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infectious disease > DISEASES > Flashcards

DISEASES Flashcards

1
Q

fever of unknown origin (FUO)

A
  • temp >38.3, >3wks, one week inpatient eval

- virus is most common

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2
Q

bacteremia/septicemia

A

-

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3
Q

sepsis/septic shock

A

-

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4
Q

nosocomial infections

A

-

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5
Q

bacterial endocarditis

A

-

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6
Q

what does exanthem mean?

A

-eruption on the skin (usually caused by viruses but can be other infections)

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7
Q

what does enanthem mean?

A

-eruption on mucous membranes (viruses or bacteria or hypersensitivity

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8
Q

Kawasaki syndrome (rash section) –fever AND 4 of 5 things?

A
  • fever AND (4/5):
    1. conjunctivitis (no exudate)
    2. mucous membrane changes (injected pharynx, erythema, swelling/fissuring of lips, strawberry tongue)
    3. peripheral extremity changes (edema, desquamation, erythema, beau lines (transverse lines on nails)
    4. polymorphous rash
    5. cervical lymphadenopathy

mainly kids 3mo-5yrs

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9
Q

Rocky Mountain spotted fever (rash section)

A
  • tick bites (rickettsia)
  • NORTH CAROLINA, tenessee, okla, missouri, ark
  • faint macules to maculopapules to petechiae (appears 2-6 days into fever)
  • starts on wrists/ankles, spreads centrally
  • tx w/ doxycycline
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10
Q

erythema infectiosum (fifth disease) (rash section)

A
  • parvovirus
  • SLAPPED CHEEK rash (firey red)
  • progresses to LACY RETICULAR rash on trunk and extremities
  • school aged (5-15)
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11
Q

toxic shock syndrome (rash section)

A
  • S. aureus toxin (cultures are negative)
  • diffuse macular erythematous rash, DESQUAMATION of hands and feet
  • rash appears AFTER fever
  • adults
  • rehydration (due to diarrhea and vomiting) and IV antistaphylococcal drugs
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12
Q

varicella / herpes zoster (rash section)

A

-both caused by varicella zoster
-vzv: dew drops on a rose petal (become vesicles, pustules then crust;
begin on face/trunk then move to extremities
-shingles: usually over 60yrs, dermatomal rash

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13
Q

scarlet fever (rash section)

A
  • strep throat with a fever
  • diffuse, erythematous rash, like a sunburn, intense in groin and axillas
  • blanchable, recedes in 2-5 days
  • tx w/ PCN or erythromycin
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14
Q

rubella (German measles) (rash section)

A
  • blueberry muffin rash (fine pink maculopapular rash)
  • togavirus
  • worry about this w/ pregnancy (deafness in infant)
  • face first then trunk/extremities
  • post. cervical and post auricular lymphadenopathy
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15
Q

roseola (exanthem subitum, 6th disease) (rash section)

A
  • primarily with young kids (3mo-3yrs)
  • blanchable macules and papules AFTER resolution of fever
  • starts on TRUNK and spreads to head/neck/extremities
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16
Q

Lyme disease (rash section)

A

-erythema migrans; TICK bite (borrelia bergdorferi)
-red TARGET LESION at site of tick bite
-rash before fever
stage 1: flu like with rash
stage 2: facial palsy, meningitis
stage 3: arthritis
-tx w/ doxycycline

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17
Q

rubeola (measles) (rash section)

A
  • koplik spots (pathonogmonic)
  • cough, coryza, conjunctivitis (3 C’s)
  • BRICK RED irregular, maculopapular rash
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18
Q

typhus – endemic / epidemic

A
  • endemic: flea borne (rickettsia typhi); maculopapular rash on TRUNK fades rapidly; appears after fever
  • epidemic: louse borne (rick prowazeki) in africa, central/south america; maculopapular, after fever, begins in AXILLA then moves to body (NO FACE, PALMS, SOLES)
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19
Q

hemophilus influenza pneumonia

A
  • 2nd most common chronic cardiopulm disease
  • one of the most common CAP
  • gradual onset - fever and sputum
  • sudden onset - chest pain, dyspnea, sputum, chills, fatigue
  • amoxycillin, macrolide
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20
Q

klebsiella pneumonia

A
  • typical pneumonia; hospital acquired (common in alcoholics)
  • currant jelly sputum
  • flu like s/s; cough associated w/ aspiration
  • aminoglycosides or cephalosporins
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21
Q

mycoplasmal pneumonia

A
  • ATYPICAL pneumonia: walking pneumonia
  • young adults, crowded areas
  • incessant cough (non or mildly productive)
  • xray is atypical (patchy infiltrates)
  • macrolides, fluoroquinolones, tetracyclines
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22
Q

tuberculosis

A
  • incarceration, household exposures, 1/3 world pop
  • chronic cough (blood), slowly progressive, fatigue
  • xray shows pulm opacities (apical)
  • culture 3 consecutive sputum
  • tx w/ mult drugs
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23
Q

pertussis (whooping cough)

