Exam 2, Lobo lectures Flashcards
(199 cards)
1
Q
What are the three most common URI bacterias?
A
strep pneumo (#1 most common), haemophilus influenza and moxarella catarhalis- these commonly travel though your sinuses and give you sinusitis, otitis media or CAM pneumonia
2
Q
Haemophilus influenza is seen most commonly in who for URIs?
A
People with COPD- people who smoke
3
Q
Haemophilus influenza thrives well where?
A
Blood agar plates, it likes blood
4
Q
Moxarella catarhalis is seen often in what kind of infection?
A
otitis media
5
Q
What percentage of pharyngitis is viral?
A
90%
6
Q
Which meds work well for viral sinusitis?
A
antiinflammatories (NSAIDs), antihistamines (for congestion) like sudafed and benadryl= they treat the symptoms
7
Q
What ingredients in cough syrup help with the symptoms?
A
Dextromethorphan and Codeine
8
Q
What is the most common culprit for bronchiolitis in children?
A
RSV
9
Q
What is HCAP? What is VAP?
A
HCAP= pneumonias you get in the hospital, VAP= pneumonia you get when on an ventilator
10
Q
CAP often precedes what?
A
often a precedes a viral infection (influenzae)
11
Q
What are the types of bacterial pneumonias you often get after a viral infection?
A
Pneumococcus or Staph A
12
Q
What are the symptoms of atypical pneumonia?
A
Present subacutely, fatigue, SOB, not clearly from the lungs, non-productive cough, interstitial pattern on xray, more generalized symptoms instead of pulmonary symptoms
13
Q
What are three common atypical pneumonias?
A
Mycoplasma, Chlamydia and Legionella
14
Q
Which antibiotics treat atypical pneumonia?
A
Azithromyacin and the quinolones Levo and Moxa. Doxycycline can also be used because it is less expensive, but the others work better.
15
Q
What are the symptoms and bacteria of typical pneumonia?
A
Strep pneumoniae, pulmonary symptoms (cough, pluritic chest pain), chest pain, rusty sputum (rusty because of blood), xray shows lobe infiltrates. Klebsiella (alcoholics, curant jelly sputum)
16
Q
Which pneumonia can present as typical or atypical?
A
legionella
17
Q
What is a good antibiotic for strep pneumo?
A
Ceftriaxone, (2nd and 3rd generation cephalosporins), Levofloxacin, Moxafloxacin (quinolones), Penicillin G (will probably miss 60-70% of them though)
18
Q
Which antibiotic travels less to the head than ceftriaxone?
A
vancomycin
19
Q
How does strep pass through the body to form meningitis?
A
travels through cribiform plate and causes meningitis
20
Q
What is the most common bacteria for meningitis?
A
strep pneumo
21
Q
Does sound travel faster in a healthy or consolidated lung?
A
consolidated
22
Q
How many pneumococcal vaccines are there? What kind of organisms do they cover?
A
2 vaccines for pneumococcus= capsulated organism
23
Q
23 serotypes in the pneumococcal vaccine cover what percentage of the bacteria?
A
85%
24
Q
What does rhonchi sound like?
A
wind blowing through a tube
25
During a pleural effusion, what will percussion sound like?
dull
26
Soft and muted lung sounds are?
vesicular
27
If legionella is found in the hospital, what should you think of?
problems with the water supply in the hospital
28
If someone has upper resp symptoms, myalgias and athralgias, what kind of test should they get?
should get a nasal swab to rule out influenzae
29
What kind of test is more sensitive than a nasal swab?
Nasal flushes are better than nasal swabs, they PCR the results. Nasal swabs aren't as sensitive.
30
Why might older people have more immunity towards h. flu than younger people?
older people may have pre-existing immunity to h. flu- and then they get the vaccine so their immunity is stronger than young healthy people
31
Why do we get the flu vaccine annually?
Antigenic drift= happens on continuous basis, which is why we need to get the flu vaccine annually and not just once or twice, every year they have to decide which strands to put in the vaccine
32
What is an antigenic drift?
