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Didactic Year > Clin Med ID > Flashcards

Clin Med ID Flashcards

1
Q

Gram-positive bacteria have a _________ peptidoglycan layer

A

Thick

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2
Q

Do gram positive bacteria retain or not retain crystal violet stain?

A

Retain

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3
Q

What color do gram negative bacteria stain?

A

Pink

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4
Q

Do gram negative bacteria have an outer lipid membrane?

A

Yes

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5
Q

In microbiology lab, serology includes

A

Antibody testing
antigen testing

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6
Q

What is a culture used to identify?

A

Susceptibility

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7
Q

How long to get species identification in culture

A

Within 24 hours

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8
Q

How long to get susceptibilities of a culture

A

Within 48 hours

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9
Q

What is prevalence?

A

The number of cases of an illness overall, whether new or chronic

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10
Q

What is incidence?

A

Number of new cases

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11
Q

5 families of gram + bacteria (broad) we discussed

A

Staphylococcus
Streptococcus
Enterococcus
Clostridium
Corynebacterium

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12
Q

Families of gram - bacteria (broad) we discussed

A

Campylobacter
Salmonella
Vibrio
Shigella
Bordetella

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13
Q

What are the two non cell wall organisms mentioned in lecture?

A

Chlamydia
Mycoplasma

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14
Q

Morphology of streptococcus

A

Gram + clusters

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15
Q

Staphylococcus catalase positive result indicates what specific bacteria

A

Staph aureus

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16
Q

Staphylococcus catalase negative result indicates what possible bacteria?

A

S. epidermis
S. saprophyticus
S. lugdunensis

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17
Q

S. aureus found where

A

Also common on skin, found in moist areas, nasal carriage 30% of people

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18
Q

Most common portal of entry for s. aureus is

A

Skin

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19
Q

Staph saprophyticus is a common cause of

A

Urinary tract infections

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20
Q

S. aureus is a ________ mediated disease

A

Toxin

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21
Q

Scalded skin syndrome caused by

A

S. aureus

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22
Q

Purulent drainage in a wound would indicate what bacteria

A

S. aureus

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23
Q

Erythematous wound with no purulent drainage would indicate what bacteria

A

Strep

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24
Q

MSSA

A

Methicillin Sensitive Staph Aureus

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25
Q

Methicillin is what type of antibiotic?

A

Beta-lactam

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26
Q

Frontline oral ABx choice for MSSA?

A

Cephalexin

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27
Q

Frontline IV ABx choice for MSSA?

A

Nafcillin or cefazolin if needed

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28
Q

What are the two types of MRSA?

A

Community acquired
Hospital acquired

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29
Q

Frontline ABx for community acquired MRSA?

A

Doxycycline, bactrim

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30
Q

Why is clindamycin not recommended empirically for MRSA?

A

Resistance is common

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31
Q

Frontline ABx for hospital acquired MRSA

A

Vancomycin, daptomycin, ceftaroline

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32
Q

Empiric coverage of severe infections is always what ABx?

A

Vancomycin

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33
Q

Once sensitivities are available, what can you do to ABx regimen?

A

De-escalate

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34
Q

Why is source control important?

A

If possible, drainage and removal of infected source can lead to better outcomes

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35
Q

S. saprophyticus treatment

A

Bactrim, augmentin (amox), cipro

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36
Q

Alpha hemolysis

A

Partial hemolysis (green)

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37
Q

Beta hemolysis

A

Complete lysis of red blood cells (no green on blood agar)

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38
Q

Group A strep, also known as

A

Strep pyogenes

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39
Q

Strep pyogenes found where?

A

Skin

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40
Q

Common syndromes caused by strep pyogenes?

A

Pharyngitis
Skin/soft tissue infections (non purulent cellulitis)

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41
Q

Two possible severe syndromes caused by strep pyogenes?

A

Scarlet fever
Toxic shock syndrome

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42
Q

Two POST infectious syndromes caused by strep pyogenes?

