Causes shigella-like dysentery, direct invasion of colonic cells
111
Enteroaggretive E. Coli (EAEC)
Traveller’s diarrhea, PERSISTENT diarrhea
adherence and replication
112
98% of uncomplicated cystitis cases are caused by
E. coli
113
More serious complications of E. coli related UTI?
Pyelonephritis
Urosepsis
114
How can E. coli become pathogenic in the intestines?
If the natural barriers are disrupted, can lead to peritonitis or intraperitoneal abscess
115
What is a neonatal risk for E. coli?
Neonatal meningitis
116
Treatment for E. coli
Hydration/symptomatic treatment
Non bloody diarrhea: Cipro, bactrim, rifaximin
Blood diarrhea: NO ABX OR MOTILITY AGENTS (until you confirm diagnosis with stool culture)
117
Treatment for (E. coli) uncomplicated cystitis
Macrobid
Bactrim
118
Treatment for E. coli complicated cystitis
Quinolone
3rd Gen cephalosporins
119
Pyelonephritis (E. coli) treatment
Ciprofloxacin, ceftriaxone, bactrim
120
Intra-abdominal infections (E. coli)
3rd or 4th gen cephalosporins
Quinones
Zosyn
121
Gonococcus morphology
Gram negative diplococcus
122
Neiserria meningitidis can cause what
Bacterial meningitis
123
Neisseria gonorrhoeae is the _______ most reportable condition in the US (2017)
2nd
124
Diagnosis of Neisseria
NAAT/PCR
Swabs: urine, endocervical, rectal, throat, blood culture
125
What is one life threatening/altering complication of gonoccal infections that he mentioned several times
Conjunctivitis that can lead to blindness/permanent vision loss
126
What is fitz-hugh-curtis syndrome?
Perihepatic gonorrhea infection
127
Treatment for uncomplicated gonococcal infection
Ceftriaxone + Azithromycin
Gentamicin + Azithromycin
128
Treatment for disseminated gonococcal disease
Ceftriaxone + Azithromycin
129
TB is diagnosed via what
Acid fast bacillus
130
Three spectrums of TB
Pulmonary TB
Latent TB
Disseminated disease
131
TB forms small ______ in the lungs due to alveolar macrophages phagocytizing the infection
Granulomas
132
Hallmark sign of active TB
Cough for 3+ weeks
Hemoptysis
Fever with night sweats
Weight loss
133
Latent TB likes to live in the upper or lower lobes?
Upper
134
Latent TB is contagious or not
Not contagious
135
Diagnosis of active TB
Sputum culture - morning sputum for AFB
136
Diagnosis of latent TB
Quantiferon/T-spot
PPD
137
Treatment for active TB
Notify Public Health
Airborne isolation
RIPE (rifampin,isoniazid, pyrazinamide, ethambutol)
Multiple drugs, multiple months
138
Treatment for latent TB
Isoniazid x9 months
Isoniazid + rifapentine weekly x12
139
Major atypical mycobacteria we talked about?
Mycobacterium avium complex
140
Treatment for pulmonary MAC?
Macrolide (“mycin”) + ethambutol + rifampin
Duration is 12 months after last positive culture
141
Treatment for disseminated MAC?
Macrolide (“mycin”) + ethambutol + rifampin
Continue until 12 months, no signs of MAC, and CD4 >100 for >6 months
142
What atypical mycobacteria can commonly cause skin infections?
M. marium
143
Histoplasma capsulatum
Dimorphic fungi (mold or yeast)
144
Histoplasm capsulatum is found where
Dirt/soil
145
Primary disease histoplasma presentation
Often asymptotic and self limiting, but can progress
Localized to lungs, lymphadenopathy
146
Histoplasma diagnosis
Culture (sputum, blood, tissue biopsy)
Stains
Serology (most helpful with subacute)
Urinary antigen
147
Treatment for pulmonary histoplasma?
