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Clin Med > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Acquired immunity is considered…

A

Antigen specific. T and B cell immunities

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2
Q

Innate immunity is considered…

A

Defenses found in the body that are not as specific, such as macrophages and white blood cells, or barriers such as skin and mucosal linings

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3
Q

Immature neutrophils are called…

A

Band cells

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4
Q

Neutrophils are the ___ common

A

Most

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5
Q

Lymphocytes consist of _____ and perform the actions of ____

A

B and T cells, cell mediated immune defense and the production of antibodies

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6
Q

Monocytes perform the action of ____ and are considered part of which immune response?

A

Transforming into macrophages and assisting in phagocytosis, innate immunity

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7
Q

Eosinophils are commonly found ___

A

In the fight against parasites

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8
Q

Basophils perform the action of…

A

Releasing histamine

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9
Q

Name the granulocytes

A

Neutrophils, basophils, eosinophils

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10
Q

Name the agranulocytes

A

Lymphocytes and monocytes

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11
Q

Cycle of the B lymphocyte:

A

B cells with surface receptor to a specific antigen present after initial exposure to the antigen, then when the antigen presents again, B cells transforms into plasma cell and starts to create antibodies against the antigen

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12
Q

Role of cd4 helper cells

A

Play a large role in antigen presenting, start the process for B cells

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13
Q

Role of cd8 cytotoxic cells

A

Bind to infected cells and induce apoptosis

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14
Q

What is the difference between cell mediated and humoral immunity?

A

Cell mediated protects against viral infections, or intracellular pathogens, and is mediated by T cells. Humoral protects against extra cellular pathogens and their toxins, and is mediated by B lymphocytes and their antibodies

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15
Q

MHC class 1 focuses on

A

Self versus non self, with cd8 cells

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16
Q

MHC class 2

A

Focused on external pathogens with cd4 cells

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17
Q

IgM characteristics

A

Acute antibody, first one created when exposed to an antigen, disappears within 2-3 weeks after exposure

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18
Q

IgG characteristics

A

Later response of antibody, determines immunity, can cross the placenta

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19
Q

IgA characteristics

A

Mucosal antibody, when low it is common to have respiratory and mucosal infections

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20
Q

IgE characteristics

A

Found in allergies and parasitic infections

Anaphylaxis

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21
Q

Sepsis

A

Disregulation response to infection, can lead to MODS, body cannot support its own blood pressure and starts shutting down

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22
Q

Hep A characteristics

A

Transmitted fecal oral, not endemic to the US so comes with people that travelled, no chronic condition of HAV

Fever, nausea, vomiting, anorexia, large and tender liver, pale stools and dark urine, jaundice

Elevated aminotransferase levels, increased AST and ALT levels

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23
Q

HBV characteristics

A

DNA virus, transmitted through blood/high risk sex/other bodily fluids, long incubation period, can become chronic then cirrhotic (and maybe even hepatocellular carcinoma)

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24
Q

Describe different markers for HBV

A

HBsAg- active infection or vaccinated
HBsAb- immunity, don’t know if they had the infection or were vaccinated, just know that they are immune
HBcAb- present following active infection, NOT vaccination (vaccination only contains the outer surface of the virus, not the viral core)
HBeAg- indicated that the soluble component of the core is in the blood, actively infected by HBV
HBeAb- the acute phase of the infection is over and there is a decrease in infectivity

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25
Q

Rotavirus characteristics

A

Fecal-oral, ubiquitous, causes more problems in children, stable RNA virus that can last for weeks if not cleaned

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26
Q

Rotavirus symptoms

A

Nausea, vomiting, severe dehydration, best to orally rehydrate.