A mechanism for variation in viruses that involves the accumulation of mutations within the genes that code for antibody-binding sites. This results in a new strain of virus particles which cannot be inhibited as effectively by the antibodies that were originally targeted against previous strains, making it easier for the virus to spread throughout a partially immune population. Antigenic drift occurs in both influenza A and influenza B viruses.
33
What syndrome could you get from being vaccinated?
guillan barre syndrome
34
If you get the flu, what are you at risk of getting? (you're also at risk for it when getting the vaccine as well)
GBS-just getting the flu itself you're 10x at higher risk for getting GBS than if you get the vaccine
35
What kind of vaccines do not have eggs in them?
re-combinant vaccines
36
Adenovirus typically causes what?
conjunctivitis and hemorrhagic cystitis
37
What is included in the flu vaccine every year?
Far east most popular virus, and last year's most popular strand
38
What are you at higher risk for when you have HIV?
you are at increased risk for PCP/PCJ (presents like atypical pneumonia)
39
What labs will be increased and decreased in someone who has HIV and PCP/PCJ?
LDH will be up (in PCP it will go up significantly) and neutropenia will be present
40
How do you treat someone who has HIV and PCP/PCJ?
treatment for this will be bactrum, use it IV
41
What infections are fatal for people without spleens?
When you don't have a spleen (it's basically one big lymph node), encapsulated organisms, and Capnocytophaga (from a dog bite)
42
What is the most common way to get TB?
Being/living/being born in a foreign country
43
How is small bowel diarrhea different from large bowel?
more mucusy diarrhea from small bowel
44
What are the most common sources to get diarrhea?
Most common sources: Other people, food and water
45
What is the most common cause of diarrhea in children as well as travelor's diarrhea?
Enterotoxigenic Escherichia coli (ETEC)
46
If the only symptom of ETEC is diarrhea how do you treat it? What if bloody diarrhea is present?
If JUST diarrhea is present, most of the time you don't require treatment, just stay hydrated and wait for it to pass. Fevers, blood and mucus in stool, abdominal cramping= have them take antibiotics.
47
What are some of the most common sources for shiga toxin?
The most common sources for Shiga toxin are the bacteria S. dysenteriae and the Shigatoxigenic group of Escherichia coli (STEC), which includes serotypes O157:H7, O104:H4, and other enterohemorrhagic E. coli (EHEC).
48
E.coli with serotype 0157 H7 can lead to what kinds of problems?
Infection may lead to hemorrhagic diarrhea and to kidney failure. It also may lead to HUS (hemolytic-uremic syndrome).
49
What is hemolytic-uremic syndrome?
disease characterized by hemolytic anemia, acute kidney failure (uremia), and a low platelet count (thrombocytopenia). It predominantly, but not exclusively, affects children. Most cases are preceded by an episode of infectious, sometimes bloody, diarrhea acquired as a foodborne illness or from a contaminated water supply and caused by E. coli O157:H7, although Shigella, Campylobacter and a variety of viruses have also been implicated.
50
You should not take antibiotics for HUS or e.coli contaminated meat because...?
If you give antibiotics, the toxin hops over to your normal bacteria and infects that.
51
Salmonella can cause what conditions?
typhoid and gastroenteritis
52
What are the risk factors for C Diff?
antibiotics (even for UTI's and sinusitis) it takes a while to normalize the flora in your body, and c diff can take over, people in hospitals (workers and patients) often get this
53
What kind of medications slow down your gut?
Opioids, leading to constipation
54
What is toxic megacolon?
Toxic megacolon (megacolon toxicum) is an acute form of colonic distension. It is characterized by a very dilated colon (megacolon), accompanied by abdominal distension (bloating), and sometimes fever, abdominal pain, or shock.
55
What are the different tests for c diff?
Tests for C. Diff= cytotoxin assay, but it is only 70% sensitive, and it is complicated to do. The most sensitive test is culturing. PCRs are expensive but they are the best. GDH Elisa is performed and if it's positive a PCR is performed.
56
What type of antibiotic is good used rectally?
Vancomycin is good rectally so it can reach the colon, if you take it orally, the gut is slow so it won't reach it quickly
57
What is gel electrophoresis?
Gel electrophoresis is a method for separation and analysis of macromolecules (DNA, RNA and proteins) and their fragments, based on their size and charge.