Mild = no treatment necessary
Moderate to severe: liposomal amphoterocin B followed by Itraconazole
148
Treatment for disseminated histoplasma
Mild to moderate: Itraconazole
Disseminated: Lipopsomal amphoterocin B followed by Itraconazole
149
Cryptococcus morphology
Yeast, found in soil
150
Cryptococcus is most severe in patients with
Decreased cell mediated immunity (HIV, chronic steroids, transplant patients)
Healthy people rarely become infected
151
Clinical presentation of cryptococcus
Pneumonia
Thin disseminated spread
Most common: Meningoencephalitis
152
Cryptococcus diagnosis
Cryptococcal antigen
CSF culture and stain (India ink)
Respiratory culture
153
Pulmonary cryptococcus treatment
Fluconazole
154
CNS cryptococcus treatment
Induction phase: Flucytosine + liposomal
amphoterocin B
Consolidated phase and maintenance: Fluconazole
155
Treponema pallidum
Syphilis causative agent
156
Syphilis transmitted via
Sexual contact
Mother to fetus
Blood products
Breaks in skin
157
Syphilis penetrates _________
Intact mucous membranes (doesn’t need opening)
158
Primary Syphillis
Painless chancre (ulcer), punched out base and rolled edges
159
Secondary syphillis
Mucotaneous lesions over whole body (including palmer/plantar)
Condylomata lata (warts)- painless, highly contagious lesions on warm moist sites
160
Tertiary syphillis
Cardiovascular syphillis
Neurosyphillis
Gummatous
Syphillis meningitis
161
What is an Argyll Robertson pupil?
One that accommodates but does not I react to light
Seen in syphillis meningitis
162
What is most common presentation of cardiovascular syphillis?
Ascending aortic aneurysm
163
Congenital syphilis
Paresis
Saber shins (outward curve like a saber)
Saddle nose
Hutchinson’s teeth (smaller and more widely spaced)
164
Syphillis diagnosis
Dark field microscopy
Serology (VDRL)
Rapid plasma reagent (RPF) with serial dilution
165
Syphillis treatment
Primary: Benzathine penicillin 2.4 MU IM
If allergy: doxycycline
Latent: Benzathine penicillin 2.4 MU IM weekly x3
Neuro/ocular syphillis: Penicillin G IV 10-14 days
166
Rocky Mountain spotted fever causative agent
Rickettsia rickettsii
Dog tick
167
Rocky Mountain spotted fever hall mark
Petechial rash beginning on the palms of the hands and soles of feet
168
RMSF most common in what geographic locations
North, Central America, especially SE and United States
169
Fever and petechial rash, you should be thinking
RMSF
Have high index of suspicion, this presentation isn’t good
170
RMSF can lead to
Sepsis like picture due to vascular permeability
171
Lab findings in RMSF
Leukopenia
Elevated LFTs
Thrombocytopenia
172
RMSF diagnosis
Serology
Blood culture
Lumbar puncture
173
RMSF treatment
Doxycycline
Chloramphenicol in pregnancy
Prevention
174
Lyme disease causative agent
Borrelia burgdorferi
175
Lyme common in what geographic areas
Northeastern US and Europe
176
Primary reservoirs for Lyme
Rodents
177
Early localized phase of Lyme
Erythema migricans
Flu-like
Bullseye rash
178
Early disseminated phase of Lyme
Weeks to months
Multiple lesions
Possible meningitis/Bell’s palsy
Cardiovascular: AV block, BBB
TRIAD: Meningitis, cranial neuropathy/cerebellar ataxia, encephalomyelitis
179
Late Lyme phase
If untreated
Arthritis, encephalopathy (months to years later)
180
Lyme disease diagnosis
Early: clinical
Disseminated or late: serology, PCr, CSF
181
Lyme treatment
Doxycycline
Amoxicillin (kids)
IV ceftriaxone for severe
Prophylaxis one time with 200 mg doxycycline 80% effective
182
Anaplasma morphology
Intracellular gram - rod
Tick borne
183
Anaplasma presentation
Abrupt flu like illness (headache, myalgia, N/V/ABD pain
maculopaular exanthema +/- petechiae)
184
Anaplasma diagnosis
Serology
PCr
Morulae on blood smear
185
Anaplasma treatment
Doxycycline
Rifampin if pregnant
186
Ehrilichia morphology
Intracellular gram - Rod
Tick borne
187
Ehrilichia seen in what geographic areas
Southern US, “lone star tick”
188
Ehrilichia presentation
5-15 days after bite
Cough
Diarrhea
LFTs increases, thrombocytopenia, leukpenia
Rash
Meningitis
189
Ehrilichia diagnosis
Serology
PCr
Morulae on blood smear
190
Ehrilichia treatment
Doxycycline
Rifampin if pregnant
191
Mycoplasma pneumoniae (walking pneumonia) morphology
Non cell wall bacteria
192
Important clinical distinction for mycoplasma pneumonia
Non productive cough (sputum is scant)
193
Why can't we use beta-lactam ABx on mycoplasma pneumoniae?