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27
Q

Diphtheria characteristics

A

Can be asymptomatic carriers, causes respiratory or cutaneous dz, spread mainly by respiratory secretions

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28
Q

Diphtheria symptoms

A

Inflammation of respiratory tract and skin, caused by the exotoxins (extremely potent)
Cutaneous- chronic wound with grey pseudo membrane
Oropharyngeal- nasal discharge, laryngeal inflammation and grey pseudomembrane

Could later cause myocarditis or cranial nerve palsies from the toxins

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29
Q

Pertussis virus characteristics

A

Bordetella pertussis, pleomorphic (alters shape and size to respond to environment)

Travels on droplets, adults are the main reservoir

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30
Q

Pertussis stages

A

Catarrhal- nonspecific signs/symptoms, highly contagious
Paroxysmal- bouts of severe coughing followed by vomiting and exhaustion
Convalescent- susceptible to other respiratory infections, gradual recovery where coughing lessens, but bouts may occur

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31
Q

Pertussis characteristics

A

Causes profound lymphocytosis, in adults may appear as bronchitis, but consider if cough lasts longer than 2 weeks. Diagnose with a nasopharyngeal swab *all the way through the nose to the back of the “throat”

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32
Q

Tetanus characteristics

A

Clostridium tetani, ubiquitous, blocks GABA release in the inhibitory spinal neurons to cause spasms

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33
Q

Tetanus symptoms

A

Early on- spasticity at the sight, tingling, stiff jaw/neck

Later on- hyperrelfexia, spasms from minor triggers, trismus, risus sardonicus, constipation, asphyxia, rigidity of muscles

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34
Q

Which three organisms should asplenic patients be vaccinated for and why?

A

Neisseria, haeophilus, strep pneumoniae

The spleen plays a large role in opsonizing encapsulated organisms, and these three are encapsulated

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35
Q

H influenzae characteristics

A

Most significant strain of haemophilus
Causes epiglottitis- obstructs airway, whistling while breathing, can’t handle secretions

May produce beta lactamase, don’t use amoxicillin, but use augmentin instead

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36
Q

Human papillomavirus characteristics

A

Causes genital warts, cervical cancer, anal cancer, and head/neck cancer.
Transmitted via sexual contact. Vaccine for it

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37
Q

Streptococcus pneumoniae “pneumococcus” characteristics

A

Encapsulated bacteria, in normal flora, causes respiratory issues.

Vaccine prevents: bacteremia, endocarditis, meningitis, and septic arthritis.

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38
Q

Pneumococcus diagnoses and most common presentations now?

A

Sputum culture for pneumonia

Pneumonia, otitis media, sinusitis, mastoiditis

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39
Q

Poliovirus characterstics?

A

RNA, fecal-oral spread, often asymptomatic, vaccine prevents it

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40
Q

What are the neurological complications of poliovirus?

A

Meningoencephalitis, anterior horn disease (weakness and maybe paralysis, possible respiratory failure, bulbar poliomyelitis)

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41
Q

Influenza characteristics of the virus

A

RNA, droplet transmission (some airborne), three types (A B and C) with type A further classified by H and N surface proteins

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42
Q

What does the v after a type of influenza mean?

A

V means variant, or the strain that previously only infected an animal can now infect humans

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43
Q

Why does mortality for influenza differ for different age groups?

A

Based upon prior exposure and immunity to the specific strain

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44
Q

Influenza signs and symptoms

A

Abrupt onset of fever, chills, malaise, myalgias, cough and sore throat (respiratory disease more than GI disease, but GI can be present in addition to the other symptoms)

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45
Q

Measles

Rubeola characteristics

A

RNA, transmitted via droplets, very high attack rate, vaccine quite effective with herd immunity as the goal

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46
Q

Measles rubeola signs and symptoms

A

About 2 week incubation, nonspecific fever cough etc, but KOPLIK’S SPOTS are pathognomonic, exanthem that starts at the head and spreads inferiorly

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47
Q

mumps characteristics

A

RNA virus, transmitted via droplets, 2-3 week incubation

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48
Q

Mumps signs and symptoms

A

Parotitis, could cause orchitis or meningitis, fever, malaise and anorexia

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49
Q

Rubella characteristics

A

RNA, transmitted via droplets and trans-placentally, IG can be given to exposed patients. Vaccine is live so can’t be pregnant when you have it

