Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PAM Semester 2 > Clinical Medicine Exam 2 ID > Flashcards

Clinical Medicine Exam 2 ID Flashcards

1
Q

Endocarditis criteria for Dx

A

Accepted criteria for diagnosis

Modified Duke Criteria
Definitive diagnosis: 80% accuracy IF 
2 major criteria, or
1 major criterion + 3 minor criteria, or
5 minor criteria are fulfilled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chlamydia testing

“gold standard”

A

NAAT testing: urine or swabs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Syphillis Tertiary

A

years later - effect neurological system

blindness, paralyzed, cognitive decline, meningitis, hearing loss, aphasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of the following is the most common risk factor associated with right-sided IE?

A. Left sided infective endocarditis
B. Intravenous drug use
C. History of alcohol abuse
D. Pulmonic stenosis

A

B. Intravenous drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tetanus vaccination types

A

Dtap (kids) = 2,4,6 mo / 15-18mo / 4-6 yrs

Tdap = 11-64 yrs

Td (booster) = Q 10 yrs, 5 if dirty wound
TIG human or equine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Infectious Diarrhea Presentation

Noninflammatory

A

Noninflammatory
Non bloody or watery
=mild
giadia, noro, roto, crypto, ecoli, vibrio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sepsis Definition

A

A potentially life-threatening condition that occurs when the body’s response to an infection damages its own tissues.

When the infection-fighting processes turn on the body, they cause organs to function poorly and abnormally.

Sepsismay progress to septic shock.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathogenicity

A

ability to cause disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lyme Disease

A

Tick must be on for 24–36 hours

Erythema migrans: target rash
Headache or stiff neck.
Arthralgias, arthritis, and myalgias

no true test

doxy 100mg BID x 10-14d
Amox in Pregos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MMR in pregnant women

A

Pregnant women without evidence of immunity:

It is recommended that they receive immune globulin.

Measles vaccination, in conjunction with mumps andrubella, is contraindicated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

HSV-2 Genital Herpes in pregnancy

A

can be transmitted to the neonate during delivery

Risk is high enough that cesarean delivery is preferred
unless asymptomatic

Acyclovir(oral and topical) appears to be safe during pregnancy

Cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Endocarditis Prophylaxis with dental

A

Prosthetic cardiac valve
Previous infective endocarditis
Congenital heart disease (CHD)

Amox 2G

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diptheria Presentation

A

Classic physical exam finding – pseudomembrane covering tonsils and pharynx

mild sore throat, fever, malaise

Erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Congenital Syphillis

A

skin lesions, lymphadenopathy, hepatosplenomegaly, failure to thrive, blood-stained nasal discharge, perioral fissures, meningitis, choroiditis, hydrocephalus, seizures, intellectual disability, osteochondritis, and pseudoparalysis (Parrot atrophy of newborn)

Diagnosis is clinical, confirmed by microscopy or serology

Treatment is penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sepsis labs

A

Neutropenia
Neutrophilia (most common)
Thrombocytopenia (50% of patients)
DIC

Draw 3 cultures from seperate sites (95% discovery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bacterial vs Viral STI’s

A

Bacterial

Chlamydia, LGV, gonorrhea & syphilis
Can be treated and cured with antibiotics
Untreated infection can cause PID, infertility, & epididymitis

Viral

Viral STI’s include HPV, HIV, Herpes, & Hepatitis A,B,C
Medication available to treat symptoms only
There is NO cure (C*)
Can pass onto others for the rest of your life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bacterial Meningitis CSF results

A

Elevated opening pressure >180
Low glucose <2.2
HIgh Protein >0.45
High WBC 10-10000 (mostly Neutrophils)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

GAS Strep Infection Misc.

A

Skin = Impetigo, cellulitis

Others = Arthritis, endocarditis, empyema, necrotizing fascitits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Group D strep

A

Streptococcus gallolyticus (bovis)and the enterococci.S gallolyticus (bovis)is a cause of endocarditis in association with bowel neoplasia or cirrhosis and is treated like viridans streptococci

Tx: PCN G or Ceftriaxone or Vanc alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following is the drug of choice for MSSA bacteremia due to endocarditis?

Oxacillin
Ceftaroline
Doxycycline
Daptomycin

A

Oxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

COVID-19

A

Supportive care, vaccine

80% asymptomatic or mild sx with low grade fever, mild cough, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Infectious Diarrhea mild vs moderate vs severe

A

Mild less than 3
mod 4 or more with loal symptoms
severe 4 or more withsystemic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A previously healthy 20-year-old college student presents to the office complaining of 2 days of sore throat, fevers, and myalgias. On physical exam, he has a fever (temperature of 101.3 °F), tonsillar enlargement with exudates, and freely moveable, tender anterior cervical lymphadenopathy. His exam is otherwise normal and he has no rashes. The patient’s rapid antigen detection test for group A Streptococcus (GAS) is negative, so he is sent home without antimicrobials. The serum monospot test for heterophile antibodies is also negative. However, 2 days later, the throat culture is growing group A, ß-hemolytic streptococci. The student is contacted and returns to clinic, but is reluctant to do anything further because he feels much better. He has no known drug allergies.

Which one of the following options would be most appropriate?