A

-most cases occur before age 2
3 stages:
1. catarrhal - 2 wk prodrome w/ insidious onset hacking night cough, malaise, anorexia, coryza
2. paroxysmal - burst of rapid cough with deep WHOOPING inspiration
3. convalescent stage - 4wks post onset, decreases in severity and frequency

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24
Q

coccidiomycosis

A
  • mold in soil of SW US, mexico, opportunistic inf.
  • influenza like, erythema nodosum, arthralgia w/ pariarticular swelling
  • respiratory tract (can be pneumonitis or cavitation on the xray)
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25
Q

diptheria

A
  • coynebacterium
  • exotoxin
  • tenacious gray membrane over pharynx (mild sore throat, malaise)
  • tx w/ antitoxin and removal of membrane
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26
Q

legionella pneumonia (Legionnaire’s disease)

A
  • ATYPICAL pneumonia; affects immunocompromise
  • 3rd or 4th most common CAP
  • pleuretic chest pain, little sputum, toxic appearing, high fever
  • xray: focal patchy infiltrates/consolidation
  • higher mortality w/out tx
  • tx w/ azithromycin, fluoroquinolone
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27
Q

pneumococcal pneumonia (strep pneumoniae)

A
  • most common CAP
  • typical
  • productive cough, fever, rigors, dyspnea, pleuretic chest pain
  • xray: consolidating lobar pneumonia
  • amoxicilin
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28
Q

hantavirus

A
  • rodent transmission (aerosols of feces, urine); SW US
  • VASCULAR LEAKAGE, resp compromise, pulm edema
  • supportive care; 35% fatality, intubation in many cases
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29
Q

influenza

A
  • epidemic pattern in fall/winter
  • abrupt onset: fever chills, malaise, non productive cough, myalgias
  • reye syndrome: rapid hepatic failure & encephalopathy (DONT GIVE ASA TO KIDS)
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30
Q

mumps

A
  • spread by resp droplets; mostly kids, severe in adults; spreads in spring time
  • uni or bilateral swollen parotid glands and facial edema
  • viral disease
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31
Q

psittaccosis

A
  • ATYPICAL pneumonia
  • from BIRDS
  • delayed signs of pneumonitis but RAPID onset
  • fever, chills, myalgia, dry cough (contact w/ infected bird)
  • tx w/ tetracycline, erythromycin
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32
Q

severe acute respiratory syndrome (SARS)

A
  • coronavirus
  • ATYPICAL pneumonia
  • horse shoe bat
  • range from asymptomatic to severe resp illness
  • fever, chills, rigor, dry cough, SOB
  • antiviral therapy inconclusive
  • mortality 10-14%
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33
Q

anthrax

A
  • found in SOIL gram + anaerobe (SHEEP, CATTLE)
  • cutaneous: painless, necrotic eschar w/ raised erythematous skin at site of innoculation - limited
  • pulm: inhalation of spores (pneumonia and flu like sx) - fatal if no tx
  • CIPRO or DOXY
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34
Q

dengue

A
  • FLAVI VIRUS
  • MOSQUITO in TEXAS AND MEXICO
  • 1st infection=severe head, back, joint, muscle PAIN, rash (from extremities to torso)
  • 2nd infection=fatal autoimmune response
  • tx w/ volume support
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35
Q

cat scratch disease

A
  • papule/ulcer develops at scratch site (KITTEHHH)
  • bartonella henselae
  • EPITROCHLEAR NODES
  • erythromycin
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36
Q

toxoplasmosis

A
  • KITTEEEEHHHH
  • primary: fever, malaise, resembles mono
  • congenital-infected momma, leads to CNS abnormalities in infant
  • immunocompromised-encephalitis, necrotizing brain lesions
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37
Q

tularemia

A
  • francisella tularensis (gram neg)
  • RABBIT transmission - necrotic ulcer at site of infection; tick bite
  • fever, headache, nausea
  • pneumonia
  • streptomycin
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38
Q