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50
Q

Rubella signs and symptoms

A

Prodrome fever and malaise, then maculopapular rash that starts on face and spreads inferiorly, maybe arthritis, posterior cervical lymphadenopathy, 2-3 week incubation

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51
Q

Congenital rubella syndrome

A

Teratogen, heart, eye and brain malformations, blueberry muffin lesions

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52
Q

Neisseria meningitidis characteristics

A

Gram negative bacteria, encapsulated, transmitted via respiratory droplets, infective in crowded areas

Bacteria enters nasopharynx then blood

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53
Q

Neisseria meningitidis sign to worry about

A

Non-blanching rash and fever!

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54
Q

Consequences of N meningitidis?

A

Sepsis, Waterhouse-Fridrichson syndrome (hemorrhage and infarction of adrenal glands that worsens shock)

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55
Q

How is neisseria meningitidis diagnosed?

A

Through culture

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56
Q

What is the etiology of rabies?

A

Caused by rhabdovirus, transmitted through saliva, enters body through animal bite, usually wild animals

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57
Q

What is the pathophysiology of rabies?

A

3-7 week incubation depending on the distance of the wound from the CNS, brain then salivary glands

BULLET SHAPED
CYTOPLASMIC INCLUSION BODIES

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58
Q

What are the two types of CNS rabies?

A

Furious (encephalitic) and dumb (paralytic)

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59
Q

What are the classic manifestations of rabies and which type of rabies is it?

A

Aerophobia, hydrophobia, excess salivation, seizures, agitation

Encephalitic “furious” rabies

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60
Q

What is the less common presentation of rabies and what are the signs/symptoms?

A

Dumb aka paralytic, ascending, mimics Guilin-barre. Along with furious/encephalitic rabies, progresses to coma, ANS dysfunction and death

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61
Q

What is the common postexposure/prophylaxis for potential rabies exposure?

A

Human rabies immune globulin, full dose infiltrated around the wound or if unable, injected IM. Then 4 injections of the vaccination

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62
Q

How many species of what genus causes malaria?

A

5 species of plasmodium

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63
Q

Which genus/species of malaria is the most virulent? Which species/genus is also common in the US?

A

Plasmodium falciparum, plasmodium vivax

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64
Q

What is the classic malarial paroxysm?

A

Chills, high fever, then sweats. Can appear well between episodes, and the fever is irregular and cyclical

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65
Q

What are the physical findings of malaria infection?

A

Extreme splenomegaly, mild hepatomegaly, jaundice, anemia

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66
Q

What are some of the subjective findings of a malaria infection?

A

Malaise, myalgia so, arthralgias, cough, chest pain, abdominal pain, anorexia, nausea, vomiting & diarrhea

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67
Q

A high parasite load and organ dysfunction are characteristic of a _____________ infection

A

P. Falciparum

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68
Q

What is the gold standard for testing for malaria?

A

Giemsa-stained blood smear

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69
Q

What is the finding indicative of malaria infection on a giemsa-stained blood smear?

A

Trophozoites

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70
Q

What is the name and type of bacteria that causes Lyme disease?

A

Borrelia burgdorferi, spirochete

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71
Q

How long does a tick have to feed to transmit Lyme disease

A

24-36 hours

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72
Q

Stage 1 lyme’s disease signs and symptoms

A

Flu-like, Bulls-eye around the tick bite (erythema migrans)

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73
Q

Stage 2 lyme’s disease signs and symptoms

A

Happens if the person is left untreated, malaise, fever, fatigue, achiness

Can have neurological manifestations (bell's palsy, aseptic meningitis) or can have 
Cardiac manifestations (myo/pericarditis with atrial or ventricular arrhythmias or block)
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74
Q

Stage 3 Lyme disease

A

Late disease, months to years later

Arthritis, memory loss, mood changes, sleep disturbance, paresthesias

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75
Q

Genus/species that causes Rocky Mountain spotted fever?