A. He should be treated with oral penicillin to reduce the likelihood that rheumatic fever will develop
B. He should be treated with oral azithromycin due to increasing penicillin resistance against GAS
C. Hold antibiotics because it is too late to prevent non-suppurative complications of GAS infection
D. Hold antibiotics because he is colonized, no infected

A

A. He should be treated with oral penicillin to reduce the likelihood that rheumatic fever will develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Measles Immz

A 
Routine Immunization 
(1st dose 12-15 mo, 2nd dose 4-6 y/o or 1 month after first dose if >12 mo)

(vaccine ↓ deaths by 75%),

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cytomegalovirus in pregnancy Tx

A

Treatment: Mainly supportive
Parenteralgancicloviror oralvalganciclovirmay prevent hearing deterioration and improve developmental outcomes and is given to infants with symptomatic disease identified in the neonatal period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Malaria presentation

A

headache and fatigue, followed by fever
Then
chills, high fever, then sweats

Rash, lymphadenopathy are NOT typical in Malaria – if present – look for another reason for the fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A 66-year-old diabetic man with past medical history significant for alcoholism and HIV presented to an outside ED for severe scrotal pain. He first noted a small “pimple” 2 days ago, and since noted increased rash, some drainage, and increasing pain. Exam revealed an area of erythema and copious, foul-smelling purulent discharge and crepitus in the soft tissue. The local ED did not have access to a surgeon and transferred the patient to the hospital for further care. No fluids, antibiotics, or other interventions were initiated there. On arrival, vitals show a heart rate of 123 bpm, blood pressure of 67/39 mmHg, respiratory rate of 22, and temperature of 38.9 °C.

Which one of the following steps is the most urgent next step in caring for this patient?

A. Start empiric antibiotics, such as Vancomycin and piperacillin/tazobactam
B. Obtain gram stain of pus to help select the most appropriate antibiotic
C. Obtain a CT scan of the pelvis and upper thighs
D. Fluid bolus, blood cultures and urgent surgical consultation

A

D. Fluid bolus, blood cultures and urgent surgical consultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Trichomoniasis

A

protozoan parasite

Most common curable sexually transmitted parasitic infection

Strawberry Cervix
dysuria, urethral itching, urethral discomfort, painful intercourse, foul smelling frothy discharge

Metronidazole 2G

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

2nd most common bacterial STI worldwide and US

A

Gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Syphillis Testing

A

Dark Field Microscopy

Neuro CSF evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Helminth Testing

A

CBC will show eosinophilia, stool sample shows eggs under microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Infectious Diarrhea acute vs chronic

A

under 2 weeks is acute

over 2 weeks is chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Syphillis Treatment

A

Treatment depends on stage

1 or 2 = IM Bicillin 2.4 million units single dose or doxy

3rd or Latent = IM Bicillin 2.4 million units Qwk x 3

Neuro = Pen G qd x 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Most common cause of STI in the world

A

Chlamydia Trachomatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Bacterial meningitis

A

Fever, headache, stiff neck

bacterial and viral can be indisguinishable clinically

Group B strep (under 2 months), H flu, Listeria, N. meningitis, 
s pneumo (most in adults and peds)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

FUO Most common Autoimmune Disorders

A

Still Disease
Lupus
Cryoglobulinemia
Polyarteritis Nodosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Endocarditis tx

A

MRSA, PCN Allergy = vanc/dapto

otherwise oxacillin or nafcillin (MSSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pinworm tx

A

Treatment – Albendazole 400mg
or
Pyrantel pamoate 11mg/kg to max of 1 gram, mebendazole 100mg – all single doses

Repeat dose in two weeks due to frequent reinfection

Wash all cloths and bedding

Treatment of household members is advocated to eliminate potential reinfection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Left sided vs right sided endocarditis

A 
Left = 
valves = mitral, aortic
prior endocarditis
Cardiac murmurs (85%)
Right = 
IVDA (90%)
10% of all endocarditis cases
Fever in 90% (most common)
S. aureus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Varicella -Zoster in pregnancy

A

Approximately 10-20%of those infected with varicella developpneumonia

A pregnant mother can transmit varicella to her baby via the placenta

during the first 12 weeks of pregnancy, the baby has a0.5-1% risk of developing a rare birth defect known as congenital varicella syndrome

May have underdeveloped arms and legs, eye inflammation, and incomplete brain development

Primary – anti-viral – Acylovir most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Pinworm Testing

A

identification of eggs or adult worms on perianal skin

Scotch tape test

Albendazole 400mg or Pyrantel pamoate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Tetanus Presentation

A

Trismus (lockjaw), muscle pain and stiffness, back pain, and difficulty swallowing

muscle spasms and pain in trunk, jaw, and neck, respiratory distress or arrest

Metronidazole (Flagyl), Antitoxin Equine/Human

Vaccine, TIG Booster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Etiology of endocarditis

A

Valve disease (50%)

IV drug use
Protthetic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Endocarditis

A

Etiology
Underlying valve disease (~50% of cases)
IV Drug use
Prosthetic valve

Most common cause is S Aureus

Fever, murmur, cough, SOB

Classic sx:
Splinter hemorrhages, Petechiae,
Janeway Lesions = PainLESS lesions on soles, palms
Oslers nodes = PAINFUL lesions on fingers, toes, feet
Roth spots = lesions on retina

TEE = Trans esphogeal echo
Modified duke criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Pleuritis

A

infection of the pleura (pain on inspiration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

A 34-year-old man presents in the clinic today for a 2 to 3 day history of abdominal cramping and multiple frequent loose stools. His past medical history is significant for hypertension for which he has been on chlorthalidone. He has been hydrating himself well and, per physician’s advice, had stopped his chlorthalidone when his diarrhea persisted for more than 24 hours. He says that he recently ate at a new restaurant in his neighborhood and seems to think these symptoms began after that. He does not appear clinically ill and his physical examination is unremarkable except for hyperactive bowel sounds. Stool cultures are requested and results come back 2 days later with growth of Salmonella spp. (not Salmonella typhi) from the specimen.

Which one of the following steps is the next best step in management of this patient?