plague

A
  • yersinia pestis (gram neg)
  • rapid onset fever, tachycardia, headache
  • regional BUBOS (around flea bite) hemorrhagic lymphadenopathy (neck, groin, axilla)
  • pneumonia fatal if untreated
  • CALIFORNIA, SW USA, 4CORNERS AREA
  • vancomycin, streptomycin (IV)
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39
Q

brucellosis

A
  • cattle, hogs, goats INGESTION OF UNPAST. MILK
  • severe low back pain, fever, cervical/axillary lymphadenopathy
  • MEXICO, MEDITERRANEAN, SPAIN, S. AMERICA
  • doxy AND rifampin, strep, genta
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40
Q

malaria

A
  • INTERMITTENT fever, chills, sweating
  • anemia, splenomegaly
  • FEMALE ANOPHELES MOSQUITO
  • south/central america, africa, middle east, india, SE asia
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41
Q

typhoid fever

A
  • salmonella typhi and paratyphi
  • prolonged fever (4 wks)-step ladder
  • GI s/s delayed
  • PEA SOUP diarrhea
  • macular rash (ROSE SPOTS)
  • recurrent/sustained bacteremia common
  • tx w/ quinolones or 3rd gen cephalosporins
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42
Q

enterohemorrhagic E. coli

A
  • produces SHIGA toxin; more common in developed regions
  • hallmark grossly bloody diarrhea (w/in few hrs or days)
  • LACK OF FEVER; significant abd pain
  • HUS in very young or elderly
  • AVOID ABX!!–increases toxin production and HUS
  • tx w/ h2o and electrolytes
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43
Q

salmonella

A

-salm. highest foodborne in US
-under cooked food and turtles/reptiles
-n/v THEN diarrhea
- +fever, RLQ tenderness
<7days

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44
Q

traveler’s diarrhea

A
  • watery diarrhea, bloating, cramping
  • blood uncommon
  • ETEC a common bacteria (bacteria = 80-90% of cases)
  • manage s/s if mild, cipro if severe
45
Q

C. difficile

A
  • abx associated colitis
  • fecal oral
  • common in hospital but community acquired increased
  • watery mucoid diarrhea and abd pain, low grade fever, small amts of blood
  • cobble stone appearance on endoscopy
  • tx w/ metronidazole or vanco
46
Q

cholera

A
  • not seen a lot in US–CONTAMINATED SEAFOOD
  • Asia/Africa
  • “rice water” stool (gray w/ flecks of mucus, NO BLOOD)
  • rapid severe dehydration
  • oral rehydration salts
  • abx can decrease duration (tetracycline or doxy)
47
Q

giardiasis

A
  • most common PARASITE in US from fecally contam. drinking water (person hiking or well water)
  • cyst and trophozoite formation
  • FOUL smelling and FATTY diarrhea, bloating, farting
  • fever uncommon
  • chronic illness: loose stool (not diarrhea) and sulfurous belching
  • avoid lactose for 1 mo post tx
  • tx w/ metronidazol or tinidazole
48
Q

viral gastroenteritis

A
  • most common cause of infectious gastroenteritis
  • rotavirus (children) and norovirus (adults)
  • blood not common, more mild
  • fluid/electrolyte replacement
49
Q

amebiasis

A
  • 90% aysmptomatic
  • entamoeba hystolytica
  • MOSTLY blood and mucous in stool
  • fecal oral (food and water)
  • metronidazole
50
Q

campylobacter

A
  • poultry, second most common foodborne
  • children/teens/young ppl
  • diarrhea begins LATER (lasts up to 1 week)
  • watery to bloody
  • tx if >1wk, high fever, bloody, immunocomp.
  • erythromycin w/in 3 days of start
51
Q

cystitis – acute / recurrent

A
  • E. coli
  • hematuria, pain, suprapubic discomfort
  • abx
52
Q

pyelonephritis

A

-FLANK pain, fever, chills, sx of uti spread to kidneys

53
Q

ascariasis

A
  • nematode, contaminated food/water; most common helminth
  • often asymptomatic
  • can affect lungs, abdominal discomfort
  • stool O&P shows eggs
  • albendazole, mebendazole
54
Q

trichinosis

A
  • nematode
  • UNDERCOOKED MEAT/PORK
  • abd pain, vomiting, diarrhea
  • later fever, myalgia, periorbital edema, rash
  • eosinophilia
  • albendazole, mebendazole
55
Q

cysticercosis

A
  • human fecal contam of food
  • CESTODE
  • Benign unless intraventricular cysts, intracerebral etc.
  • seizures
  • corticosteroids for seizure control
  • albendazole
56
Q