A

Rheumatic fever
Glomerulonephritis

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43
Q

Most common presentation of rheumatic fever is ______________

A

Carditis/valvitis (mid systolic murmur)

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44
Q

Syndenham’s chorea

A

Associated with strep pyogenes
causes involuntary rapid movement of limbs, trunk, face, neck

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45
Q

Erythema marginatum in rheumatic fever

A

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)

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46
Q

Group B strep, also known as

A

Strep. Agalactiae

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47
Q

Group B strep often causes

A

Neonatal sepsis, bacteremia, soft tissue infections

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48
Q

Group D strep associated with what malignancy?

A

GI - colon cancer

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49
Q

Virdans streptococci

A

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

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50
Q

Strep pneumoniae morphology

A

Gram positive diplococcus

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51
Q

Common syndromes of strep pneumoniae

A

Otitis media
Pneumonia
Sinusitis
Meningitis
Conjunctivitis

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52
Q

Name of vaccine for strep pneumoniae?

A

Prevnar (peds)
Pneumovax (adults)

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53
Q

Treatment of choice for group A strep?

A

Penicillin and amoxicillin
Others: Cephalexin
Clindamycin

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54
Q

Why is azithromycin not recommended for treating group A strep?

A

Increasing resistance

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55
Q

Strep pneumoniae have an increasing resistance to what

A

Beta lactam ABx

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56
Q

Drug of choice for strep pneumoniae?

A

IV or oral 2nd or 3rd gen cephalosporin (ceftriaxone IV or cefdinir oral)

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57
Q

Alternatives to beta lactam ABx for strep pneumoniae?

A

Levofloxacin
Vancomycin
Linezolid

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58
Q

Enterococcus morphology

A

Gram positive short chains

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59
Q

Why does male foley catheter make more susceptible to enterococcal infection?

A

Insertion can take away natural defense mechanism and introduce bacteria into urethra

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60
Q

VRE

A

Vancomycin resistant enterococcus

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61
Q

Treatment for VRE

A

Daptomycin, linezolid

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62
Q

Treatment for enterococcus

A

Ampicillin IV or Amoxicillin oral (if susceptible)
Vancomycin if resistant or have beta-lactam allergy

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63
Q

Enterococcus are always resistant to __________ and ___________

A

Bactrim
Cephalosporins

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64
Q

Clostridium tetani morphology

A

Gram positive bacillus, forms spores (important)

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65
Q

Clostridium tetani found where

A

Soil and feces

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66
Q

Clostridium tetani can cause

A

“Lock jaw”
Possible death from autonomic instability and respiratory arrest

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67
Q

Treatment for clostridium tetani

A

Prevention! Vaccination
Metronidazole for soft tissue infection

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68
Q

Clostridium botulinum morphology

A

Gram + bacillus, spore former, obligate anaerobe

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69
Q

Source for clostridium botulinum?

A

Food borne (amongst other things)

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70
Q

Symptoms of botulism

A

( The 4 Ds)
-Diplopia
-Dysarthria
-Dysphagia
-*Descending paralysis

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71
Q

Clostridium difficile morphology

A

Gram + bacillus
Spore former
Obligate anaerobe

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72
Q

Treatment of clostridium difficile

A

Oral vancomycin
IV metronidazole
Vancomycin enema if unable to tolerate PO

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73
Q

Clostridium perfringens, septicum, sordelli

A

Gram + obligate anaerobe

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74
Q

Clostridium perfringens, septicum, sordelli can rapidly progress into

A

Fever, shock, pain, (sepsis)

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75
Q

Treatment for clostridium perfringens, septicum, sordelli

A

Surgery
Clindamycin
Penicillin

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76
Q

Corynebacterium morphology

A

Gram + bacillus
Club shaped
Facultative anaerobe

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77
Q

Disease in corynebacterium caused by

A

Exotoxin

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78
Q

Mortality cases of corynebacterium

A

Airway obstruction (remember bull neck and pseudomembrane on back of pharynx)

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79
Q

Treatment for corynebacterium

A

Vaccine (diphtheria)
Antitoxin
Penicillin or erythromycin

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80
Q

Campylobacter jejuni morphology

A

Gram negative curved bacillus

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81
Q

Most common bacteria causing food poisoning?

A

Campylobacter jejuni

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82
Q

How long for onset of campylobacter infection symptoms?

