Diagnosis only exam 1 Flashcards

1
Q

Staph skin

A

Culture of abscess (after its drained)

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2
Q

Staph osteomyelitis

A

Xray done first
Bone scan is a sensitive confirmatory step
culture purulent fluid after (if obtainable)

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3
Q

Toxic Shock syndrome

A

Clinical presentation + history

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4
Q

Scalded Skin syndrome

A

Clinical, confirm with skin biopsy and culture

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5
Q

Strep pyogenes pharyngitis

A

Dx is clinical only.
Do a rapid strep and throat culture

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6
Q

Otitis Media

A

Clinical.
Tympanogram optional.

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7
Q

Acute sinusitis

A

Clinical.
If not improving, order a CT prn

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8
Q

Pneumococcal pneumonia

A
  • CXR gold standard. +- lobar consolidation effusion.
  • but you can diagnose by clinical only
  • sputum cx ordered only if comorbidities are there or if an inpatient
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9
Q

Bacillus anthracis

A

Culture
biopsy (of black eschar)
Gram stain (purple rods)
Nasal swab and CXR (for inhalation type)
LP if systemic (it can cause meningitis)

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10
Q

Listeriosis

A

Culture blood and CSF

this is listeria monocytogenes

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11
Q

pseudomonas aeruginosa

A

Culture.
If positive, may need hospitalization.

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12
Q

Corynebacterium dipltheriae

A

Clinical.
Culture confirms it.

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13
Q

N. meningococcal meningitis

A

Gram stain and culture:
Lumbar puncture CSF analysis
Blood

gram stain reveals pink diplocci shaped like kidney beans

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14
Q

N. gonorrhoeae

A

Grain stain and culture:
reveal intracellular diplococci (-)
urine
vaginal swab>urine swab for females
notify health dept

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15
Q

Bordetella Pertussis

A

Nasopharyngeal culture + clinical
Health department

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16
Q

Legionelle Pneumophilla

A

CXR - focal patchy infiltrates or consolidation
Antigen detection confirms (PCR of lower respiratory secretions, urine antigen, and respiratory tract fluid culture)

sputum grain shows nothing

*anti = bad, the legion from wow.
legionelle is an atypical thats why you cant gram stain

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17
Q

Klebsiella pneumoniae

A

CXR + sputum culture
Sensitivity testing

think drunk woman getting into fights (sensitive)
sputum b/c spits

CXR for all pneumoniae

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18
Q

Shigellosis

A

WBC in stools
organism isolated on a stool culture

19
Q

Cholera

A

Stool culture

20
Q

Non cholera vibrio

A

Stool culture

21
Q

Typhoid fever (salmonella enterica)

A

Blood, stool, and urine culture will show salmonella

22
Q

Enterocolitis (salmonella)

A

Stool culture

23
Q

Francisella Tularensis Tularemia

A

Clinical only.
Confirmation is serologic tests of culture of ulcer/lymph node and blood aspirate

24
Q

Fever of unknown origin noninfectious

A

CT disease, vasculitis, granulomatous disorders, giant cell arteritis, SLE, RA

25
Fever of unkn. Infectious
TB, cat scratch, EBV, shakes, chills
26
Fever. of unknown origin. Misc
Cirrhosis, Chrons, PE
27
Order what labs for fever of unknown origin
CBC with diff, peripheral smear, CMP, Hep ABC panel, ESR SED rate, UA and cx, blood cultures (3 different sites several hours apart), HIV serology, TB serology, CXR
28
Fever of unknown origin- differentiate between what 5 things
Classic, hospital aquired, IC, neutropenic, HIV related
29
What qualifiers diagnose someone w/ fever of unknown origin
Fever above 101.9 F and 38.3 C (oral) Greater than 3 weeks
30
SIRS diagnosis
response to ischemia, infection, inflammation, trauma Fever above 100.4 F, 38 C Lower than 96.6 F, 36 C HR greater than 90 RR greater than 20 WBC greater than 12,000 or less than 4000, greater than 10% bands
31
Sepsis
qSOFA >=2 RR greater than 22 altered mentation SBP less than 100 Warm flush skin, poor cap refill, cyanosis, mottling, altered mental status, absent bowel sounds
32
Mycopolasma pneumoniae
Chest auscultation clear CXR: nonconsolidation. nondiagnostic patchy infiltrates Clinical diagnosis + NP swab *this is the less severe pneumonia in YA, so findings are less 'severe'
33
Chlamydia trachomatis
no gram stain! no cell wall. Screening + Cx ## Footnote STD
34
Syphillis
**Culture of ulcer to look for spirochetes** (dark field microscopy) **Non-treponemal antibody tests** (first line **RPR and VDRL** **Tremonemal antibodies test** - if above is positive, is confirmational **FTA-ABS i**s confirmational
35
Neurosyphillis
LP RI: HIV man 45 yr old
36
Lyme disease
Erythema migrans/one late manifestation AND lab confirmation ## Footnote late manifestations (neuro, cardio, bacteremia, secondary skin lesions, MSK)
37
Leptospirosis
Serologic testing
38
Rocky mountain Rickettsia rickettsii
Clinical + serological testing
39
Anaerobic gram positive
Clinical + gram stain + culture CXR: aspiration pneumonia -infiltrates, cavitation -Lucency - lung abscess - Abdominal/pelvic CT - -Intraabdominal abcess
40
Clostridial soft tissue infections
clinical, graim stain, culture culture takes barely any time (6 hrs) If negative, its not Clostridium ## Footnote rem** Claw-stridium is a purple claw. so gram staining is useful here. looking for a purple rod.
41
Tetanus
clinical only cultures do not work
42
Botulism
Culture (**stool** for ingested, **wound** for injected, any **food** source) Toxic assays are done by the **CDC**
43
Pseudomembrane colitis
-1st Stool sample for toxin and fecal leukocytes -2nd - colonscopy/sigmoidoscopy (it destroys the lining of the GI) -imaging for ileus or distended colon