hookworms

A
  • live in sm intestine, passed through stools
  • mostly asymp
  • anemia
  • eggs in stool
57
Q

scabies

A
  • mite burrows
  • severe itching, vesicles, pustules, finger webs, wrist creases
  • permethrin cream
58
Q

enterobiasis

A
  • PINWORM
  • common cause of intestinal problems in school aged kids
  • mostly asx
  • nocturnal PERIANAL PRURITIS, excoriation
  • pinworm prep test (scotch tape over the butthole)
  • NO eosinophilia, no eggs in stool
59
Q

tapeworms

A
  • undercooked pork, beef, freshwater fish
  • asymp or gi s/s
  • eosiniphilia, eggs in stool (several samples needed)
  • praziquantel (single dose)
60
Q

cutaneous larva migrans

A
  • larvae of cat/dog hookworms, migrates through skin
  • southeast us and children
  • intensly pruritic erythmatous papules (feet and hands)
  • serpiginous tracks
  • no tx needed for mild cases
61
Q

schistosomiasis

A
  • TREMATODE blood flukes
  • infected snails in fresh water
  • fever, abd pain, diarrhea, urinary s/s
  • praziquantel single dose
62
Q

blastomycosis

A
  • SOIL, S. central and E. US FUNGAL
  • males
  • pulm infection (resembles bacterial pneumonia)
  • itraconizole
63
Q

candidiasis

A
  • opportunistic FUNGAL
  • thrush (oral, vaginal, esophageal)
  • scrapes off
  • KOH
  • Nystatin
  • Itraconazole
64
Q

histoplasmosis

A
  • ohio/mississippi river valleys FUNGAL
  • soil w/ bird/BAT droppings
  • resembles TB, can be acute but benign and progress into chronic/fatal disease
  • Itraconazole
  • slow to grow on culture
65
Q

mucormycosis

A
  • spores in nature FUNGAL
  • opportunistic!!
  • sinuses and lungs
  • High dose Amphotericin B.
  • surgical debridement
  • often fatal
66
Q

cryptococcoses

A
  • abundant in soil with pigeon droppings
  • present in PACIFIC NW
  • opportunistic FUNGAL
  • INDIA INK!! of csf blood
  • pneumonia like s/s, sob, fever
  • Amphotericin B.
  • most common fungal meningitis
  • HIV pts put on fluconazole for prophylaxis
67
Q

purulent (bacterial) meningitis

A
  • S. PNEUMONIAE, N. MENINGITIDIS, H. FLU
  • at least two of: fever, headache, stiff neck, aloc
  • LP
  • vancomycin AND …
68
Q

meningococcal meningitis

A
  • n. meningitis
  • schools military barracks
  • fever, HA, vomiting, confusion
  • rash
  • PCN G IV
  • LP - cloudy/purulent CSF
69
Q

brain abscess

A
  • space occupying lesion
  • bacterial usually
  • HA, drowsiness, confusion, focal neuro deficits
  • NO LP
  • CT scan
  • IV abx and surgical drainage
70
Q

poliomyelitis

A

-

71
Q

tetanus

A

-

72
Q

aseptic meningitis

A
  • VIRAL
  • acute onset of ha, fever, chills, photophobia
  • benign and self limited
  • supportive therapy
73
Q

encephalitis

A

-

74
Q

rabies

A

-

75
Q

botulism

A

-

76
Q

West Nile virus

A

-

77
Q

syphilis - primary, secondary and tertiary

A
  • primary: PAINLESS CHANCRE
  • secondary: diffuse macular rash (hands and soles too), fever, malaise
  • tertiary: organ sys involvement, gummas
  • PCN in all cases
  • treponema palladium
78
Q

gonorrhea

A
  • N. gonorrheae
  • purulent urethral discharge, dysuria, pain w/ intercourse, may become disseminated
  • NAAT
  • ceftriaxone, AND azithro or doxy
  • can progress to PID if untreated
79
Q

genital herpes - primary and recurrent

A
  • primary=BAD
  • recurrent = mild, less painful
  • TZANCK smear
  • acyclovir at first signs of sx
80
Q

chancroid

A
  • PAINFUL ulcer w/ necrotic base
  • unilateral lymphadenopathy
  • azithromycin
81
Q

granuloma inguinale

A
  • PAINLESS firm nodule, beefy red, rolled edges
  • DONOVAN BODIES on wright stain
  • Klebsiella
  • doxycycline
82
Q