58
What is the most toxic C Diff strain?
NAP1 strain
59
What test can detect NAP1, the most toxic C diff strain?
PCR
60
What is the treatment for NAP1 C diff strain? Why does this treatment work well?
Metronidazole is the treatment. In order to kill toxin, you need to get to the lumen of the intestines, and metro is absorbed well in the gut. It may not get to the colon though if the ileus is slow or obstructed.
61
How long does it take for your normal colonic flora to get back to normal after illness and antibiotics?
6-8 weeks
62
What medication works just as well as vancomycin for C Diff but recurrence will more likely happen?
-Fidaxomicin works just as well as vancomycin, but recurrence is more likely to happen if you give them fidaxomicin.
63
What is the most important thing to do to prevent C Diff? What will not work?
Most important thing one can do is handwashing to prevent C Diff (alcohol does not work!!!)
64
What is the most common area in the hospital for C Diff?
-Neonatal unit= They don't get it until they are older though because they don't have the receptors for the toxin yet
65
How do you treat people who have recurrent C Diff problems?
-Fecal transplants are the best way for people who have recurrent problems, 60-75% effective, it can also be transplanted straight to the colon instead of through the mouth (ugh gross)
66
What does botulism do to the nerves?
-Botulism= paralyzes the nerves, -Dysphagia, dysphonia, extremities get weak- bulk of cases come from alaska, they eat a lot of fermented fish, it goes in a ziplock bag and they let it sit there for a while and then they eat it
67
Which bacteria causes a lot of diarrhea but it takes longer to pick up?
-Clostridium perfringens= causes a lot of diarrhea, takes longer to pick up, around 24 hours
68
What kind of bacteria comes from refried beans?
Bacillus Cereus
69
Which food poisoning resembles gram negative rods and resembles an allergic reaction?
Scombroid food poisoning is a foodborne illness that results from eating spoiled (decayed) fish. Along with ciguatera, it is listed as a common type of seafood poisoning. It is gram negative rods.
However, it is often missed because it resembles an allergic reaction. It is like eating a big bowl of histamines.
70
What food poisoning produces a neurotoxin and is found in seafood?
-Dinflagellates= from eating seafood, they produce a neurotoxin, pufferfish also gives these dinoflagellates
71
What percentage of people with cellulitis have staph A? What are the symptoms?
Cellulitis= 30-40% of them have staph A. Edema, dry skin, look between the toes, they travel up the lymphatics
72
How do you tell the difference between venous insufficiency and cellulitis?
Venous insufficiency= they look dark red, and it won't be painful, so sometimes it looks like cellulitis, if you keep the legs elevated than 5-10 mins later it will go away, obviously this doesn't occur with cellulitis
73
What is necrotizing fasciaitis and who do you see it in?
Fasciaitis- bacteria/fungus travels really quickly all the way to the fascia, the area above gets gangrene and it is necrotizing fasciaitis! You can die from this. Diabetics and people with bad vascularity this is more common. You can see a lot of inflammation but they won't be having any pain. Call a surgeon immediately. Chunks of skin have to be taken out.
74
What is fournier's gangrene?
necrotizing fasciaitis seen in the groin, most commonly in men
75
Necrotizing fasciatis as deep as the bone is called what? How do you treat this condition?
Osteomyelitis! Chronic osteomyelitis= surgical disease. When bone gets infected, part of the bone dies because it doesn't get blood supply. Surgeon scrapes it and it doesn't bleed. We have to get rid of this, it is sequestrum. You cannot sterilize it. You need to remove it. Once its gone, you then need to give them antibiotics.
76
What is an antibiotic that targets skin problems?
Cellulitis, strep and staph A= use clindamycin
77
What kind of scan for bone works better than a bone scan?
MRI
78
Why is an MRI good for diabetics with feet problems?
diabetics feet get misshapen, an MRI is good for this.... do not do it if they are on antibiotics.
79
What is the treatment for chronic osteomyelitis?
needs a surgeon. Long course of antibiotics, 6 weeks or longer. If peripheral pulses are not felt you NEED a surgeon. You need to monitor everyone, with or without peripheral pulses. You need to see if they have blood supply it is the most common thing missed.