A

2-5 days

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83
Q

Guillian barre syndrome has associated with what

A

Campylobacter jejuni

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84
Q

Diagnosis of campylobacter jejuni

A

Stool culture

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85
Q

Campylobacter treatment

A

Azithromycin
Increasing resistance to cipro

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86
Q

Salmonella morphology

A

Gram negative rods, aerobic

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87
Q

Salmonella responsible for what syndromes

A

Acute gastroenteritis
Non blood diarrhea, cramps potential for renters syndrome
Reactive arthritis
Conjunctivitis
Urethritis
Bacteremia
Osteomyelitis
Septic arthritis

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88
Q

Treatment for salmonella

A

Mild: rehydration, no ABx
Severe: Oral/IV ABx

Ceftriaxone
Cipro
Azithromycin
Bactrim

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89
Q

Vibrio morphology

A

Gram negative coccobacillus, aerobic

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90
Q

Vibrio is _______ borne

A

Water

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91
Q

Main clinical feature of vibrio

A

Profound, acute watery diarrhea (looks like rice water, literally)

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92
Q

Treatment for vibrio

A

Rehydration

Doxycycline
Azithromycin
Bactrim
Cipro

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93
Q

Shigella dysenteriae morphology

A

Gram negative rod

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94
Q

Clinical manifestation of shigella?

A

“Dysentary picture”
Fever, cramps, tenesmus
Bloody diarrhea

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95
Q

Shigella treatment

A

Fluid
Azithromycin, cipro, bactrim, ceftriaxone

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96
Q

Bordetella Pertussis is also known as

A

Whooping cough

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97
Q

Bordetella morphology

A

Gram - coccobaccli, aerobic

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98
Q

Stages of Bordetella infection

A

Catarrhal
Paroxysmal
Convalescent

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99
Q

Treatment for pertussis (Bordetella)

A

Vaccination

Azithromycin
Bactrim
Consider prophylaxis

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100
Q

8 year old with fever, sore throat, no coryza symptoms, anterior lymph nodes.
Likely bacteria and treatment?

A

Group A strep
Penicillin, amoxicillin

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101
Q

24 year old with swollen, red left arm.
Febrile 3x3 abscess with pointing and erythema
Likely bacteria? Treatment?

A

S. aureus
Bactrim or doxycycline

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102
Q

37 y/o with abdominal cramping and soft diarrhea
n/a, afebrile
Likely bacteria?
Treatment?

A

Campylobacter/salmonella
Hydration and supportive care

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103
Q

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?

A

Rheumatic fever
Supportive care
Get rid of the strep!

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104
Q

E. coli morphology

A

Aerobic gram negative rod
Spore forming

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105
Q

Name 2 virulence factors for E. coli

A

Lipopolysaccharides
Shiga toxin

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106
Q

E. coli is the most common cause of

A

Urinary tract infections

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107
Q

Enterotoxigenic E. coli (ETEC)

A

penetrate the intestinal epithelium and produce a toxin that causes gastroenteritis
Traveler’s diarrhea

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108
Q

Shiga toxin producing E. coli (STEC)

A

This group contains E. coli O157:H7 and other virulent strains that cause hemolytic uremic syndrome and other debilitating effects

109
Q

Enteropathogenic E. coli (EPEC)

A

Person to person spread, causes watery diarrhea, adhesion to intestinal lining

110
Q

Enteroinvasive E. coli (EIEC)

A

Causes shigella-like dysentery, direct invasion of colonic cells

111
Q

Enteroaggretive E. Coli (EAEC)

A

Traveller’s diarrhea, PERSISTENT diarrhea
adherence and replication

112
Q

98% of uncomplicated cystitis cases are caused by

A

E. coli

113
Q

More serious complications of E. coli related UTI?

A

Pyelonephritis
Urosepsis

114
Q

How can E. coli become pathogenic in the intestines?

A

If the natural barriers are disrupted, can lead to peritonitis or intraperitoneal abscess

115
Q

What is a neonatal risk for E. coli?

