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Internal Medicine > Deja - Internal - Infectious Diseases > Flashcards

Deja - Internal - Infectious Diseases Flashcards

1
Q

How is AIDS defined?

A

CD4 <200/μL of blood or 14% of all lymphocytes.

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2
Q

How is an HIV infection diagnosed?

A

A positive ELISA for HIV is then CONFIRMED with a Western blot assay.

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3
Q

How is HIV ruled out?

A

A negative ELISA for HIV.

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4
Q

What marker is used to follow the EXTENT of disease?

A

CD4 count.

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5
Q

What can be used as a marker of disease PROGRESSION?

A

Viral load - it will tell how well the treatment is working.

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6
Q

Complications when CD4 is <500:

A
  1. Multiple episodes of vaginal candidiasis.

2. Lymphadenopathy.

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7
Q

Complications when CD4 is <400:

A
  1. Pneumonia
  2. Pulmonary TB
  3. Oral candidiasis
  4. Shingles
  5. Kaposi
  6. NHL
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8
Q

Complications when CD4 is <200:

A
  1. PCP
  2. Wasting
  3. Dementia
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9
Q

Complications when CD4 is <100:

A

Cryptococcus or toxoplasmosis.

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10
Q

Complications when CD4 is <50:

A
  1. MAC
  2. CMV
  3. CNS lymphoma
  4. Cryptosporidiosis
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11
Q

When should antiretroviral therapy be initiated?

A

At CD4 counts <350.

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12
Q

Management for CD4 <200:

A

Start prophylaxis against PCP + toxoplasmosis with bactrim (SMX-TMP).

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13
Q

Management for CD4 <100:

A

Start prophylaxis against MAC with clarithromycin or azithromycin.

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14
Q

Management for CD4<50:

A

Start prophylaxis against fungal infections with fluconazole.

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15
Q

AIDS-related complication - Presents as non productive cough:

A

PCP

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16
Q

MCC of AIDS death in the USA:

A

Disseminated MAC

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17
Q

MC fungal infections in HIV:

A

Candidiasis

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18
Q

AIDS-related complication - Presents as painless progressive vision loss:

A

CMV retinitis.

19
Q

AIDS-related complication - Ring enhancing lesion on head CT:

A
  1. Toxo
  2. CMV
  3. CNS lymphoma
20
Q

AIDS-related complication - Perivascular hemorrhages and exudates on funduscopic exam:

A

CMV

21
Q

AIDS-related complications - Elevated ALP:

A

MAC

22
Q

What are the gummas of syphilis?

A

Rubbery granulomatous lesions in CNS, aorta, heart, skin, bone.

23
Q

What is tabes dorsalis?

A

Posterior column degeneration.

24
Q

How is syphilis diagnosed?

A

4 POSSIBLE TESTS:

  1. VDRL/RPR-rapid test.
  2. Dark-field microscopy will show motile spirochetes.
  3. Enzyme immunoassay - Antitreponemal IgG.
  4. FTA-ABS/MHA-TP –> Sensitive + Specific.
25
Q

On what type of medium is gonorrhea diagnosed?

A

Thayer-Martin.

26
Q

MCC of vaginitis:

A

Bacterial vaginosis caused by Gardnerella.

27
Q

What is the classic odor associated with bacterial vaginosis?

A

Fishy odor = Positive Whiff test with KOH prep.

28
Q

How is bacterial vaginosis treated?

A

Metronidazole.

29
Q

Which type of vaginitis is caused by a flagellated, motile protozoan?

A

Trichomonas

30
Q

How is Trichomonas diagnosed?

A

Protozoa seen on wet mount.

31
Q

What are the classic symptoms of Trichomonas infection?

A

Fishy odor of discharge + strawberry cervix.

32
Q

How is candidiasis diagnosed?

A

Pseudohyphae on KOH prep.

33
Q

2 vaccines approved to protect against cervical cancer?

A
  1. Gardasil

2. Cervarix

34
Q

Which of the 2 vaccines is also protective against genital warts?

A

Gardasil.

35
Q

When should a female start getting Pap smears?

A

Age 21 or 3 yrs after 1st sexual activity.

36
Q

How often should a Pap smear be done?

A

If a patient has had 3 normal consecutive Pap smears, they can get them every 3 years after age 30.

37
Q

What is SIRS?

A

Includes the following:

  1. Tachycardia
  2. Tachypnea
  3. Fever
  4. WBC >12.000, 10%bands.
38
Q

What is the treatment of sepsis?

A
  1. IV fluids.
  2. Antibiotics to treat infection.
  3. Vasopressors
  4. Remove potential sources of infections - Foley etc.
  5. Steroids, sometimes.
39
Q

2 MCCs of osteomyelitis in IVDA:

A
  1. Pseudomonas

2. S.aureus

40
Q

Gold standard for diagnosing osteomyelitis?

A

MRI

41
Q

Osteomyelitis treatment:

A

Appropriate IV antibiotics for 4-6weeks.

42
Q

Possible complications of osteomyelitis:

A
  1. Chronic osteomyelitis
  2. Sepsis
  3. Septic arthritis
  4. SCC secondary to a draining sinus tract.
43
Q

How is HIV transmitted?

A
  1. Sexually
  2. Blood products
  3. Mother to child
  4. Needle stick injury

Internal Medicine (106 decks)

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