DISEASES Flashcards
fever of unknown origin (FUO)
- temp >38.3, >3wks, one week inpatient eval
- virus is most common
bacteremia/septicemia
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sepsis/septic shock
-
nosocomial infections
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bacterial endocarditis
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what does exanthem mean?
-eruption on the skin (usually caused by viruses but can be other infections)
what does enanthem mean?
-eruption on mucous membranes (viruses or bacteria or hypersensitivity
Kawasaki syndrome (rash section) –fever AND 4 of 5 things?
- 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
Rocky Mountain spotted fever (rash section)
- 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
erythema infectiosum (fifth disease) (rash section)
- parvovirus
- SLAPPED CHEEK rash (firey red)
- progresses to LACY RETICULAR rash on trunk and extremities
- school aged (5-15)
toxic shock syndrome (rash section)
- 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
varicella / herpes zoster (rash section)
-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
scarlet fever (rash section)
- 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
rubella (German measles) (rash section)
- 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
roseola (exanthem subitum, 6th disease) (rash section)
- primarily with young kids (3mo-3yrs)
- blanchable macules and papules AFTER resolution of fever
- starts on TRUNK and spreads to head/neck/extremities
Lyme disease (rash section)
-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
rubeola (measles) (rash section)
- koplik spots (pathonogmonic)
- cough, coryza, conjunctivitis (3 C’s)
- BRICK RED irregular, maculopapular rash
typhus – endemic / epidemic
- 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)
hemophilus influenza pneumonia
- 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
klebsiella pneumonia
- typical pneumonia; hospital acquired (common in alcoholics)
- currant jelly sputum
- flu like s/s; cough associated w/ aspiration
- aminoglycosides or cephalosporins
mycoplasmal pneumonia
- ATYPICAL pneumonia: walking pneumonia
- young adults, crowded areas
- incessant cough (non or mildly productive)
- xray is atypical (patchy infiltrates)
- macrolides, fluoroquinolones, tetracyclines
tuberculosis
- 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
pertussis (whooping cough)
-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
coccidiomycosis
- 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)