80
What are decubitus ulcers?
position ulcers
81
Is eschar unstageable?
yes
82
What stage is non blanching erythema in an ulcer?
Non blanching erythema= where you want to intervene!!! Stage 1
83
What treatment is good to use a little bit of?
Dakin's= good to use, but not a lot of it= may slow down healing process
84
For foot wounds/ulcers, what are the main things you must pay attention to?
Blood supply, do they need debridement?, pick the right antibiotics, control diabetes, and make sure they have the right foot wear.
85
How does septic arthritis present?
painful, swollen joints
86
What do you do when you suspect septic arthritis? Which bacteria should you worry about the most?
analyze the synovial fluid, worry the most about staph A
87
What are the most common viruses for septic arthritis?
parvovirus and enterovirus
88
Which virus causes slap cheek in children?
parvovirus
89
How do you place a triple lumen catheter or a PICC for antibiotic use in someone?
line goes straight into the vein
90
How do you place a tunneled line in someone?
they go into skin and travel under skin for a little while and then enter the vein- there is a disc present and these are in for a while
91
How do you place a portal catheter in someone?
there is a pouch under the skin.... you stick a needle in and the disc is made of sillicone, this is for people who need once a month chemotherapy
92
How do you test blood for bacteremia? Peripherally or centrally?
The standard now is to get blood peripherally and not centrally in order to test for bacteremia.
93
What do you do if you see persistent bacteremia after the central line comes out?
There is a different source of infection independent of the line. Look at the vein the catheter was in. There might be a thrombus present.
94
coag neg staph= all staphs except which?
staph aureus
95
When there is bacteremia but you cannot find the source? What should you suspect?
Endovascular source= endocarditis
96
Bulk of anaerobes are gram negative or positive? Rods or cocci?
gram negative rods
97
What will you see on someone's nails who has endocarditis?
splinter hemorrhages (near bottom of nail)
98
What are the most common causes for endocarditis?
Staphylococcus aureus followed by Streptococci of the viridans group and Coagulase negative Staphylococci are the three most common organisms responsible for infective endocarditis. Candida albicans, a yeast, is associated with endocarditis in IV drug users and immunocompromisedpatients. Other fungi demonstrated to cause endocarditis are Histoplasma capsulatum and Aspergillus.[
99
For a UTI, what do you base your diagnosis on? Symptoms or culture?
-UTI's= least important thing is a urine culture. Base diagnosis on symptoms not culture. You will see WBC's in the urine. It will be greater than 5?
100
Why should you get an ultrasound when you see staph A in the urine?
Get an ultrasound to see if there is a renal carbuncle= common when staph A is present in the urine.
101
Bacteria is present in what percentage of people with foley catheters?
Foley catheters= bacteria is present in 80-90% of people with these catheters, so the bacteria doesn't mean anything
102
What works for an E. coli UTI treatment?
-E.coli= 2nd generation cephs, bactrum,
103
What works for an enterococcus UTI treatment?
enterococcus= amoxicillin is drug of choice, and vancomycin could also work
104
Unasyn is what 2 antibiotics?
ampicillin and sulbactam
105
Kernig's sign indicates what and what is it?
Lifts leg and pain is felt= indicates meningitis
106
Brudzinski's sign indicates what and what is it?
Head lifts chin to chest and they move their legs along with it because of pain= meningitis
107
How many tubes of CSF do you retrieve for meningitis?
You get 4, you look at 1 and 4 and get WBC count- also look at their symptoms
108
What is the most common bacteria for meningitis? What is the 2nd most common?
strep pneumo, meningococcal is the 2nd
109
What is the difference between septic and aseptic meningitis?
Septic= pus is present, it's bacterial, Aseptic= no pus, viral
110
What can you use as an antibiotic to get rid of an intermediate strain pneumococcal meningitis?
Ceftriaxone
111
What can you use for resistant pneumococcal meningitis?
vancomycin
112
What can you use for inflammation of meningitis?
steroids
113
What could cause septic meningitis? (and it comes from cheese)
Lysteria
114
How will septic meningitis present? What will the white cell count, protein, and glucose look like?