A. Inform the patient about the results and start intravenous ceftriaxone
B. Inform the patient about the results and encourage good supportive care with fluid and food intake
C. Inform the patient about the results and start trimethoprim/sulfamethoxazole
D. Inform the patient about the results and start ampicillin

A

B. Inform the patient about the results and encourage good supportive care with fluid and food intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Syphillis Testing

A

Dark field microscopy- allows direct examination of spirochetes

Serological testing: Treponemal/Nontreponemal

Neuro patients: CSF fluid evaluation

Imaging studies depend on organ involved
CXR – aortic aneurysm -> CT confirmation
Echo rule out aortic regurgitation

Tx: Depends on stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Noscomial pneumonia bacteria

A

more likely to be caused by a resistant bacteria

MRSA or pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Shigellosis Presentation

A

stool with mucus and blood,

abdominal cramps, tenesmus, diarrhea, fever, chills, anorexia, malaise, headache

Rehydrate
Empiric Azithromycin, Ciprofloxacin or Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

GAS Strep Infection

Pharyngitis

A

group a beta-hemolytic strep (Gram Pos)

Pharyngitis

Sudden fever, sore throat, odynophagia, tender cervical adenopathy, malaise, nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

GAS Strep Infection types

A

group a beta-hemolytic strep (Gram Pos)

Pharyngitis
Sudden fever, sore throat, odynophagia, tender cervical adenopathy, malaise, nausea

Scarlet Fever
Diffuse fine red papules, sand paper-like; resembles sunburn-> Groin, axilla. Blanches. “Strawberry tongue”
GAS pharyngitis, wound infections and burns

Rheumatic fever
(Jones Criteria)
arthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

FUO Most Common Neoplasms

A

Lymphoma
Leukemia

**there are many types of cancer that may manifest fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Cryptococcosis Presentation

A

Most common cause of fungal meningitis

presents clinically as chronic meningoencephalitis

CNS disease predominates

Nuchal rigidity and meningeal signs present ~ 50%,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Sepsis Presentation

A 
Fever, chills (often abrupt onset)
Hypothermia (15%)
Tachycardia
Hyperventilation 
Hypotension and shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Malaria General

A

Most important protozoan parasitic disease of humans

Hundreds of millions of illnesses and hundreds of thousands of deaths each year

Plasmodium falciparum is responsible for nearly all severe disease (4 types of plasmodium)

All travelers to endemic areas who present with fever and similar symptom complex must be evaluated for Malaria

Severe disease has a very high morbidity and mortality

It may take up to 2 months for symptoms to begin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Tetanus TIG indications

A 
Administer Antitoxin (early) 
Human tetanus immune globulin (TIG)-PREFERRED OR equine antitoxin

TIG is the preparation of choice, A single IM dose (3000–5000 IU) is given, with a portion injected around the wound.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Infectious diarrhea

secretory (watery)

A 
Bacteria = ie vibrio cholera
Virus = Rotavirus, norovirus
protozoa = giargdia, cryptosporidium
copious diarrhea (rice water stools)
can lead to dehydration and vascular collapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Rocky Mountain SPotted Fever Presentation

A

Acute onset of high fever, chills, headache, nausea, and vomiting, myalgias, restlessness, insomnia, irritability

Rash days 2-6

Doxycycline 100 mg BID – continue treatment at least 3 days after fever is gone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Jones criteria

A

Jones criteria -

1 required,
2 major or 1 required,
1 major and 2 minor criteria must be present for diagnosis.

1 required – evidence of antecedent strep infection

Major (JONES)– polyarthritis, Carditis, subcutaneous nodules, erythema marginatum, chorea

Minor – fever, arthralgias, previous rheumatic fever or rheumatic heart disease, acute phase reactions – ESR, CRP, leukocytosis, prolonged PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Infectious Diarrhea Etiology

A 
Emotional stress
Food intolerance
Inorganic agents
Organic substances
Medications
Infectious Agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Bacterial Meningitis etiology

A

Strep Pneumo (50%) adults

N. meningitis (25%)
Group B strep (15%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Varicella -Zoster in pregnancy treatment

A

Primary – anti-viral – Acylovir most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Influenza

A

2 types, A & B

Inflammation of the upper respiratory tree and trachea w/i 2 days of transmission

aerosolized respiratory droplets via coughing, sneezing, talking, or touching inanimate objects

Self limiting, supportive, flu vaccine, tamiflu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Helminth Presentation

A

(Round worms most common)

cough, blood tinged sputum, wheezing, late – anorexia, abdominal pain, nausea, vomiting, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Syphillis treatment

A

Treatment depends on stage

1 or 2 = IM Bicillin 2.4 million units single dose or doxy

3rd or Latent = IM Bicillin 2.4 million units Qwk x 3

Neuro = Pen G qd x 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Erythema Infectiosum

A

Fifth disease (Parvo virus)

targets red blood cells and marrow

1 of 6 of the most common viral rashes in children

respiratory droplets

Fever, HA, sore throat

Slapped cheek: bright red, raised erythema over cheeks
Red lacelike reticular pattern

Papular Purpuric Gloves and Socks
caused by Parvo B19

Self limiting, supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Cryptococcosis Testing

A

Respiratory disease is diagnosed by culture of secretions

Meningeal disease – lumbar puncture

Gram stain of CSF usually reveals budding yeast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Infectious Diarrhea Tx

A

usually self limiting, supportive

mild = replace fluids, avoid dehydration

Severe=rehydration, ORS

Bloody = Flouroquinolone or azithro

Avoid lopermide in shigella or toxic megacolon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Tetanus Vaccination times

A

Receive a series of 3 vaccinations
Tdap initially
Td at least 4 weeks later
TD again between 6-12 months

Then every 10 years

In pregnancy, best to wait until 2nd trimester unless tetanus prone wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Tetanus prone wounds

A

Greater than 6 hours old

Stellate, avulsion

Greater than 1cm deep

Missile, crush, burn, frostbite

Devitalized tissue

Contaminants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

EBV

A

Epstein Barr Virus (Herpes Family)

95% of people will get it in their lives

direct contact saliva, bodily fluid

Might be asymptomatic, mononucleosis, fever, malaise, spleenomegaly

supportive, avoid contact sports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Pneumonia

A

Typical ”Classic” Presentation:

Chills, followed by fever, pleuritic pain and productive cough

Atypical = MAC , legionella, chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Acute Rheumatic fever Presentation

A

Migratory joint pain, fatigue, fever, heart murmur, flat rash, chorea (Sydenham) and unusual behavior

JONES
Joints
Carditis
Nodules
Erythema
Chorea

PCN-G x 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Zika

A

Serum or urine Zika virus IgM, screen pregnant women with reverse-transcriptase PCR, NAAT

during pregnancy can cause microcephaly

Supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Syphillis Secondary

A

2-24 weeks
morbilliform rash on the body, dark spots on palms and soles, hair loss, feeling ill, condyloma lata

HA, myalgia, arthralgia, hepatosplenomegaly, alopecia, malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

HPV Testing

A

Clinically based on visible lesions

Pap smear, anal pap, colposcopy, anoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Histoplasmosis Presentation

A

Most are asymptomatic, go unrecognized

Past infection leaves pulmonary and splenic calcification
May have a mild flu like illness

Moderate = clinical picture of pneumonia with fever, cough and mild central chest pain

78
Q

Infectious diarrhea

A

loss of intravascular volume
loss of electrolytes
can result in cardiovascular failure

Common bugs =
cholera, a aureus, salmonella, shigella, rotavirus
norovirus,campylobacter, e. coli, c dif,

3 types
secretory (watery)
inflammatory
Hemorrhagic

79
Q

Empiric skin treatment

A

Cephalosporin 500 QID

80
Q

Sepsis Tx

A

Removal predisposing factors i.e. immunosuppresants

Identifying the Source of Bacteremia
ie venous catheter, abcess etc.

Supportive = fluid, pressors etc

Antibiotics = IV ABX for both gram pos/neg bugs
3rd 4th gen ceph if CNS involve

81
Q

Syphillis Primary

A

3 days- 3 months
smal chancres
goes away on it’s own

82
Q

Viral meningitis Etiology

A

Enteroviruses-MOst common cause

coxsackieviruses, echoviruses, and human enteroviruses 68–71

83
Q

Fifth Disease during Pregnancy

A

There is no single recommended way to monitor pregnant women with parvovirus B19 infection

low-grade fever, malaise, slapped cheek

84
Q

TB Presentation

A

Primary infection = Rarely causes acute illness, 95% asymptomatic. cough, fever, night sweats, or weight loss

Latent infection = The Tb skin test becomes positive during the latent phase

Active infection = low grade fever, night sweats, dyspnea, pneumothorax or pleural effusion.

85
Q

TORCH infections

A 
Toxoplasmosis
Other (syphillis, varicella-zoster, parovirus b19)
Rubella
Cytomeglovirus
Herpes
86
Q

Scabies

A

microscopic mites

prolonged skin to skin contact
(rarely off bedding, clothing, towels)

Pimple-like rash with burrows, blisters, scales, excoriations, intense pruritis

Permethrin cream

87
Q

Pregnancy pearls

A

Maternal infections that can damage the fetus include

cytomegalovirus infection, 
herpes simplex virus infection, 
rubella, 
toxoplasmosis, 
hepatitis B,
syphilis
88
Q

TB Testing

A

Cultrue first
Chest x-ray
Acid-fast stain and culture

Tuberculin skin test

89
Q

Syphillis

A 
treponema pallidum (spirochete)
Primary, secondary, latent, tertiary

3 phase infection that progresses in stages with periods of asymptomatic latency, without treatment invades CNS

Treatment depends on stage
1 or 2 = IM Bicillin 2.4 million units single dose or doxy
3rd or Latent = IM Bicillin 2.4 million units Qwk x 3
Neuro = Pen G qd x 14

90
Q

Cholera Presentation

A

Acute diarrheal disease that can lead to death within hours, primary from dehydration.

Clinical appearance – sudden onset of severe, frequent watery diarrhea (up to a L/hr), dehydration, hypotension

”rice water stool” – grey, turbid without fecal odor, pus or blood

Erythromycin, Azithromycin, cipro (fluids)

91
Q

TB General

A

The most common mycobacterial infection

One of the most widespread and deadly illnesses globally

– M tuberculosis, a small, slow growing aerobic bacilli

Rarely causes acute illness, 95% asymptomatic.

Primary, latent & active infections

92
Q

Hepatitis B

A

Direct contact through blood or bodily fluids

95% with acute Hep B may naturally produce antibodies and is self-cleared; Asymptomatic

Chronic HBV presents with serum sickness-like syndrome w/ fever, rash, arthralgia, cirrhosis
etc

Liver Cancer/Cirrhosis/Liver Failure/Death

Supportive during acute phase; Antivirals treatment with acute or severe disease; NO Cure

Prevention through vaccination

93
Q

2 types of pneumonia

A

community aquired

noscomial pneumonia (hospital)

94
Q

FUO

A

The termFUOshould be reserved for prolonged febrile illnesses without an established etiology despite intensive evaluation and diagnostic testing

Minimum of 3 weeks duration of illness

Fever greater than 38.3C on several occasions

No know immunocompromised state

Diagnosis has not been made post 3 outpatient visits or 3 days of hospitalization

Arbitrary

travel, diet, known exposure, history and family history

95
Q

Chlamydia Trachoma

A

Chlamydia of the eyes

96
Q

TB Tx

A

Isoniazid INH +Rifampin +Pyrazinamide +Ethambutol

Daily dosing for the first 2 months (intensive phase)

Daily dosing or three times per week (continuation phase)

97
Q

Chlamydia

A

Chlamydia Trachomatis, (gram neg)

Most common bacterial STI in US
females twice as often
Direct contact with infected tissue/fluid