No cell wall!
194
Mycoplasma pneumonia diagnosis
Serology
PCr
No sputum culture
195
Mycoplasma pneumonia treatment
Macrolides (Azithromycin, doxycycline)
Quinolones (levaquin/moxifloxacin)
196
Chlamydophilia psittaci morphology
Non cell wall
197
Chlamydophilia psittaci comes from where
Birds
198
Chlamydophilia psittaci presentation
Abrupt onset of constitutional symptoms
199
Chlamydophilia psittaci treatment
Macrolides (Azithromycin, doxycycline)
Quinolones (levaquin/moxifloxacin)
200
Chlamydia trachomatis most commonly reported
STD
201
#1 main important side effect of chlamydia trachomatis
Blindness
Chronic keratoconjunctivitis
202
Erythromycin ointment at birth used to prevent
Chlamydia trachomatis
203
Chlamydia trachomatis diagnosis
Urine PCr (men mostly)
Swab for NAAT/PCr
204
Chlamydia trachomatis treatment
Azithromycin (1gram PO)
or doxycycline (100 mg Q12 x7 days)
Levofloxacin
No sex for at least 7 days after treatment
205
“Dysregulated inflammatory response than can lead to life threatening multi-organ failure”
Sepsis
206
Mortality rate of sepsis
10-52%
207
Clinical presentation of sepsis
Hypotension
Fever
Tachycardia
Tachypenia
Decreased urine output
Progressive shock
208
Labs in sepsis
Leukocytosis
Elevated lactate
Elevated CRP
Hyperglycemia
Elevated creatinine
Elevated bilirubin
209
Sepsis treatment
Supportive care (fluids, vasopressors, ventilatory support)
Empiric ABx and quickly!
210
Ascasris Lumbricoides is what type of worm
Roundworm (nematode)
211
Risk factors for Ascasris lumbricoides
Poor sanitation, travelers
212
Ascasris Lumbricoides presentation
Presents as pulmonary symptoms (cough/weezing), then potential for severe GI complaints due to blockage
213
Ascasris Lumbricoides diagnoses
Stool O&P for established infection
Sputum may reveal larvae
214
Ascasris Lumbricoides treatment
Albendazole or mebendazole
Pyrantel (safe in pregnancy)
Passage of worms (or possible EGD/colonoscopy, surgery)
215
Two types of hookworms
Nector americanus (lives longer, less blood loss) and
Ancylostoma duodenale (lives shorter, but more blood loss)
216
Big thing to look out for in hookworms
Iron deficiency anemia
217
Hookworm diagnosis
Direct microscopy
Chronic eosinophilia
218
Hookworm treatment
Albendazole or mebendazole
219
Pin worms causative agent
Enterobius vermicularis
220
Pin worms live where
Cecum
221
Hallmark classic presentation of pin worms
Pruritis ani at nighttime
222
Pinworms diagnosis
Cellophone tape test
Repeat examinations
223
Pinworms treatment
Albendazole or mebendazole
treat cohabitants
224
Tapeworms, AKA
cestodes
225
What is unique about tapeworms (in terms of a host)?