White cell count will be very high, and it is neutrophilic. This also includes a really low glucose and a high protein (normal glucose is about 50% of conc)
115
How well aseptic meningitis present?
Aseptic= high white cell count (but not THAT high), lymphocytes, it is viral. Antroviruses is the culprit usually in the summer. In the winter it tends to be respiratory viruses. Treat the symptomatically.
Glucose levels are normal to high
116
Is encephalitis usually viral or bacterial? What virus is the usual culprit?
Encephalitis is usually viral, herpes is the usual culprit. 2 tends to cause a type of meningitis. 1 tends to cause encephalitis. Altered mental status, enhancement of temporal lobe. It is treated conservatively.
117
What is transverse myelitis?
inflamed spinal cord
118
What can discitis cause?
-discitis= inflamed vertebral disc. If fluid leaks out it infects other areas. It can reach lumbar space and cause infection. It can cause epidural abscess.
119
Why should you get a good history in someone with staph A in their blood?
-If someone has staph in their blood, you must then get a good history. They may have a pacemaker or prosthetic something inside of their bodies/attached to their bodies that is causing the infection.
120
Where does TB usually infect the lung?
middle/upper right lung usually
121
What kind of stain to you use for TB? Why is this stain potentially unreliable?
Acid fast stain= used for TB culture. It takes about 8-10,000 on culture to get a positive result. This is not good because you only need ONE to get infected.
122
How long does it take for TB to multiply?
Most people get it from a reactivation of an old infection. It takes a little while. 18 hours to multiply
123
When is sputum retrieved and how many cultures are done for suspected TB?
Sputum is retrieved in the morning because it builds up during the night. Get 3 different sets of sputum. This is done in 3 days. Even if all 3 sputums are negative, they could still have TB.
124
Who is at risk for TB?
Immunosuppressed, alcoholics, foriegners, people who are on meds for TNF. (crohn's disease) These people are susceptible for reactivation for TB.
125
Bacteria may take how many days to grow?
Bacteria may take 10-20 days to grow!
126
What do you give people when they are infected with TB but the disease is not active?
INH given over 9 months, Rifamptine= 3 months, 12 doses, cannot use in immunosuppressed or pregnant people.
127
What is ghon's complex?
a lesion seen in the lung that is caused by tuberculosis. The lesions consist of a calcified focus of infection and an associated lymph node. These lesions are particularly common in children and can retain viable bacteria, so are sources of long-term infection and may be involved in reactivation of the disease in later life.[3]
128
What is a blood test for TB that is more sensitive than a PPD?
QuantiFERON
129
PPD positive test result is...how big?
10 mm for PPD
130
What # type of hypersensitivity is the type for a PPD?
Type 4 hypersensitivity= type of infection for PPD (takes a few days for it to show)
131
What does an AFB sputum test for? How accurate is it?
-Sputum AFB positive= DNA probes are used- they have 90-95% accuracy. If negative, you may have to wait a few more weeks and try again.
132
LGV is caused by what kind of bacteria?
Lymphogranuloma venereum (also known as "Climatic bubo", "Durand–Nicolas–Favre disease," "Poradenitis inguinale," and "Strumous bubo" is a sexually transmitted disease caused by the invasive serovars L1, L2, L2a or L3 of Chlamydia trachomatis. Usually by homosexual men.
133
What are the treponema antibodies?
-Treponema antibodies= FTA-ABS, MHA-TP, these are the standard ones. They are positive for life and they will never go away.
134
Where are the non-treponema antibodies?
Non-treponema antibodies= RPR and VDRL
135
Which STD antibody can you find in CSF?
VDRL
136
When do you do daily prophylaxis for someone with herpes?
daily prophylaxis= getting outbreaks 4-6x a year
137
Which illness has a toxin that goes every which way and primarily affects the heart, and causes painful cervical LN?
diphtheria
138
When does immunity for pertussis start? What do you give for pertussis?
Immunity of petussis= 30's-40's= give them one vaccine= coughing and less one sounds like a whoop and then they vomit, it is not easy to diagnose. Warn them that it will be there for a while, give them macrolides or doxy.