A

Neonatal meningitis

116
Q

Treatment for E. coli

A

Hydration/symptomatic treatment
Non bloody diarrhea: Cipro, bactrim, rifaximin
Blood diarrhea: NO ABX OR MOTILITY AGENTS (until you confirm diagnosis with stool culture)

117
Q

Treatment for (E. coli) uncomplicated cystitis

A

Macrobid
Bactrim

118
Q

Treatment for E. coli complicated cystitis

A

Quinolone
3rd Gen cephalosporins

119
Q

Pyelonephritis (E. coli) treatment

A

Ciprofloxacin, ceftriaxone, bactrim

120
Q

Intra-abdominal infections (E. coli)

A

3rd or 4th gen cephalosporins
Quinones
Zosyn

121
Q

Gonococcus morphology

A

Gram negative diplococcus

122
Q

Neiserria meningitidis can cause what

A

Bacterial meningitis

123
Q

Neisseria gonorrhoeae is the _______ most reportable condition in the US (2017)

A

2nd

124
Q

Diagnosis of Neisseria

A

NAAT/PCR
Swabs: urine, endocervical, rectal, throat, blood culture

125
Q

What is one life threatening/altering complication of gonoccal infections that he mentioned several times

A

Conjunctivitis that can lead to blindness/permanent vision loss

126
Q

What is fitz-hugh-curtis syndrome?

A

Perihepatic gonorrhea infection

127
Q

Treatment for uncomplicated gonococcal infection

A

Ceftriaxone + Azithromycin
Gentamicin + Azithromycin

128
Q

Treatment for disseminated gonococcal disease

A

Ceftriaxone + Azithromycin

129
Q

TB is diagnosed via what

A

Acid fast bacillus

130
Q

Three spectrums of TB

A

Pulmonary TB
Latent TB
Disseminated disease

131
Q

TB forms small ______ in the lungs due to alveolar macrophages phagocytizing the infection

A

Granulomas

132
Q

Hallmark sign of active TB

A

Cough for 3+ weeks
Hemoptysis
Fever with night sweats
Weight loss

133
Q

Latent TB likes to live in the upper or lower lobes?

A

Upper

134
Q

Latent TB is contagious or not

A

Not contagious

135
Q

Diagnosis of active TB

A

Sputum culture - morning sputum for AFB

136
Q

Diagnosis of latent TB

A

Quantiferon/T-spot
PPD

137
Q

Treatment for active TB

A

Notify Public Health
Airborne isolation
RIPE (rifampin,isoniazid, pyrazinamide, ethambutol)
Multiple drugs, multiple months

138
Q

Treatment for latent TB

A

Isoniazid x9 months
Isoniazid + rifapentine weekly x12

139
Q

Major atypical mycobacteria we talked about?

A

Mycobacterium avium complex

140
Q

Treatment for pulmonary MAC?

A

Macrolide (“mycin”) + ethambutol + rifampin
Duration is 12 months after last positive culture

141
Q

Treatment for disseminated MAC?

A

Macrolide (“mycin”) + ethambutol + rifampin
Continue until 12 months, no signs of MAC, and CD4 >100 for >6 months

142
Q

What atypical mycobacteria can commonly cause skin infections?

A

M. marium

143
Q

Histoplasma capsulatum

A

Dimorphic fungi (mold or yeast)

144
Q

Histoplasm capsulatum is found where

A

Dirt/soil

145
Q

Primary disease histoplasma presentation

A

Often asymptotic and self limiting, but can progress
Localized to lungs, lymphadenopathy

146
Q

Histoplasma diagnosis

A

Culture (sputum, blood, tissue biopsy)
Stains
Serology (most helpful with subacute)
Urinary antigen

147
Q

Treatment for pulmonary histoplasma?

A

Mild = no treatment necessary
Moderate to severe: liposomal amphoterocin B followed by Itraconazole

148
Q

Treatment for disseminated histoplasma

A

Mild to moderate: Itraconazole
Disseminated: Lipopsomal amphoterocin B followed by Itraconazole

149
Q

Cryptococcus morphology

A

Yeast, found in soil

150
Q

Cryptococcus is most severe in patients with

A

Decreased cell mediated immunity (HIV, chronic steroids, transplant patients)
Healthy people rarely become infected