70% have NO symptoms

Scant yellow d/c, dysuria, posytcoital bleeding

Untreated can lead to ectopic pregnancy and infertility, reactive arthritis

Azithromycin (preferred): Single dose therapy, 1G

98
Q

Candidiasis Testing

A

Can be cultured from the mouth, vagina, and feces of most people

wet prep koh

99
Q

Histoplasmosis Testing

A

Pancytopenia on CBC
Increased alkaline phosphatase and LDH
Antigen test – sputum or urine
Cultures

CXR – pulmonary infiltrates, hilar or mediastinal lymphadenopathy

100
Q

Infectious Diarrhea Presentation

inflammatory

A 
inflammatory  / Bloody (bloody think bacteria)
Colonic involvement (bacteria, parasites, toxins)

frequency, small stools, bloody, fever, cramps

Shigella, salmonella, campy, yersinia, ecoli, cdiff

Fecal leukocytes are often positive

101
Q

Viral meningitis Presentation

A

Headache
Fever
Nuchal rigidity

Constitutional signs: malaise, anorexia, nausea/vomiting, abd pain, diarrhea

102
Q

Virulence

A

the degree or extent of pathogenicity of a microorganism

103
Q

Epidemiology

A

how often disease occurs in population and why

104
Q

Roseola

A

(Herpes family)
Self limiting, supportive,

10-45% 9-12 mo old infant; 77% by 24 months with febrile illness

saliva via respiratory droplets.

High fever (104F+) 3-5 days, seizures, malaise, 
after fever dissapates, rash develops

2-5mm rose-pink/red maculopapular appearance with halos, starting on trunk spreading to neck, face, and extremities.

105
Q

Most common curable sexually transmitted parasitic infection

A

Trichomoniasis

106
Q

Most common laboratory abnormality in septic patients

A

Neutrophilia, often with increased numbers of immature forms of polymorphonuclear leukocytes, is the most common laboratory abnormality in septic patients

107
Q

GAS Strep Infection

Scarlet Fever

A

group a beta-hemolytic strep (Gram Pos)

Scarlet Fever

Diffuse fine red papules, sand paper-like; resembles sunburn-> Groin, axilla. Blanches. “Strawberry tongue”

GAS pharyngitis, wound infections and burns

108
Q

Bacterial vs Viral Meningitis CSF results

A 
Bacterial
Elevated opening pressure >180
Low glucose <2.2
HIgh Protein >0.45
High WBC 10-10000 (mostly Neutrophils)
Viral
normal glucose,
normal or mildly elevated opening pressure
normal or mildly elevated protein
neg gram stain
109
Q

Methicillin-resistant Staphylococcus aureus (MRSA)

Presentation

A

Abscess formation common and typically more purulent

Folliculitis, Furuncles

Rarely a cause of necrotizing fasciitis

Treatment – Incision and drainage, refer to local advisements as to antibiotic choice.

110
Q

FUO Imaging Workup

A

Chest X-ray – all patients with FUO

CT scan of body part that is symptomatic (above & below for some)

MRI reserved for suspected CNS or vascular disease

Ultrasound – kidney, pancreas, biliary tree

Echo – suspected endocarditis or atrial myxoma

111
Q

GAS Strep Infection

Rheumatic fever

A

group a beta-hemolytic strep (Gram Pos)

Rheumatic fever

(Jones Criteria)
arthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum

112
Q

Most common bacterial STI in US

A

Chlamydia Trachomatis

113
Q

C diff risk factors

A

7-10 days of anitbiotics but can occur after single dose

mostly with clindamycin and b lactams
can be due to flouroquinolones as well

114
Q

HACEK organisms

A

Gram negative
ampicillin resistant

penicillin and ampicillin should not be used
highly susceptible to 3rd gen cephs (ceftriaxone)

Haemophilus aphrophilus
Acintobacillus actinomycetemcomitans
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae
115
Q

Trichomoniasis Testing

A

Microscopic evaluation using vaginal discharge with saline and observing motile protozoa

NAAT – vaginal swab or urine

Rapid Ag and DNA hybridization test – POC 1hr

116
Q

Congenital Toxoplasmosis Risks

A

Prematurity, intrauterine growth restriction,

jaundice, hepatosplenomegaly,

myocarditis, pneumonitis,

rash, chorioretinitis,

hydrocephalus, intracranial calcifications,

microcephaly, and seizures

117
Q

HIV Testing

A

p24Antigen testing

2 weeks after infection

118
Q

Bacterial endocarditis

A

Bacteria infect the leaflets of the valves

Most common factor is structurally abnormal cardiac valve

Almost always left side = mitral and aortic valves

Rheumatic / congenital heart disease
Prior heart valve, prior endocarditis

IV drug users

Usually gram postive Streptococci, S. aureus, enterococci

119
Q

MAC

A

M. avium Complex

Elderly and immunocompromised primary

No known person to person transmission

Typically present as lung disease

macrolides

120
Q

CMV

A

Cytomegalovirus (Herpes Family)

Intial asymptomatic, mild symptoms
2nd rx (immuno comp) = fever, night sweats, myalgia...
Self limiting (supportive)
Immunocomp = antiviral ganciclovir
121
Q

Pubic Lice

A

Crabs (Crab louse)
Can live off human host x24-48h

Wash all clothing, towels, bedding

Permethrin cream
Ivermectin topical

122
Q

Most common newly diagnosed STI in US

A

HPV

123
Q

Herpes Simplex Virus

A

Oral or Genital Herpes/ HSV1 and 2

30% of the world has symptomatic HSV
90% worlwide asymptomatic w/ ~65% in US

Direct contact withsaliva or bodily secretions

Acyclovir

124
Q

Campylobacter jejuni Presentation

A

watery diarrhea, +/-bloody, fever, cramps, weight loss lasting ~ 6 days.

Azithromycin, cipro (fluids)

125
Q

Mumps immz

A

Endemic worldwide with epidemic outbreaks, due to insufficient vaccination

Vaccine ↓ 99.8% of cases in US in the late 60’s

126
Q

Measles (rubeola)

A

Kids 4-5 y/o; Extremely contagious (vaccine ↓ deaths by 75%),

countries with poor health system and/or whose children at risk for malnutrition(Vitamin A def);
pregnant women, immunosuppressed individuals.