139
How often do you have the tetanus vaccine?
Tetanus= give every 10 years= re-do it if they have a cut contaminated with soil.
140
Is MMR vaccine alive?
Yes
141
How do the measles spread?
start upper part of body and moves peripherally
142
If you give someone a live vaccine, what should you ask them/parents of patient?
-If you give them a live vaccine= ask them about the people around them, be concerned if there are immunosuppressed people around them, stays active for about a week
143
Which hepatitis do you see in travelors?
hep A (also typhoid)
144
Which hep vaccine should you get for people working in healthcare?
-Hep B= working in healthcare you should def get this, there is 5-8% of people who DO NOT respond to the vaccine!
145
What could possibly occur in someone who gets the yellow fever vaccine? (small chance)
necrotizing hepatitis (or fasciaitis) could occur (small chance)
146
Which organisms cause problems in people who do not have a spleen?
Capsulated organisms= pneumococcus, H flu (not common) and meningococcus, causes a lot of infections in people who do not have a spleen
147
How does the Immunodeficiency (Not HIV) Terminal complement kill bacteria? What are the types C#-C#?
inserts itself into bacterial cell wall, puts holes in it and kills it. (C5-C9)
148
Are deficiencies in the terminal complement common?
no
149
Which type of bacteria is VERY bad for people without spleens and is given through animal bites?
Capnocytophaga canimorsus infections in people without spleens can be BAD (seen in animal bites)- they can go into shock
150
How do you get babesia?
comes from tick bites, red blood parasite, looks like malaria, hemolytic anemia occurs from RBC hemolysis
151
An IgA deficiency could indicate what?
-IgA deficiency= mucosal problems= predisposes you to anaphylaxis. This is important when they get transfusions.
152
What will chemo do to your white blood cell count?
Neutropenia= chemo will cause this, and then they will bounce back up. When they're down, you're susceptible to infections. Most chemo regimens for solid tumors will cause you to be susceptible for infections.
153
What may be confusing when you get labs back from someone with suspected pneumonia while they're taking chemo?
-You may get pneumonia but you do not have the inflammation to show for it because neutrophils are so low
154
What do you take to cover pseudomonas?
pseudomonal coverage= cefepine (4th gen cephalosporin)
155
What do you give someone who has MRSA and invasive medical equipment in them?
vancomycin
156
If you see someone with HIV and cryptococcus is in their blood, what kind of infection should you suspect?
-Cryptococcus= another yeast, specific serologic test for it, can find it in blood cultures, worry most about meningitis. If you see someone with HIV and this is in their blood definitely do a lumbar puncture.
157
People who take chronic steroids and have chronic leukemia, what bacteria may you see in their blood?
-Chronic high dose steroids= you may see crypto in the blood of people with chronic leukemias
158
-pneumocystis carini pneumonia is now called what?
now it's jiroveci
159
You see neutropenic fever in people who are sick from
being sick from hospital molds
160
How does sporothrix present?
fungal nodules up the arm
161
What are the most common fungal skin infections?
Dermatophytes= most common! Skin infections. Tinea, ringworm, seen in all different places and different names depend on the area they're in.
162
Nystatin is used for what?
Oral fungals, you swish it around
163
What triazole fungal medications are most commonly used?
Vori and fluconazole
164
Which fungal infection is not as bad as it looks?
Parapsilosis
165
60-70% of people with herpes have also veeb infected with what other virus?
Herpes 60-70% have been infected with EBV- 3 types of antibodies= EBV, CVA, IGM, IGG and EBNA. EBNA is most important.
166
Which antbody indicates an acute infection if EBNA is negative?
Normally, IgM does not indicate acute infection. If EBNA is negative and you have IgM than you have an acute infection.
167
A monospot test is good for testing for which virus?
EBV
168
-atypical lymphocytosis indicates what virus?
-atypical lymphocytosis= mononucleosis
169
Which antibiotic treats CMV?
gangcyclovir
170
What kind of blood crisis may you see in people with parvo virus infections?
aplastic crisis with parvo virus infections
171
How does enterovirus present in people?
common family of viruses= infects GI tract, febrile illnesses, but NO N/V, aches and pains is present
172
During the summer months, enterovrius infects which area of the body most commonly?
it causes aseptic meningitis
173
How do you screen for influenza?
nasal swab
174
What is the most common virus for gastroenteritis?