151
Q

Clinical presentation of cryptococcus

A

Pneumonia
Thin disseminated spread
Most common: Meningoencephalitis

152
Q

Cryptococcus diagnosis

A

Cryptococcal antigen
CSF culture and stain (India ink)
Respiratory culture

153
Q

Pulmonary cryptococcus treatment

A

Fluconazole

154
Q

CNS cryptococcus treatment

A

Induction phase: Flucytosine + liposomal
amphoterocin B

Consolidated phase and maintenance: Fluconazole

155
Q

Treponema pallidum

A

Syphilis causative agent

156
Q

Syphilis transmitted via

A

Sexual contact
Mother to fetus
Blood products
Breaks in skin

157
Q

Syphilis penetrates _________

A

Intact mucous membranes (doesn’t need opening)

158
Q

Primary Syphillis

A

Painless chancre (ulcer), punched out base and rolled edges

159
Q

Secondary syphillis

A

Mucotaneous lesions over whole body (including palmer/plantar)
Condylomata lata (warts)- painless, highly contagious lesions on warm moist sites

160
Q

Tertiary syphillis

A

Cardiovascular syphillis
Neurosyphillis
Gummatous

Syphillis meningitis

161
Q

What is an Argyll Robertson pupil?

A

One that accommodates but does not I react to light
Seen in syphillis meningitis

162
Q

What is most common presentation of cardiovascular syphillis?

A

Ascending aortic aneurysm

163
Q

Congenital syphilis

A

Paresis
Saber shins (outward curve like a saber)
Saddle nose
Hutchinson’s teeth (smaller and more widely spaced)

164
Q

Syphillis diagnosis

A

Dark field microscopy
Serology (VDRL)
Rapid plasma reagent (RPF) with serial dilution

165
Q

Syphillis treatment

A

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
Q

Rocky Mountain spotted fever causative agent

A

Rickettsia rickettsii
Dog tick

167
Q

Rocky Mountain spotted fever hall mark

A

Petechial rash beginning on the palms of the hands and soles of feet

168
Q

RMSF most common in what geographic locations

A

North, Central America, especially SE and United States

169
Q

Fever and petechial rash, you should be thinking

A

RMSF
Have high index of suspicion, this presentation isn’t good

170
Q

RMSF can lead to

A

Sepsis like picture due to vascular permeability

171
Q

Lab findings in RMSF

A

Leukopenia
Elevated LFTs
Thrombocytopenia

172
Q

RMSF diagnosis

A

Serology
Blood culture
Lumbar puncture

173
Q

RMSF treatment

A

Doxycycline
Chloramphenicol in pregnancy
Prevention

174
Q

Lyme disease causative agent

A

Borrelia burgdorferi

175
Q

Lyme common in what geographic areas

A

Northeastern US and Europe

176
Q

Primary reservoirs for Lyme

A

Rodents

177
Q

Early localized phase of Lyme

A

Erythema migricans
Flu-like
Bullseye rash

178
Q

Early disseminated phase of Lyme

A

Weeks to months
Multiple lesions
Possible meningitis/Bell’s palsy
Cardiovascular: AV block, BBB

TRIAD: Meningitis, cranial neuropathy/cerebellar ataxia, encephalomyelitis

179
Q

Late Lyme phase

A

If untreated
Arthritis, encephalopathy (months to years later)

180
Q

Lyme disease diagnosis

A

Early: clinical
Disseminated or late: serology, PCr, CSF

181
Q

Lyme treatment

A

Doxycycline
Amoxicillin (kids)
IV ceftriaxone for severe

Prophylaxis one time with 200 mg doxycycline 80% effective

182
Q

Anaplasma morphology

A

Intracellular gram - rod
Tick borne

183
Q

Anaplasma presentation

A

Abrupt flu like illness (headache, myalgia, N/V/ABD pain
maculopaular exanthema +/- petechiae)

184
Q

Anaplasma diagnosis

A

Serology
PCr
Morulae on blood smear

185
Q

Anaplasma treatment

A

Doxycycline
Rifampin if pregnant

186
Q

Ehrilichia morphology

A

Intracellular gram - Rod
Tick borne

187
Q

Ehrilichia seen in what geographic areas

A

Southern US, “lone star tick”

188
Q

Ehrilichia presentation

A

5-15 days after bite
Cough
Diarrhea
LFTs increases, thrombocytopenia, leukpenia
Rash
Meningitis

189
Q

Ehrilichia diagnosis

A

Serology
PCr
Morulae on blood smear

190
Q

Ehrilichia treatment

A

Doxycycline
Rifampin if pregnant

191
Q

Mycoplasma pneumoniae (walking pneumonia) morphology

A

Non cell wall bacteria

192
Q

Important clinical distinction for mycoplasma pneumonia

A

Non productive cough (sputum is scant)

193
Q

Why can’t we use beta-lactam ABx on mycoplasma pneumoniae?