Person to person droplets in the air (2 hours)

Immune response is suppressed by the virus and thus promoting replication.

Can be transmitted 4 days before and after the appearance of the rash

Fever and rash 1-2 weeks after infection

3 C’s = Cough, coryza, conjunctivitis; depletes vitamin A

127
Q

FUO Most common Infections

A 
TB
Q Fever
Brucellosis
HIV
Abdominal/Pelvic Abscess
Cytomegalovirus
Cat Scratch Disease
Typhoid
Toxoplasmosis
128
Q

Syphillis in pregnancy

A

risk of transplacental fetal infection is about 60 to 80%

Likelihood is increased during the 2nd half of the pregnancy

Untreated primary or secondary syphilis in the mother usually is transmitted, but latent or tertiary syphilis is transmitted in only about 20% of cases

Untreated syphilis in pregnancy is also associated with a significant risk of stillbirth and neonatal death.

Many patients are asymptomatic, and the infection may remain clinically silent throughout their life.

129
Q

Bacterial Meningitis Presentation

A

classic triad

Fever, Headache, Nuchal rigidity
positive Kernig and Brudzinski signs

Decreased LOC (75%)
NV
photophobia
Seizures 20-40%

130
Q

Toxoplasmosis Presentation

A

Most acute infections are asymptomatic

Nontender cervical or diffuse lymphadenopathy may last for months

Malaise, headache, sore throat, rash, myalgias, hepatosplenomegaly
Severe – pneumonitis, meningoencephalitis, hepatitis, myocarditis, polymyositis and retinochoroiditis

Can be congenital

131
Q

A 27-year-old woman presents in the hospital setting. She was initially admitted to the ICU with respiratory failure due to pulmonary edema. The cardiac evaluation revealed moderately severe mitral stenosis on echocardiogram with no vegetations. Throughout the hospitalization, she has had no fevers, rash, pharyngitis, or arthritis. Blood cultures have remained negative. The patient has undergone successful diuresis with resolution of shortness of breath and dyspnea. She is on room air with a normal physical exam other than an opening snap and low-pitched diastolic murmur on cardiac auscultation, consistent with mitral stenosis. The patient is ready for discharge. Upon taking a more in depth history, the patient is from Turkey and emigrated to the U.S. about 3 years ago. She has been working in daycare centers for several years, and continues to do so. She has been well since arriving in the U.S., but had several episodes of chest pain or joint swelling, arthralgias, and fevers between the ages of 5 and 16 years while living in Turkey, which was diagnosed as rheumatic fever.

For long-term outpatient management, which one of the following recommendations would be best for rheumatic fever prophylaxis?

A. IM benzathine penicillin monthly for 5 years
B. Oral penicillin for 12 months
C. IM benzathine penicillin until the patient is at least 40 years of age
D. IM benzathine penicillin monthly until anti-streptolysin O (ASO) titers are normal for 12 months

A

C. IM benzathine penicillin until the patient is at least 40 years of age

132
Q

Sepsis complications

A

Septic shock = vasodilatory or distributive shock

133
Q

Most common empiric treatment for bacterial meningitis

A 
MC Empiric= 
Dexamethasone
\+ 3rd or 4th cephalosporin (Ceftriaxone, Cefotaxime)
And Vancomycin PLUS 
Acyclovir

Tx Course: Until pt is afebrile for 5 days

134
Q

Hepatitis C

A

Multiple genotypes 1-6
~178 million living with HCV worldwide; ~2 million in US

Direct contact with bodily fluid, specifically blood (IVDU, sex)

Acute -usually asymptomatic or slight fever, malaise, nausea, RUQ pain, dark urine jaundice

Liver Cancer/Cirrhosis/Liver Failure/Death

Chronic(10-20yr after infection

Direct acting antiviral
2nd generation protease inhibitors

135
Q

Salmonellosis Presentation

A

3 distinct clinical syndromes
– fever (Typhoid),
Gradual onset of malaise, headache, cough, sore throat, abdominal pain and constipation

  • bacteremia (immunocompromised)
    Recurrent fevers, arthralgias, local infection in bone, joints, pleura, pericardium, lungs, other sites
  • Gastroenteritis (most common form of salmonellosis)
    Fever, chills, cramping, nausea/vomiting, diarrhea (may be grossly bloody) – lasts for 3-5 days

ciprofloxacin for all

136
Q

Hepatitis Testing

A

Serologic antibody and antigen (blood)

137
Q

Rabies

A

30-70k deaths/year worldwide from rabid animals, 10% domestic animals; 2 deaths/yr in US

Targets CNS by means of peripheral nervous system

Tingling at bite site w/i days-fever, malaise, myalgia
Neuro sx of anxiety, agitation, delirium

Rabies Immune globulin ASAP along with rabies vaccine (4 in 14 d)

138
Q

Gonorrhea testing

“gold standard”

A

NAAT testing: urine or swabs

139
Q

Gonorrhea

A

Neisseria gonorrhoeae (Clap) (Gram Neg)

2nd most common bacterial STI worldwide and US

Direct contact with infected tissue/fluid
often asymptomatic

Copious mucopurulent green, yellow, white d/c

Azithromycin - Single dose therapy, 1G PLUS Rocephin 250mg IM

140
Q

Rubella vaccine in pregnant women

A

Pregnant women should NOT get

MMR vaccine
until after they hav given birth

avoid getting pregnant for at least four weeks after receiving MMR vaccine.