lymphogranuloma venereum

A
  • clamydia trachomatis
  • primary lesion: lymph node abscess, turns into rectal fistula, proctitis (MSM)
  • NAAT, PCR
  • azithromycin
83
Q

chlamydia

A
  • cervicitis, urethritis
  • LESS painful/purulent than gonorrhea
  • NAAT
  • azithromycin
84
Q

human papilloma virus (HPV) / condyloma acuminata

A
  • cauliflower like warts
  • pap smear
  • wart removal
85
Q

streptococcal skin infections*

A
  • impetigo, kids, amber colored crust

- erysipelas, adults, well demarcated, face

86
Q

staphylococcal skin infections (MSSA/MRSA)*

A
  • MSSA:

- MRSA:

87
Q

gas gangrene*

A
  • clostridium species (spores in soil)

- spreading necrotized tissue, see gas

88
Q

necrotizing fasciitis*

A

-group A strep, staph aureus, clostridium perfringens

89
Q

osteomyelitis

A

-

90
Q

non-joint bacterial infection arthritis

A

-

91
Q

septic arthritis (gonococcal, nongonococcal)

A

-

92
Q

tuberculosis

A
  • opportunist in HIV pts
  • malaise, dyspnea, fever, hemoptysis
  • given prophylaxis if exposed, if + test but no s/s and ppl w/ s/s
93
Q

toxoplasmosis

A
  • most common CNS lesion in HIV pts
  • aloc, focal neuro deficits, headache
  • tx w/ big gun chemotherapy
  • prophylaxis=TMP-SMX (bactrim) once daily; avoid undercooked meats, avoid litter box
94
Q

cryptosporidiosis

A
  • opportunist in HIV pts
  • chronic diarrhea w/ frequent foul smelling stools; malabsorption and weight loss
  • avoid lakes and swimming pools
95
Q

cytomegalovirus retinitis

A
  • late stage HIV; blurred vision, loss of central vision
  • dx w/ fundoscopy
  • prophylaxis when CD4<50
  • tx w/ valganciclovir
96
Q

oral hairy leukoplakia

A
  • opportunistic infection in HIV
  • benign hyperplasia of oral mucosa
  • EBV–white corrugated plaques
  • antivirals help; reassure pt condition is benign
97
Q

pneumocystis pneumonia*

A
  • very common opportunistic cause of pneumonia in HIV patients
  • happens early (CD4>500)
  • tx w/ TMP-SMX (bactrim)–prophylaxis in compromised pts
98
Q

cryptococcal meningitis

A
  • opportunistic inf. of HIV pts
  • immunocompetent: acute pneumonitis
  • immunocompromised: CNS infection
  • tx w/ amphotericin B and flucytosine
99
Q

AIDS dementia complex

A
  • subtle impairment can lead to aphasia and motor abnormalities
  • tx if underlying cause can be determined
100
Q

Kaposi Sarcoma

A
  • lesions appear anywhere and can be visceral too
  • purplish, non blanching papules or nodules
  • tx w/ systemic chemotherapy
101
Q

vaginal /oral /esophageal candidiasis

A

-systemic seen w/ CD4 ct <100
-nothing can reduce exposure
-systemic prophylaxis not recommended
-tx w/ potent antifungal:
itraconazole
fluconazole

102
Q

enterocolitis

A
  • very common complication of HIV
  • profuse watery, recurrent diarrhea
  • prophylaxis=avoid raw oysters
  • tx based on organism and fluid replacement
  • can be viral, bacterial, protozoal
103
Q

shigella*

A
  • person to person spread; S. sonnei and S. dysenteriae (complicated one)
  • s/s start w/in 48 hrs
  • bloody w/ mucus and pus
  • <5y/o
104
Q

what are the three most common causes of meningitis?

A

N. meningitidis
strep pneumoniae
H. influenzae

105
Q

three most common diarrhea causing organisms?

A

shigella, salmonella, campylobacter

106
Q

what are the six gram + bugs we need to know?

A

Strep, enterococcus, staph (cocci)
Clostridium, bacillus (spore causing)
Corynibacteria, listeria

107
Q

what does haEMOPhilus influenza

A

epiglotitis
meningitis
otitis media
pneumonia

108
Q

which bugs cause rash on palm and soles? CARS

A

Coxsakievirus A
Rocky mtn spotted fever
Syphilis

109
Q

what does klebsiella cause (4As)

A

aspiration pneumonia
abscess in lungs and liver
alcoholics
diAbetics

infectious disease (3 decks)

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