Most common is norovirus, it is notorious for causing big outbreaks and it is very infectious, lots of vomiting and some diarrhea- lasts 2-5 days
175
What kind of viral vaccine is too expensive for poorer countries to afford?
Rotovirus= expensive vaccine- so kids in poor countries cannot get this often and that is where the problem lies- it is self limiting, treat symptomatically.
176
What kind of people does toxoplasmosis usually infect?
immune system can combat it usually unless- but if you're immunosuppressed or pregnant it's bad! It is self limiting though.
177
What does malaria infect in the body?
a parasite of red blood cells, first stage is always in liver, sticks around in liver for a while and then breaks out of there. Treat the blood and liver. Prophylaxis is important for people traveling.
178
What drug is used to prevent and treat malaria?
Malarone- It needs to be taken every day. Covers the problem in the liver. Doxy is another one for this (photosensitivity is a side effect though)
179
What 2 drugs make up malarone (drug that treats and prevents malaria)?
atovaquone and proguanil
180
Giardia is a bacteria that invades where?
parasite of small intestine= green frothy diarrhea, it can hang around for a while, well water people get this, common variable immunodeficiency people get it
181
Cryptospiridium can cause what? Who is it especially harmful to?
Cryptospridium= causes gastroparietis (?) self limiting, HIV and AIDs people can get a chronic diarrhea with this- in these cases you must treat. It is less than an issue now that we control people with HIV/AIDS better than we used to.
182
Ascaris is what kind of infection?
Round worms, harmful when consumed
183
How do hookworms affect the stomach lining?
they suck blood from the stomach lining- so it could cause iron deficiency anemia
184
Where do you often find pinworm eggs on children?
found in children, eggs laid in perianal region, scotch tape in anal opening, look for eggs on tape the next day-
185
Do schistosomes go to large or small intestines?
large intestines- it may be the cause of bladder cancer in poor countries!
186
Strongyloides causes what kind of syndrome? What medication can you give that will actually make it worse?
Strongyloides= hyper infection syndrome, when they penetrate the gut wall and go into bloodstream they give gram negative rods – sometimes if you give them steroids (presents like asthma) they get worse!
187
What is the most common zoonoses?
most common is influenzae, histo, crypto, all seen in bird poop
188
Which bacteria causes cat scratch disease and how do the cats get it?
Cat scratch disease= not febrile (so don't call it cat scratch fever)- floats around in cat's bloodstream- doesn't do much harm to them, they get infected from fleas. They scratch themselves and they get flea feces on their claws, then they scratch you and you can get botanella. Usually with younger cats, but it can be with any of them.
189
What is a symptom of cat scratch disease?
bad LN inflammation
190
If a cat bites you, what kind of bacteria can you become infected with?
If they bite you, you can get pasterella. They will come in with bacteremia. You can also get it from a dog bite, but its most commonly seen with cat scratches. Treat with antibiotics. Cat bites= osteomyelitis. They penetrate deeply.
191
What kind of bacteria can give you encephalopathy if you drink it in water?
leptospirosis
192
What kind of workers get tularemia?
landscaping people
193
What can trichinella give you if you eat it in pork?
a week later you get rhabdomyolysis
194
Hemorrhagic colitis can come from consuming what bacteria?
E. coli in food
195
bacteroids are found mainly where?
In the colon
196
If you suspect hasek endocarditis, what should you get a ct scan of?
the jaw
197
Strep is associated with rheumatic fever. What is the JONES criteria for rheumatic fever?
Major: Carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. Minor: Fever, athralgia, previous rheumatic fever,
acute phase reactants: Leukocytosis, elevated eritrosedimentation rate (ESR) and C-reactive protein (CRP) and prolonged P-R interval on electrocardiogram (ECG).
198
What is the most common cause of endocarditis from a NON-drug user?
MC cause of endocarditis- not a drug user= veridans strep (comes from where?) or enterococcus (comes from gut)
199
Enterococcus is covered by which antibiotic?
ampicillin