A

No cell wall!

194
Q

Mycoplasma pneumonia diagnosis

A

Serology
PCr
No sputum culture

195
Q

Mycoplasma pneumonia treatment

A

Macrolides (Azithromycin, doxycycline)
Quinolones (levaquin/moxifloxacin)

196
Q

Chlamydophilia psittaci morphology

A

Non cell wall

197
Q

Chlamydophilia psittaci comes from where

A

Birds

198
Q

Chlamydophilia psittaci presentation

A

Abrupt onset of constitutional symptoms

199
Q

Chlamydophilia psittaci treatment

A

Macrolides (Azithromycin, doxycycline)
Quinolones (levaquin/moxifloxacin)

200
Q

Chlamydia trachomatis most commonly reported

A

STD

201
Q

1 main important side effect of chlamydia trachomatis

A

Blindness
Chronic keratoconjunctivitis

202
Q

Erythromycin ointment at birth used to prevent

A

Chlamydia trachomatis

203
Q

Chlamydia trachomatis diagnosis

A

Urine PCr (men mostly)
Swab for NAAT/PCr

204
Q

Chlamydia trachomatis treatment

A

Azithromycin (1gram PO)
or doxycycline (100 mg Q12 x7 days)
Levofloxacin

No sex for at least 7 days after treatment

205
Q

“Dysregulated inflammatory response than can lead to life threatening multi-organ failure”

A

Sepsis

206
Q

Mortality rate of sepsis

A

10-52%

207
Q

Clinical presentation of sepsis

A

Hypotension
Fever
Tachycardia
Tachypenia
Decreased urine output
Progressive shock

208
Q

Labs in sepsis

A

Leukocytosis
Elevated lactate
Elevated CRP
Hyperglycemia
Elevated creatinine
Elevated bilirubin

209
Q

Sepsis treatment

A

Supportive care (fluids, vasopressors, ventilatory support)
Empiric ABx and quickly!

210
Q

Ascasris Lumbricoides is what type of worm

A

Roundworm (nematode)

211
Q

Risk factors for Ascasris lumbricoides

A

Poor sanitation, travelers

212
Q

Ascasris Lumbricoides presentation

A

Presents as pulmonary symptoms (cough/weezing), then potential for severe GI complaints due to blockage

213
Q

Ascasris Lumbricoides diagnoses

A

Stool O&P for established infection
Sputum may reveal larvae

214
Q

Ascasris Lumbricoides treatment

A

Albendazole or mebendazole
Pyrantel (safe in pregnancy)
Passage of worms (or possible EGD/colonoscopy, surgery)

215
Q

Two types of hookworms

A

Nector americanus (lives longer, less blood loss) and
Ancylostoma duodenale (lives shorter, but more blood loss)

216
Q

Big thing to look out for in hookworms

A

Iron deficiency anemia

217
Q

Hookworm diagnosis

A

Direct microscopy
Chronic eosinophilia

218
Q

Hookworm treatment

A

Albendazole or mebendazole

219
Q

Pin worms causative agent

A

Enterobius vermicularis

220
Q

Pin worms live where

A

Cecum

221
Q

Hallmark classic presentation of pin worms

A

Pruritis ani at nighttime

222
Q

Pinworms diagnosis

A

Cellophone tape test
Repeat examinations

223
Q

Pinworms treatment

A

Albendazole or mebendazole
treat cohabitants

224
Q

Tapeworms, AKA

A

cestodes

225
Q

What is unique about tapeworms (in terms of a host)?

