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Infectious Disease > Exam 2 - Immunocompromised, Rashes, Congenital > Flashcards

Exam 2 - Immunocompromised, Rashes, Congenital Flashcards

1
Q

intrauterine infections aka

A

congenital infections

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2
Q

transplacental infections cause infections in what timeframe

A

congenital, perinatal

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3
Q

infections transmitted by breastfeeding cause infections in what timeframe

A

perinatal, postnatal

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4
Q

what is vertical transmission

A

mother to baby

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5
Q

clinical manifestations of intrauterine transmission

A

low birthweight, malformations, rash, jaundice, anemia, low platelets, hepatosplenomegaly

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6
Q

congenital rubella ssx

A

sensorineural deafness, cataracts, congenital heart disease

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7
Q

congenital toxoplasmosis ssx

A

hydrocephalus, diffuse intracranial calcifications, chorioretinitis

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8
Q

congenital CMV ssx

A

microcephaly, ventricular calcifications

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9
Q

congenital parvovirus B19 ssx

A

diffuse edema (in utero hydrops fetalis)

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10
Q

congenital varicella zoster ssx

A

limb abnormalities, cicatricial lesions

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11
Q

congenital syphilis ssx

A

skin lesions, including palms and soles, dactylitis, osteochondritis, periostitis, rhinorrhea

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12
Q

mechanisms of perinatal infection

A

transplacental, ascending, maternal-fetal transfusion, inoculation, breastfeeding

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13
Q

clinical manifestations of perinatal infections

A

normal weight, no malformations, sepsis, hepatitis, coagulopathy, focal infection, may be asymptomatic

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14
Q

most frequent cause of perinatal conjunctivitis

A

chlamydia

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15
Q

causes of perinatal sepsis

A

group B strep, e coli, listeria, disseminated HSV, enterovirus

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16
Q

asymptomatic perinatal infections

A

hep B/C, HIV, HPV

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17
Q

causes of postnatal infections

A

HIV, CMV, Hep B

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18
Q

what infections can be congenital, perinatal, or postnatal

A

HIV, CMV

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19
Q

5 classic viral xanthems of childhood

A

measles, rubella, roseola, coxsackievirus, parvovirus-19

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20
Q

Rubella aka

A

german measles

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21
Q

roseola pathogen

A

HHV 6/7

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22
Q

parvovirus B19 aka

A

fifth disease, erythema infectiosum

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23
Q

measles prodrome

A

fever, cough/coryza/conjunctivitis, koplik spots

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24
Q

measles rash

A

nonpruritic, starts on face and spreads down

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25
Q

measles complications

A

secondary bacterial infection, encephalitis, subacute sclerosing panencephalitis

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26
Q

rubella prodrome

A

nonspecific, low grade fever, may be asymptomatic

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27
Q

rubella rash

A

starts on face and moves down, not as red as measles

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28
Q

rubella complication

A

congenital rubella causes hearing loss, mental retardation, cardiovascular and ocular defects

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29
Q

Roseola prodrome

A

upper respiratory ssx, high fever for 5-7 days

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30
Q

roseola usual population

A

< 2 y/o

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31
Q

when does rash start in roseola

A

when fever breaks

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32
Q

roseola rash`

A

spreads from neck/trunk to face and extremities

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33
Q

roseola complications

A

febrile seizures

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34
Q

coxsackievirus prodrome

A

fever, sore throat, malaise

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35
Q

coxsackie virus rash

A

painful sores on mouth, hands, feet that make break and ulcerate

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36
Q

coxsackievirus complications

A

nail loss, aseptic meningitis, encephalitis

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37
Q

fifth disease prodrome

A

flu-like, 3 days

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38
Q

fifth disease rash

A

slapped cheek with erythematous macular or papular lesions, lacy rash on trunk/extremities

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39
Q

fifth disease complications

A

arthralgias, aplastic crisis, fetal hydrops

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40
Q

scarlet fever pathogen

A

group A strep

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41
Q

scarlet fever prodrome

A

sore throat, high fever, HA, N/V, strawberry tongue

42
Q

scarlet fever rash location

A

begins in neck, underarms, groin and then spreads

43
Q

scarlet fever rash appearance

A

red rash with sandpaper feel, pastia’s lines, skin may desquamate

44
Q

scarlet fever complications

A

rheumatic fever, post-streptococcal glomerulonephritis

45
Q

molluscum contagiosum prodrome

A

none

46
Q

molluscum contagiosum rash

A

2-5 mm painless, flesh colored, pearly papules with central umbilication

47
Q

when does molluscum contagiosum resolve

A

6 months-4years

48
Q

molluscum contagiosum complications

A

scarring, bacterial superinfection

49
Q

HSV prodrome, 1st infection

A

fever, myalgias, HA, lymphadenopathy

50
Q

HSV prodrome, recurrent infection

A

tingling or pain in skin

51
Q

HSV rash

A

vesicles that open to painful ulcers that heal over 2-4 weeks

52
Q

HSV complications

A

aseptic meningitis, encephalitis, blindness, disseminated infection if immunocompromised