A

Rickettsia rickettsii, gram negative non-motile

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76
Q

RMSF pathophysiology

A

Vasculitis, increased vascular permeability, edema, activation of inflammatory and coagulation mechanisms

Leakage of fluid from the bloodstream to tissues can be devastating

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77
Q

What is “classic” RMSF?

A

Fever, headache, rash in a person with a history of a tick bite

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78
Q

Describe the rash found for RMSF

A

Centripetal rash, usually involving wrists and ankles, characteristic involvement of palms and soles, petechiae

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79
Q

Complications of RMSF

A

Pulmonary edema, adult respiratory distress syndrome, arrhythmias, GI bleeding, skin necrosis, etc.

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80
Q

Best treatment for RMSF

A

Doxycycline

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81
Q

What is the genus of viruses that causes dengue? What mosquito?

A

Flavivirus

Aedes

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82
Q

Signs and symptoms of dengue

A

Sudden onset of high fever and chills, break bone aching, sore throat, prostration, maculopapular rash. As rash fades, petechiae on extensor surface of limbs appears

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83
Q

Describe the 4 Cardinal features of dengue hemorrhagic fever

A

Increased vascular permeability, marked thrombocytopenia, fever lasting 2-7 days, and hemorrhagic tendency

Dengue shock syndrome when shock is present in addition to the above 4 criteria

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84
Q

Describe the tourniquet test

A

Blood pressure cuff is inflated for 5 minutes, 10 or more petechiae within one inch is positive. Seen in dengue hemorrhagic fever

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85
Q

What causes yellow fever? Where are the endemic areas?

A

Flavivirus, Aedes mosquito

Africa and South America

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86
Q

What are signs and symptoms of mild yellow fever?

A

Malaise, headache, fever, retro-orbital pain, N/V, photophobia

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87
Q

Signs and symptoms of severe yellow fever

A

“Period of intoxication”, fever, bradycardia, hypotension, jaundice, hemorrhage, delirium

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88
Q

Common laboratory findings of yellow fever

A

Proteinuria, elevated bilirubin, leukopenia, elevated AST and ALT

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89
Q

Zika virus

A

Often asymptomatic, mainly causes microcephaly in babies with pregnant mom contracting virus, may see guillian-barre syndrome

90
Q

Ebola signs and symptoms

A

Diffuse non-pruritic rash, watery diarrhea, N/V, can be hemorrhagic with blood in stool, etc. can be neurological with altered levels of consciousness, can be ocular with photophobia and blurred vision

91
Q

What is yersinia pestis?

A

Plague!

92
Q

Describe bubonic plague

A

Most common, sudden fever/chills/headache, buboes (painful and massive enlargement of nodes)

93
Q

Pneumonic plague

A

Airborne transmission, bloody sputum and rapidly worsening respiratory distress, almost 100% fatal

94
Q

C. Trachomatis commonly causes:

A

Chlamydia! Aka urethritis & cervicitis

95
Q

What are the female signs and symptoms of chlamydia?

A

Sometimes asymptomatic, mucopurulent urethral or cervical discharge, bleeding, abdominal/pelvic pain, dysuria and urinary frequency

96
Q

What are the male signs and symptoms of chlamydia?

A

Asymptomatic, mucoid or watery urethral discharge, dysuria, epididymitis, prostatitis, inflammation of rectal area (proctitis)

97
Q

Common saying wth c. Trachomatis

A

“Can’t see, can’t pee, can’t climb a tree”

Arthritis, uveitis and urethritis

98
Q

Lymphogranuloma venereum (LGV) characteristics

A

Acute & chronic STI caused by C. Trachomatis l1-l3

Infection spreads to lymph channels and lymph nodes of genital and rectal areas

99
Q

Symptoms of LGV

A

Ulcerative lesion on external genitalia, local pain and itching, inguinal buboes, tender lymphadenopathy, anorectal pain, discharge, rectal bleeding