A

Need a primary and intermediate host

226
Q

T. solium

A

Found in pork (most common)

227
Q

Diphyllobacterium

A

Found in fish

228
Q

Tapeworms primary host infection

A

Limited to GI tract

229
Q

Tapeworms intermediate host

A

Can spread

230
Q

Cysticercosis

A

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
Q

Neurocysticerocis

A

Taenia solium, predilection for brain/muscles, can cause seizures

232
Q

Tapeworms diagnosis

A

Radiographic imaging
Pernicious anemia from Diphyllobacterium

233
Q

Tapeworm treatment

A

Praziquantel or niclosamide
B-12 supplementation for Diphyllobacterium
May need dexamethasone for inflammation

234
Q

Malaria morphology

A

Protozoa
Mosquito vector

235
Q

Malaria causative agent

A

Plasmodium falciparum (most common)

236
Q

Plasmodium has a predilection for

A

Blood cells

237
Q

Malaria clinical presentation

A

-Cyclical fever
Cold phase (chills, shivering) —> hot phase (high grade fevers)
—-> sweating stage (diaphoresis, fever resolution)

238
Q

Plasmodium incubation

A

7-30 days

239
Q

Malaria complications- P.falciparum

A

Cerebral malaria (altered mental)
Renal failure
Hemoglobinuria

Non-cardiogenic pulmonary edema

240
Q

What is one “profound” finding in malaria infection?

A

Hypoglycemia - monitor blood sugars

241
Q

Malaria diagnosis

A

Thick and thin blood smear
Antigen testing
PCr

Other: G-6-PD

242
Q

P. falciparum treatment

A

Quinine (with possible addition of clindamycin or doxycycline)

243
Q

P vivax, ovale - treatment

A

Primaquine to kill liver phase

244
Q

Malaria prevention

A

DEETm long clothing, bed nets, avoid dusk/dawn

245
Q

Toxoplasma causative agent

A

Toxoplasma gondii (protozoan)

246
Q

Is toxoplasma teratogenic?

A

Yes
“T” in torch infections

247
Q

Acute toxoplasmosis presentation

A

80-90% asymptomatic
Fever, malaise, night sweats,myalgia (like everything)
Lymphadenopathy

248
Q

Retinochoroditis complication of

A

Toxoplasma

249
Q

Most significant manifestation of congenital toxoplasmosis is

A

Enecephalomyelitis

250
Q

Toxoplasma diagnosis

A

Histopathology
Serology
PCr
Imaging

251
Q

Toxoplasma treatment

A

Pyrimethamine and sulfadiazine
Bactrim, atovaquone, Azithromycin

252
Q

Amebiasis causative agent

A

Entamoeba histolytica
(protozoan)

253
Q

Amebiasis presentation

A

Most asymptomatic
Dysentary (can resemble IBD)
Amebic liver (extra intestinal disease)

254
Q

Amebiasis

A

Serology
Stool
Antigen testing
PCr
Colonoscopy
Liver abscess aspiration (“anchovy paste”)

255
Q

Amebiasis treatment (luminal)

A

Lodoquinol
Paramomycin

256
Q

Amebiasis treatment (extraluminal)

A

Metronidazole
Tinidazole

257
Q

Giardia causative agent

A

Giardia lamblia (tintestinalis)

258
Q

Giardia found where

A

Water, common intestinal parasite

259
Q

Giardia incubation

A

1-2 weeks

260
Q

Giardia presentation

A

No fever
Asymptomatic
Diarrhea “Watery, greasy, large volume”

Chronic diarrhea/malabsorption

261
Q

Giardia diagnosis

A

Stool (antigen testing, O&P, PCr)

262
Q

Giardia treatment

A

Metronidazole or tinidazole
Paramomycin in pregnancy
Albendazole

263
Q

Trichomonas causative agent

A

Trichomonas vaginalis

Motile protozoan

264
Q

Trichomonas diagnosis

A

Wet mount slide or DFA

265
Q

Trichomonas treatment

A

Metronidazole 500 mg PO BID x 7 days

266
Q

Cryptosporidium causative agent

A

Cryptosporidium parvum

267
Q

Cryptosporidium presentation

A

Acute large volume watery diarrhea

Camping
Self-limiting unless immunocompromised

268
Q

Cryptosporidium diagnosis

A

Needs special stain or AFB

269
Q

Cryptosporidium treatment

A

Not usually indicated

Didactic Year (24 decks)

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