53
Q

shingles prodrome

A

pain, itching, tingling of dermatome with rare systemic ssx (fever, malaise, HA)

54
Q

shingles rash

A

blisters to crusts in varying stages along a unilateral dermatome

55
Q

shingles complications

A

postherpetic neuralgia, ocular involvement (5th cranial nerve), bacterial superinfection, disseminated zoster

56
Q

chicken pox prodrome

A

mild fever/malaise 1-2 days before rash

57
Q

chick pox rash location

A

starts on head/chest/back and then generalizes

58
Q

chicken pox rash appearance

A

macules to papules to vesicles to crusts, will see lesions in different stages

59
Q

chicken pox complications

A

secondary bacterial infections, pneumonia (adults), encephalitis, cerebellar ataxia

60
Q

PCN skin rash timing

A

hours to days after exposure to PCN

61
Q

PCN skin rash appearance

A

macular, papular, or hives with possible associated itching, swelling, wheezing, anaphylaxis

62
Q

classic example of innate immune deficiency

A

neutropenia

63
Q

infectious etiologies in neutropenia

A

recurrent pyogenic infections, skin infections, abscesses, bone/joint infections

64
Q

neutropenia mechanism of infection

A

decreased chemotaxis and phagocytic capacity, defective intracellular killing

65
Q

common pathogens in neutropenia

A

staph, strep, e coli, aspergillus

66
Q

examples of humoral immune deficiency

A

x-linked agammaglobulinemia, multiple myeloma

67
Q

humoral immune deficiency mechanism

A

fail to make antibodies to a new antigen

68
Q

infectious etiologies in humoral immune deficiency

A

encapsulated organisms, chronic diarrhea, aseptic meningitis

69
Q

pathogens in humoral immune deficiency

A

strep pneumonia, h influenzae, giardia, enteroviruses, campylobacter

70
Q

causes of cell mediated immune deficiency

A

immunosuppressives (prednisone etc), CD4 deficiency/AIDS, DiGeorge syndrome

71
Q

infectious etiologies seen with cell mediated immune deficiency

A

intracellular organisms, viruses, opportunistic infections

72
Q

asplenia predisposes to what type of infection

A

encapsulated organisms

73
Q

definition of neutropenia

A

absolute neutrophil count below 1500

74
Q

mild neutropenia

A

between 1000 and 1500

75
Q

moderate neutropenia

A

between 500 and 1000

76
Q

severe neutropenia

A

less than 500

77
Q

causes of neutropenia

A

chemotherapy, transplant patients, abx, congenital, hematologic malignancy, viruses, lupus

78
Q

most common cause of neutropenic fever

A

bacterial infection

79
Q

what is associated with more severe neutropenic fever

A

gram negative bacterial (pseudomonas)

80
Q

what gram positive bacteria is associated with neutropenic fever

A

staph epidermidis

81
Q

fungal causes of neutropenic fever

A

candida, aspergillus

82
Q

empiric treatment for neutropenic fever

A

piperacillin/tazobactam +/- vancomycin

83
Q

when to add vancomycin in empiric tx for neutropenic fever

A

hemodynamic instability, pneumonia, central line infection, skin infection, history of MRSA

84
Q

when to provide prophylaxis for neutropenic patient

A

if ANC is less than 500 for more than 7 days

85
Q

what prophylaxis to provide for neutropenic patient

A

cipro, fluconazole, acyclovir, bactrim

86
Q

what to do prior to inducing neutropenia

A

screen for TB, hep B/C. Do not provide live vaccines 4 weeks prior to treatment

87
Q

what is acute retroviral syndrome

A

flu-like symptoms occurring 2-4 weeks after HIV infection, highly infectious

88
Q

clues of HIV infection

A

weight loss, fatigue, night sweats, recurrent candida infections, frequent pulmonary infections

89
Q

non-infectious substances in HIV

A

urine, saliva, sweat, tears, nasal secretions, sputum, vomitus, stool

90
Q

HI screening guidelines

A

test all 15-65 y/o and others outside that range if high-risk, all pregnant women

91
Q

4th generation HIV testing advantages

A

uses monoclonal antibodies, detect between 12-26 days from exposure, allows detection prior to seroconversion

92
Q

HIV treatment current guidelines

A

2 NRTI plus integrase inhibitor

93
Q

HIV pre-exposure prophylaxis consists of

A

daily 2-drug regimen given before exposure

94
Q

HIV post-exposure prophylaxis consists of

A

28 day course of daily 3-drug regimen within 72 hours of exposure

95
Q

pneumocystis ssx

A

subacute, progressive dyspnea, dry cough, pleuritic chest pain, ground glass opacities on CXR

96
Q

when to initiate pneumocystis prophylaxis

A

CD4<200

97
Q

toxoplasma reactivation ssx

A

focal encephalitis with ring-enhancing brain lesion on CT

98
Q

when to initiate toxoplasma prophylaxis and with what

A

CD4<100 and toxo IgG reactive, bactrim

99
Q

MAC ssx

A

disseminated multi-organ infection

100
Q

when to initiate MAC prophylaxis and with what

A

CD4<50, azithromycin

Infectious Disease (5 decks)

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