100
Q

Neisseria gonorrhoeae clinical presentation in men

A

Dysuria, copious purulent discharge, painful inflammation

101
Q

Neisseria gonorrhoeae clinical presentation in females

A

More likely to be asymptomatic

Symptoms increase during menses

Pain/frequency/urgency with urination, purulent urethral discharge, vaginitis, cervicitis, PID

102
Q

PID

A

Upper genital tract infection

Cervical tenderness (chandelier sign), peri hepatic adhesions (fitz-Hugh-Curtis syndrome)

103
Q

Clinical sydromes of disseminated gonorrhea

A

Purulent arthritis & dermatitis/tenosynovitis/polyarthralgias

104
Q

Purulent conjunctivitis with periorbital edema, think…

A

Gonorrhea conjunctivitis, can lead to ulceration, scarring, and visual impairment

105
Q

HSV-1 characteristics

A

Acquired usually in childhood, usually through saliva, milder symptoms

106
Q

HSV-2

A

Trasmitted sexually, 90% of the time causes genital herpes

107
Q

Describe HSV infection presentation

A

Small, painful & multiple grouped vesicular lesions

Pustules-ulcers-crusting-healing

108
Q

HSV lab findings

A

Intra nuclear inclusion bodies and multinucleated giant cells on a tzanck preparation

109
Q

HPV characteristics

A

Human papillomavirus, usual route of entry is skin/mucous membranes, generally causes genital warts

110
Q

HPV clinical presentation

A

None, plantar warts, anogenital warts, fissured skin

111
Q

Organism causing syphilis

A

Spirochete treponema pallidum

112
Q

Primary syphilis s/s

A

PAINLESS chancre usually on genitals, painless regional LAD, eventual potential pain from secondary bacterial infection

113
Q

Secondary syphilis s/s

A

Weeks-6 months after chancre

Fever, LAD, palms and soles in many cases, nonpruritic macular/papular skin lesions, mucous patches, alopecia

114
Q

Latent syphilis

A

After secondary lesions

Early latent- w/in previous 12 months, infectious

Late latent- infection >12 months ago, hidden and noninfectious except in vertical transmission

115
Q

Latent syphilis s/s

A

Localized gummatous rxn, diffuse inflammation (involves CNS and large arteries), painless nodules, destructive gummas, osteitis/arthritis

116
Q

Neurosyphilis 4 classifications

A

Asymptomatic neuroinvasion

Meningovascular syphilis

Tabes dorsalis

General paresis

117
Q

Meningovascular syphilis

A

Changes to cerebral vascular structures, HA, irritability, unequal reflexes, CVA

118
Q

Tabes dorsalis

A

Degeneration of parenchyma of posterior columns of spinal cord

Romberg sign (loss of balance with eyes closed), pupils accomodate but don’t react

119
Q

General paresis

A

Involvement of cerebral cortex, impairs memory, concentration, personality changes, tenor of fingers and lips, irritability, headaches

120
Q

Syphilis testing

A

Nontreponemal test (VDRL or RPR), if positive, then treponemal Ab test

121
Q

Main treatment for syphilis

A

Very PCN responsive

122
Q

Trichomonas vaginalis

A

Anaerobic protozoan parasite that is transmitted through sexual contact

123
Q

Male symptoms of trichomonas

A

Pruritus, irritation inside of the penis, burning after urination/ejaculation, discharge, dyspareunia

124
Q

Female symptoms of trichomonas

A

Pruritus, burning, redness, soreness of external genitalia, frothy discharge, dyspareunia

125
Q

Strawberry cervix is a sign of…

A

Trichomonas

126
Q

General treatment of trichomonas

A

Metronidazole

127
Q

What causes chancroid?

A

Haemophilus ducreyi

128
Q

Chancroid characteristics

A

Painful ulcer with ragged/dirty-appearing base, inguinal LAD. Rare in US

129
Q

Granuloma inguinale characteristics

A

Granulomatous infection, DONOVAN BODIES are pathognomonic on staining

Chronic in course

130
Q

Histoplasmosis characteristics

A

Dimorphic fungus, grows inside macrophages, bird/bat droppings, usually asymptomatic

131
Q

Histoplasmosis symptoms

A

Fever/cough/chest pain,

Cavitary lung lesions may occur, can form granulomas

132
Q

Histoplasmosis testing

A

Urinary Ag, serologies, tissue bx, CT is the best imaging

133
Q

Blastomycosis presentation is similar to…

A

Histoplasmosis

134
Q

Treatment for blasto/histomycosis

A

Itraconazole

135
Q

What is the smallpox virus?

A

Poxvirus, DNA virus. Only one serotype so eradicated from the globe due to vaccine

136
Q

How is smallpox transmitted?

A

Airborne or direct contact

137
Q

Smallpox symptoms/signs

A

Fever/malaise, then centrifugal rash (starts in the middle and works outward), vesicles of smallpox are all at the same stage of development

Macules-papules-vesicles-pustules-crusted

138
Q

Who is still vaccinated for smallpox?

A

Military personnel

139
Q

What disease does bartonella henselae cause?

A

Catch scratch disease

140
Q

Cat scratch characteristics

A

Pleomorphic gram negative, can’t grow in standard cx, transmitted by cat scratches or bites

141
Q

Cat scratch disease signs and symptoms

A

Fever, tender LAD near scratch site, rash or granulomas, if immunocompromise, can see bacillary angiomatosis, macular star or inflammation of retina and optic nerve

142
Q

Bartonella Quintana causes what disease?

A

Trench fever, a blood stream infection caused by lice.

143
Q

Trench fever characteristics

A

HA and post orbital pain, sudden fever, bone pain

144
Q

Kawasaki disease characteristics

A

Medium vessel vasculitis, coronary artery aneurysm is the most important consequence

145
Q

Kawasaki disease acute phase

A

High fever, conjunctival erythema, strawberry tongue and cracked lips, swelling/rash of hands and feet

146
Q

Kawasaki disease subacute phase

A

Desquamation of digits, thrombocytosis, coronary artery aneurysm

147
Q

Kawasaki disease convalescent phase

A

Beau lines of nails

148
Q

Kawasaki disease treatment

A

IV immunoglobulin and aspirin (the only reason to give aspirin to pediatric patients)

149
Q

Coxsackie characteristics

A

Fecal oral route, can shed virus in stool for several weeks after infection resolves, hand/foot/mouth disease

150
Q

Hand foot mouth disease signs and symptoms

A

Fever, sore mouth, red papules and small grey vesicles on hands, feet, mouth, butt, genitals

151
Q

Erythema infectiosum characteristics

A

“Fifth disease”, human parvovirus B19, springtime epidemic, common in adults! Transmitted through respiratory secretions and blood

152
Q

Erythema infectiosum signs and symptoms

A

Slapped cheek, lacy rash, usually supportive treatment.

153
Q

Erythema infectiosum problem areas

A

Pregnancy- hydrops fetalis

Sickle cell disease- aplastic anemia, pancytopenia

154
Q

Roseola infantum characteristics

A

Aka exanthem subitum or 6th disease

Herpesvirus 6 and 7, ubiquitous

155
Q

Roseola infantum clinical findings

A

High fever, maculopapular rose colored rash when fever breaks, erythematous tympanic membranes

156
Q

Molluscum contagiosum characteristics

A

Pox virus infection that is common, transmitted through contact

Genital molluscum on a child- sexual abuse

Facial molluscum on adult- HIV until proven otherwise

157
Q

Molluscum contagiosum dx

A

Dome shaped umbilicated papules

158
Q

Verruca vulgaris

A

Common warts, rough grey surface, will resolve usually without treatment

159
Q

Verruca plana

A

Flat warts, often grouped, highest rate of spontaneous remission

160
Q

Verruca plantaris

A

Plantar warts, toughest to treat, commonly at pressure points in feet and uncomfortable, no skin lines

161
Q

General mycobacterium characteristics

A

Aerobe, intracellular, non motile rod, slow growing, hydrophobic, acid fast bacilli

162
Q

Main difference between TB and NTM

A

TB spreads only by respiratory droplets and airborne transmission, and NTM infections are acquired directly from the environment

163
Q

4 possible outcomes after inhalation of M. Tuberculosis

A
  1. Immediate clearance
  2. Latent infection (non infectious)
  3. Primary disease (immediate onset of active disease)
  4. Reactivation disease (onset of disease many years after exposure)
164
Q

Latent TB findings

A

No symptoms, but positive TST or IGRA. Normal CXR and negative respiratory smear and culture specimens

165
Q

Name some high risk patients for TB and what their TST reaction size of induration would be

A

HIV, close contact with a case, immunosurpressed patients

Less than or equal to 5 mm induration

166
Q

Name some moderate risk patients for TB and their TST reaction size of induration

A

People with chronic disease or IV drug users, children younger than 4, foreign born from a country with incidence, or people in high risk settings

Greater than or equal to 10 mm

167
Q

Name some low risk TB patients and their TST reaction size of induration

A

Healthy individuals 4 or older

Greater than or equal to 15 mm

168
Q

Describe the IGRA

A

More objective, can detect latent TBI, more specific for TB versus NTM infection.

169
Q

Active pulmonary TB s/s

A

Weight loss, fever, night sweats, cough, hemoptysis

170
Q

Lab testing for active TB

A

AFB stain, need to request it, then 3 consecutive morning sputum samples

171
Q

Ghon complex

A

Calcified lung nodule commonly found in TB CXR

172
Q

Ranke complex

A

Calcified ipsilateral lymph node commonly found in TB CXR

173
Q

Reactivation TB commonly presents with…

A

Fibrocavitary apical disease

174
Q

If you have TB, test for…

A

HIV. And vice versa!

175
Q

Cervical lymphadenitis from mycobacteria, aka _____ and what causes it in adults vs. children?

A

Scrofula

Adults: M. Tuberculosis
Children: M. Avium, or NTM

176
Q

What are some common skin and soft tissue infections caused by NTM? What are they usually treated with?

A

Abscess, septic arthritis, and osteomyelitis.

Treated with macrolides

177
Q

Leprosy characteristics

A

Caused by mycobacterium leprae, intracellular parasite, human to human transmission requiring prolonged and intimate human contact.

Involved skin and peripheral nerves

178
Q

Leprosy s/s

A

Lesions involve cooler body tissues, macular lesions, erythematous nodules, diffuse infiltration of the skin

Motor abnormalities with nerves

179
Q

Tuberculoid leprosy

A

Cellular immunity in tact, benign and less progressive

180
Q

Lepromatous leprosy

A

Progressive and malignant, defective cellular immunity, leonine facies, severe ulcerations and loss of tissue

181
Q

Cutaneous candidiasis s/s

A

Erythema, intense pruritis, tenderness or pain

Erythematous papules and or pustules, confluent centrally with peripheral satellite regions, possible erosion

182
Q

Candida vulvovaginitis s/s

A

Inflamed, swollen vaginal and valvular tissue, intense vaginal itching, white and clumpy discharge

183
Q

What are the recommendations for ASA?

A

Low dose ASA recommended for prevention of CVD and colorectal cancer in 50-59 age range

  • need to take for 10 years
  • life expectancy of 10 years
  • no increased risk of bleeding
  • greater than 10% 10-year CVD risk
184
Q

Screening for high BP

A

All adults 18 years and older

185
Q

Screening for HTN, how often?