141
Q

Hepatitis A

A

Direct contact, most commonly fecal-oral route, contaminated food and water sources,

Nausea, vomiting, RUQ pain/discomfort, malaise, anorexia, myalgia, fatigue, fever, Jaundice, icteric sclera

Supportive, prevent trhough vaccine
liver transplant

142
Q

Infectious diarrhea

Hemorrhagic

A

Primarily caused by E.coli
deaths are caused by hemolytic uremic syndrome

related to contaminated foods

leads to vascular damage and in some patients a prothrombolitic state that procedes hemolytic uremic syndrome.

143
Q

Syphillis Latent

A

asymptomatic stage, tests positive

lesions or rashes can recur- but not present on exam

144
Q

3 most common etiologies of noscomial pneumonia

A

E. Coli
S. Aureus
Pseudomonas

145
Q

parainfluenza

A

Community acquired for children < 5years old
immunocompromised, elderly

Malnutrition, overcrowding, Vitamin A def, environmental smoke or toxin

Primarily through direct person to person contact

More likely with Asthma, COPD, CHF

Can cause common cold, croup, bronchilitis, pneumonia, tracheobronchilitis

Supportive, could be steroids, nebulizer etc.

146
Q

When is HIV Detectable

A

HIV not detectable <21 days

147
Q

Direct transmission

A

touching, biting, licking, kissing, sex

direct projection (droplet) via coughing or sneezing within 3f

148
Q

Herpes testing

“gold standard”

A

Viral Culture

PCR if in CSF

149
Q

HIV/ AIDS

A

HIV is a virus that destroys the immune system over time, robbing the body of its ability to fight other infections and illnesses

Once the immune system is weakened, other infections occur and AIDS develops (the fatal stage of HIV infection)

The virus is present in blood, semen, vaginal secretions & breast milk

enters the body by infecting CD4 cells
CD4 cell produces about 300 new virions

Anti-Retroviral Therapy (ART), HAART, ARV

150
Q

Congenital Syphilis

A

stillbirth, bulging fontanelles, seizures, saddle nose

151
Q

Treatment for Streps

A

Penicillins

Strep throat = Pen G 1.2u

152
Q

MRSA or PCN allergy

A

Vancomycin or Daptomycin

153
Q

FUO Lab Workup

A

CBC with differential

Metabolic profile with liver function tests

Liver Function

Blood Cultures (no abx 3 days prior if possible)

Cultures of urine, sputum, stool, cerebrospinal fluid

Sed rate, ANA, RA, Cytomegalovirus IgM, Tb test,

heterophile antibody, HIV

154
Q

Malaria Testing

A

Blood smears (Giemsa-stained) mainstay of diagnosis

Repeat smears in 8-24 hour intervals if diagnosis suspected

Severe Malaria is a medical emergency
Standard of care is IV Artesunate

Old standard – quinine – still used when/where Artesunate not available

155
Q

Cytomegalovirus in pregnancy Dx

A

Diagnosis of neonatal infection is best made by viral detection via culture or PCR testing

156
Q

Most common Sepsis etiology

A

MC etiology – bacterial pathogen (gram + in U.S.)

Sepsis is ALWAYS caused by infection

157
Q

Sepsis pearls

A

Mortality higher for Noscomial than CAD
lactate over 4 = poor prognosis

Risk factors for sepsis:
ICU admission, a nosocomial infection, bacteremia, advanced age, immunosuppression, previous hospitalization & CAP

cant always get the right abx as treatment starts before cultures

158
Q

Infectious diarrhea

inflammatory

A

bacterial invasion of mucosal lining resulting in cell death

febrile, cramp lower abdominalpain, diarrhea which may contain mucous

shigella ,salmonella, campylobacter

Shigella is cause of bacillary dysentery
person to person or food/water contamination

159
Q

Indirect transmission

A

airborne, vehicle borne(fomite), vector borne does not require physical contact ( sneezing, coughing, talking)

160
Q

6 main types (or classes) of drugs that work

against parts of HIV

A 
NRTI
NNRTI
PI
INI
CCR5
Fusion inhibs
mAbs
161
Q

Pinworms presentation

A

Enterobius vermicularis

Cardinal sign – perianal pruritis, typically nocturnal

162
Q

Parvovirus B19 (5th)

A

About half of pregnant women are immune to parvovirus B19, so they and their babies are usually protected from getting the virus and fifth disease

Those that arent ususally have mild symptoms

Risk of fetal death is 2 to 6% after maternal infection

Rarely (<5%), a baby will develop anemia from mother’s fifth disease, resluting in miscarriage

More common in 1st half of pregnancy

low-grade fever, malaise, slapped cheek

Treatment is supportive

163
Q

Varicella -Zoster

A

Chicken pox / Herpes zoster
person to person contact

Self limiting, supportive, isolation, vaccination

164
Q

C diff Tx

A

Vanc 15mg PO Q4
or
fidaxomicin 200mg BiD x 10 days

165
Q

S. aureus

A

folliculitis, carbuncle, furuncle, necrotizing fasciitis (rare)

Nafcillin or Cefazolin

166
Q

Who gets Varicella-Zoster IG

A 
Varicella = Chicken pox
Zoster = shingles

Varicella-zosterimmune globulinfor postexposure prophylaxis in

Those with no known immunity and….

Pregnant women
Immunocompromised

Hospitalized premature infants who were born at ≥ 28 weeks gestation

Hospitalized premature infants who were born at < 28 weeks gestation or who weigh ≤ 1000 g at birth

167
Q

Etiology

A

cause or origin, source

168
Q

Which one of the following regimens is recommended for prophylaxis of mycobacterium avium complex (MAC) infections in a 22-year-old HIV infected male patient with CD4 count of 40 and viral load of 65,426 copies/ml?

A. Rifampin 300mg orally daily
B. Ethambutol 800mg orally daily
C. Isoniazid 300mg orally daily
D. Azithromycin 1,200mg weekly

A

D. Azithromycin 1,200mg weekly

169
Q

Botulism Presentation

A

12-36 hours after ingestion – visual disturbance, diplopia, loss of accommodation, ptosis, CN palsies, EOM impairment, fixed dilated pupils.