Need a primary and intermediate host
226
T. solium
Found in pork (most common)
227
Diphyllobacterium
Found in fish
228
Tapeworms primary host infection
Limited to GI tract
229
Tapeworms intermediate host
Can spread
230
Cysticercosis
Caused by larvae of pork tapeworm Taenia solium
Ingested eggs hatch in intestine and larvae are hematogenously distributed, forming cysticerci
3 stages of CNS disease:
Early phase, edema and/or nodular enhancement
Later, peripheral viable cysts
Scolex may be seen as small mural nodule
Late phase, peripheral calcifications without edema or enhancement
231
Neurocysticerocis
Taenia solium, predilection for brain/muscles, can cause seizures
232
Tapeworms diagnosis
Radiographic imaging
Pernicious anemia from Diphyllobacterium
233
Tapeworm treatment
Praziquantel or niclosamide
B-12 supplementation for Diphyllobacterium
May need dexamethasone for inflammation
234
Malaria morphology
Protozoa
Mosquito vector
235
Malaria causative agent
Plasmodium falciparum (most common)
236
Plasmodium has a predilection for
Blood cells
237
Malaria clinical presentation
-Cyclical fever
Cold phase (chills, shivering) —> hot phase (high grade fevers)
—-> sweating stage (diaphoresis, fever resolution)
238
Plasmodium incubation
7-30 days
239
Malaria complications- P.falciparum
Cerebral malaria (altered mental)
Renal failure
Hemoglobinuria
Non-cardiogenic pulmonary edema
240
What is one “profound” finding in malaria infection?
Hypoglycemia - monitor blood sugars
241
Malaria diagnosis
Thick and thin blood smear
Antigen testing
PCr
Other: G-6-PD
242
P. falciparum treatment
Quinine (with possible addition of clindamycin or doxycycline)
243
P vivax, ovale - treatment
Primaquine to kill liver phase
244
Malaria prevention
DEETm long clothing, bed nets, avoid dusk/dawn
245
Toxoplasma causative agent
Toxoplasma gondii (protozoan)
246
Is toxoplasma teratogenic?
Yes
“T” in torch infections
247
Acute toxoplasmosis presentation
80-90% asymptomatic
Fever, malaise, night sweats,myalgia (like everything)
Lymphadenopathy
248
Retinochoroditis complication of
Toxoplasma
249
Most significant manifestation of congenital toxoplasmosis is
Enecephalomyelitis
250
Toxoplasma diagnosis
Histopathology
Serology
PCr
Imaging
251
Toxoplasma treatment
Pyrimethamine and sulfadiazine
Bactrim, atovaquone, Azithromycin
252
Amebiasis causative agent
Entamoeba histolytica
(protozoan)
253
Amebiasis presentation
Most asymptomatic
Dysentary (can resemble IBD)
Amebic liver (extra intestinal disease)
254
Amebiasis
Serology
Stool
Antigen testing
PCr
Colonoscopy
Liver abscess aspiration (“anchovy paste”)
255
Amebiasis treatment (luminal)
Lodoquinol
Paramomycin
256
Amebiasis treatment (extraluminal)
Metronidazole
Tinidazole
257
Giardia causative agent
Giardia lamblia (tintestinalis)
258
Giardia found where
Water, common intestinal parasite
259
Giardia incubation
1-2 weeks
260
Giardia presentation
No fever
Asymptomatic
Diarrhea “Watery, greasy, large volume”
Chronic diarrhea/malabsorption
261
Giardia diagnosis
Stool (antigen testing, O&P, PCr)
262
Giardia treatment
Metronidazole or tinidazole
Paramomycin in pregnancy
Albendazole
263
Trichomonas causative agent
Trichomonas vaginalis
Motile protozoan
264
Trichomonas diagnosis
Wet mount slide or DFA
265
Trichomonas treatment
Metronidazole 500 mg PO BID x 7 days
266
Cryptosporidium causative agent
Cryptosporidium parvum
267
Cryptosporidium presentation
Acute large volume watery diarrhea
Camping
Self-limiting unless immunocompromised
268
Cryptosporidium diagnosis
Needs special stain or AFB
269
Cryptosporidium treatment
Not usually indicated