A

40 years or older with increased risk for HTN, annually

18-39 with normal BP and no risk factors, 3-5 years

186
Q

Lipid screening

A

Men 35 and older,
Men 20-35 if they have increased risk

Women 45 and older
20-45 if they have increased risk

187
Q

AAA screening

A

One time ultrasounds in men 65- 75 who have EVER smoked

188
Q

Breast cancer screening

A

Still unclear…

Q 1-2 years women 40 or 50 years and older

189
Q

Cervical cancer screening

A

21-65 year old women with a cervix

190
Q

Lung cancer screening

A

55-80 yrs with 30-pack year hx AND currently smoke, or quit within the last 15 years

191
Q

Colorectal cancer screening

A

50-75

192
Q

DM screening

A

40-70 years who are overweight or obese

193
Q

Fall prevention

A

Community dwelling adults 65 and older, suggest exercise/physical therapy and vitamin D supplementation

194
Q

Osteoporosis screening

A

65 years and older, women

195
Q

HIV screening

A

All patients 15-65

196
Q

HIV virus general characteristics

A

Retrovirus, lentivirus genus.

HIV-1 is more common and more severe
HIV-2 is more indolent, mostly just in Africa

197
Q

What to proteins are needed for HIV to connect?

A

CCR5 and CD4

198
Q

Acute retroviral syndrome is from…and its characteristics?

A

a primary HIV infection

Mono-like dz
Fever, LAD, pharyngitis, rash, HA, etc.

High viral load in this time

199
Q

HIV effects on the immune system

A

Lymphatic tissue deteriorates and fibrosis with inflammation, hyperactive immune system which just allows the virus to replicate more, lowered CD4 counts, monocytes/macrophages are a reservoir

200
Q

HIV presentation in the oropharynx

A

Hairy leukoplakia

Unlike thrush, it cannot be scraped off

201
Q

HIV skin manifestations

A

Molluscum on the face in an adult is HIV until proven otherwise!

Norwegian scabies

Disseminated cryptococcus and histoplasmosis

202
Q

HIV eye manifestations

A

CMV retinitis is the most common cause of HIV associated blindness

203
Q

HIV manifestations in the heart

A

Inflammation and coronary artery disease, effusions, cardiomyopathy

204
Q

HIV and the brain

A

CNS lymphoma, toxoplasmosis

205
Q

When do you start prophylaxis for OI in HIV patients?

A

When the cd4 count drops below 200 (usually)

206
Q

Cryptococcosis characteristics

A

Caused by encapsulated yeast Cryptococcus neoformans

Acquired pulmonary route

Common cause of meningitis in HIV patients, also very high opening pressure and can cause brain herniation.

207
Q

Cryptosporidiosis

A

Protozoal diarrhea in HIV patients, cholera-like diarrhea

208
Q

Kaposi sarcoma

A

Commin in HIV patients progressing to AIDS, human herpesvirus type 8, cutaneous patches/plaques/nodules that become brown with time

209
Q

Primary CNS lymphoma

A

In AIDS patients, CFS cytology for malignancies

210
Q

CNS toxoplasmosis

A

In AIDS patients, significant for pregnancy

211
Q

What is the most commonly occuring OI in HIV?

A

Pneumocystis jiroveccii

212
Q

pneumocystis jiroveccii s/s

A

Fungal lung infection, progressive respiratory failure, “groundglass” filtrates, lungs sound normal but they have a hard time oxygenating

213
Q

What is included in the SOFA score?

A

Mental status, respiratory rate, and systolic blood pressure

214
Q

What cell types are most active in chronic inflammation?

A

Monocytes and macrophages

215
Q

What does COMPS stand for and what pathogen causes it?

A

Conjunctivitis, otitis, meningitis, pneumonia, sinusitis

Strep. Pneumoniae

216
Q

What is the diagnostic test for the flu?

A

ELISA

But often clinically diagnosed, especially if it is the right clinical picture during flu season

217
Q

Which disease has one of the highest attack rates in all infectious dz?

A

Measles rubeola!

218
Q

What is the dx test for dengue?

A

Serologies (IgM and IgG ELISAs)

219
Q

What is the preferred test for chlamydia?

A

NAAT

220
Q

What is the gold standard for gonorrhea and what is starting to replace it?

A

Culture, NAAT is starting to replace it

221
Q

What is the preferred test for trichomonas?

A

NAAT

Clin Med (7 decks)

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