Dysphagia, dysphonia, dry mouth, nausea and vomiting.

Paralysis progressing to respiratory failure and death

Botulinum antitoxin– cornerstone of tx
equine = adults , Human = under 1

170
Q

A 68-year-old man is being evaluated for measures to decrease his risk of acquiring a surgical site infection; he is scheduled for coronary artery bypass graft surgery in 5 weeks for limiting chronic angina despite maximal medical therapy. Medical history includes chronic stable angina, hyperlipidemia, hypertension, and diabetes. Medications are low-dose aspirin, propranolol, isosorbide dinitrate, ranolazine, chlorthalidone, lisinopril, and atorvastatin.
On physical examination, blood pressure is 126/72 mm Hg; all other vital signs are normal. On cardiac examination, an S4is present. The remainder of the examination is noncontributory.

Which of the following is the most appropriate measure to prevent surgical site infection?

Evaluate for Staphylococcus aureus nasal carriage
Provide postoperative vancomycin prophylaxis for 7 days
Provide preoperative vancomycin prophylaxis
Shave patient’s chest hair the morning of surgery

A

Evaluate for Staphylococcus aureus nasal carriage

171
Q

Candidiasis Presentation

A

Normal flora becomes an opportunistic pathogen

Can be cultured from the mouth, vagina, and feces of most people

most common in esophagus

GERD, dysphagia, nausea (no substernal pain)

Risk factors – neutropenia, recent abd sx, broad spectrum abx, renal disease, IV catheters, cellular immunodeficiency

172
Q

Modified Duke Criteria

A

Endocarditis
2 major / 1 major-3 minor / 5 minor

Major Criteria
(1) Two positive blood cultures of typical microorganism or One positive cx of Coxiella burnetii

(2) Documented ECHO showing vegetation, myocardial abscess, dehiscence of a prosthetic valve or NEW valvular regurgitation

Minor criteria

  1. Predisposing factors (IV Drug use or Heart condition)
  2. Temp over 38C
  3. Vascular phenomena (emboli, infarcts, hemorrhages)
  4. Immunilogic phenomena (RF factor +, nephritis etc)
  5. Microbiologic evidence (other positive cultures)
173
Q

Meningitis types

A

Bacterial = Acute infection in the subarachnoid space

Viral = An infection of themeninges(lining of the brain and spinal cord) by any number of viruses

Fungal = fungusspreads from elsewhere in the body to the brain or spinal cord.

174
Q

Incubation

A

period of time between exposure and onset of symptoms

175
Q

Rheumatic fever complications

A

heart valve disease

176
Q

Cytomegalovirus in pregnancy

A

Most common congenital viral infection

may be acquired prenatally or perinatally

Intrauterine growth restriction, prematurity, microcephaly, jaundice, petechiae, hepatosplenomegaly, periventricular calcifications, chorioretinitis, pneumonitis, hepatitis, and sensorineural hearing loss

177
Q

Most common community aquired pneumonia pathogen

A

Streptococcus pneumoniae

178
Q

HPV

A

Human Papilloma Virus

Low risk HPV - cause of warts
High risk HPV (16 and 18)- cause cervical or anal CA

Most common newly diagnosed STI in US

Direct skin to skin sexual contact

Genital warts flat or raised

NO CURE

vaccination is available to prevent certain types of HPV

179
Q

Empyema

A

Bacterial infection is present in the pleura

180
Q

Mumps

A

respiratory droplets, saliva and in household fomites
Highly infectious

1/3 can be asymptomatic, but contagious

Fatigue, fever, malaise
parotitis, orchitis

Self limiting, supportive, isolation

181
Q

Non-group a strep infections

A

Group B Strep

GBS-sepsis, bacteremia, meningitis

182
Q

Acute Viral Infection S/S

A 
Fever
Night sweats
Chills
Lack of Appetite
Rash
Fatigue
Diarrhea
Body Aches
Lymphadenopathy
STIs
Sore throat
Ulcers
183
Q

Sepsis

A

Dysfunction caused by dysregulated immune response to infection

SIRS – Sepsis – Severe Sepsis – Septic Shock

Most patients who die have multi organ failure or refractory hypotension

184
Q

Viral Meningitis CSF results

A

normal glucose,
normal or mildly elevated opening pressure
normal or mildly elevated protein

185
Q

Pneumonia

A

Bcteria, virus, fungi
inflammation of the lung parenchyma causes accumulation of exudate in the airway

Infection typically begins in the alveoli

Can be aquired 3 ways = inhalation, aspiration hematogenous (blood borne)

186
Q

Toxoplasmosis Tx

A

Medications do not eradicate disease and immunocompetent persons infected do not typically require tx

If severe sxs: Generally treat for 1 month with pyrimethamineplus either sulfadiazine or clindamycinand sometimes with prednisone

Treatment required in Pregnancy

Prevention – avoid cats, avoid undercooked meat

Most experts usespiramycinto treat pregnant women (controversial)

187
Q

Gonorrhea Tx

A

Gonorrhea is becoming resistant – treat with IM ceftriaxone in combination with azithromycin or doxycycline

Disseminated – Ceftriaxone 1 gm plus azithromycin 1000mg (1gm) PO, single dose until 48 hrs after improvement begins.

188
Q

parapneumonic effusion

A

The exudative inflammatory response of the pleura to pneumonia

189
Q

Toxoplasmosis Testing

A

Confirmed by isolation of Toxoplasma gondii or identification of tachyzoites in tissue or body fluids

Multiple serologic methods

190
Q

Viral Meningitis Tx

A

Supportive=

Symptomatic-analgesics, antipyretics, and antiemetics
Dispo: Home or hospital
Prognosis: Excellent

191
Q

Pneumonia 2 types

A

Noscomial (after 72 hours hospitalized)

Community acquired (before 72 hours hospitalized)

PAM Semester 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions