Endo/Repro - Infectious Disease Flashcards
In what way can the abnormal glycosylation seen in diabetes cause increased susceptibility to infection?
Phagocyte dysfunction
(due to glycosylation and inactivation of involved proteins)
Diabetic immunosuppression is mostly a defect in _________ (cellular/humoral) adaptive immunity.
Diabetic immunosuppression is mostly a defect in cellular adaptive immunity (humoral immunity mostly preserved).
An imbalance of what two factors in diabetes can lead to decreased tissue perfusion?
NO and ROS
True/False.
Diabetic neuropathy often makes patients hyperaware of their sores and lesions.
False.
Diabetic neuropathy creates a local anesthesia and a decreased awareness of one’s injury.
The compromised neurovascular supply to the foot seen in diabetic patients can lead to a swollen, deformed foot called a _______ foot.
The compromised neurovascular supply to the foot seen in diabetic patients can lead to a swollen, deformed foot called a Charcot foot.
In a diabetic patient who has not received many antibiotics, what would you expect is the cause of their foot abcesses?
Staphylococci spp.;
Streptococci spp.
In a hospitalized diabetic patient (who has received several antibiotics) who develops foot abcesses, what would you expect to be some of the potential etiologies?
Polymicrobial infections,
facultative gram-positive,
gram-negatives (e.g. Pseudomonas aeruginosa)
How is diabetic osteomyelitis with ulceration treated?
Surgical debridement
+
antibiotics as needed
A diabetic patient presents with an extremely painful and erythematous pinna and external auditory meatus.
What diagnosis do you suspect, and what is the etiology?
Malignant otitis externa;
Pseudomonas aeruginosa
Name four etiologies of rhinocerebral mucormycosis.
Rhizopus, Rhizomucor, Absidia, Mucor
A diabetic patient presents with polymicrobial necrotizing infection of the genitalia and perineum.
What is the diagnosis?
Fournier’s gangrene
(rapid surgical involvement for debridement + plastics required)
A diabetic patient presents with gas-producing organisms in her gallbladder.
What is the name of her condition, and what is the etiology?
Emphysematous cholecystitis;
Clostridium spp.
True/False.
Diabetics have a predilection for infection with group A strep (S. pyogenes) (which could cause UTIs, systemic infection, bacteremia, and sepsis).
False.
Diabetics have a predilection for infection with group B strep (S. agalactiae) (which could cause UTIs, systemic infection, bacteremia, and sepsis).
The earlier in gestation the infection with T. gondii occurs, the _____ likely there will be transmission to the fetus, but the _____ severe the disease will be if transmission occurs.
The earlier in gestation the infection with T. gondii occurs, the less likely there will be transmission to the fetus, but the more severe the disease will be if transmission occurs.
What is the treatment for congenital toxoplasmosis?
Pyrimethamine + sulfadiazine
How is congenital toxoplasmosis avoided?
Instruct pregnant women to avoid cat litter
The transmission rate of syphilis to the fetus is _____% for primary or secondary syphilis in the mother.
The transmission rate of syphilis to the fetus is 100% for primary or secondary syphilis in the mother.
Congenital syphilis is relatively ________ and has a ________ infant mortality rate.
Congenital syphilis is relatively common and has a high infant mortality rate.
A neonate presents with a rash that is prominent on the palms and soles. You identify osteochondritis and neural lesions. The patient is snuffling.
What is the diagnosis?
Early congenital syphilis
What test is used to diagnose syphilis in neonates and/or mothers while the fetus is in-utero?
RPR
(nontreponemal serology)
If infant RPR is ____x higher than mother’s RPR, evaluate and treat for congenital syphilis.
If infant RPR is 4x higher than mother’s RPR, evaluate and treat for congenital syphilis.
What TORCH infection is associated with hydrops fetalis?
Parvovirus B19
2 - 3% of cases of congenital herpes zoster will have what presentation?
Skin lesions / scarring;
atrophied limbs
True/False.
Only 2.5% of infected, pregnant mothers will pass VZV to their fetuses, and only 25% of those fetuses will develop congenital Zoster.
False.
Only 25% of infected, pregnant mothers will pass VZV to their fetuses, and only 2.5% of those fetuses will develop congenital Zoster.
True/False.
A primary maternal infection with VZV within a few days after birth can lead to neonatal Zoster in her child, leading to a neonatal mortality of up to 30%.
True.
How is congenital Zoster treated?
VZIG (if not immune)
+
Acyclovir
How is neonatal Zoster treated?
VZIG for the mother
+
Acyclovir for the infant
Rubella is the opposite of toxoplasmosis, in the sense that transmission from mother to fetus is much _______ likely with early (first trimester) infection of the mother.
Rubella is the opposite of toxoplasmosis, in the sense that transmission from mother to fetus is much more likely with early (first trimester) infection of the mother.
What is the most common congenital infection in the U.S.?
Congenital CMV
True/False.
90% of cases of congenital CMV are asymptomatic at birth, but 10% of that 90% show symptoms later.
True.
Congenital _____ is the leading cause of deafness and the second leading cause of intellectual disability in the U.S.
Congenital CMV is the leading cause of deafness and the second leading cause of intellectual disability in the U.S.
Is CMV screening routinely done?
No.
What treatment is used for congenital CMV (but only in severe cases)?
Gancyclovir
When does congenital infection with herpes occur?
At the time of delivery
True/False.
Most infants with neonatal HSV are born to women with no history, clinical findings, or lesions.
True.
A neonate presents with localized cutaneous, ocular, and mouth lesions.
The mother is asymptomatic.
What treatment do you initiate?
Acyclovir
(for congenital herpes)
If a neonate presents with congenital herpes CNS disease or disseminated disease, there is a ______ rate of serious neurological sequelae or death.
If a neonate presents with congenital herpes CNS disease or disseminated disease, there is a high rate of serious neurological sequelae or death.
How can vertical transmission of HIV be prevented?
AZT peripartum prophylaxis;
instruct not to breastfeed
Gonococcal neonatal infection presents as severe purulent conjunctivitis ____-____ days after birth.
Chlamydial neonatal infection presents as purulent conjunctivitis ____-____ days after birth.
Gonococcal neonatal infection presents as severe purulent conjunctivitis 2 - 5 days after birth.
Chlamydial neonatal infection presents as purulent conjunctivitis 5 - 30 days after birth.
Name an STI that causes painful, contagious ulcers (chancroids) and tends to be more of a tropical disease.
H. ducreyi
Klebsiella can cause what STI S/Sy?
Donovanosis/Granuloma inguinale with Donovan bodies
Which serotypes of Chlamydia trachomatis cause an STI?
D - K
A sexually-active woman presents with strawberry cervix with discharge.
What is the likely etiology?
Trichomonas vaginalis
Normal flora can cause bacterial vaginosis due to dysbiosis of normal flora.
Name some of the flora.
- Gardnerella;*
- Mobiluncus;*
- Prevotella*
A diabetic patient on antibiotics presents with a ‘cottage cheese’ vaginal discharge. What do you suspect?
Candida albicans
(part of normal flora)
What are the names given to infection with pubic lice (crabs)?
Pediculosis;
phthirus pubis
What is the latin name for scabies?
Sarcoptes scabei
_______ (lice/scabies) sit on the skin and hair follicles and lay eggs.
_______ (lice/scabies) burrow into the skin.
Lice sit on the skin and hair follicles and lay eggs.
Scabies burrow into the skin.
True/False.
The incubation time for a person infected with pubic lice to show symptoms is up to 30 days (egg incubation time), and the ncubation time for a person infected with scabies to show symptoms and for the scabies to resolve with treatment is several weeks.
True.
