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Infectious Disease > Exam 2 - Zoonoses and GU infections > Flashcards

Exam 2 - Zoonoses and GU infections Flashcards

1
Q

dysuria definition

A

burning/tingling/stinging of urethra and meatus associated with voiding

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2
Q

most common cause of dysuria in women

A

acute cystitis

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3
Q

acute cystitis mimics

A

vaginitis, prostatitis, STIs, derm conditions, allergies, hormonal conditions, bladder cancer

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4
Q

anatomic abnormalities predisposing to UTIs

A

hypospadias, BPH, vesicoureteral reflux, polycystic kidney disease

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5
Q

what is a complicated UTI

A

everything except simple cystitis in a healthy non-pregnant woman

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6
Q

confounding factors in urinalysis

A

unclean catch, dilute urine (first morning urine is the best), AZO treatment

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7
Q

major way to estimate gram + vs gram - UTI from urinalysis

A

gram negative will have nitrites, gram positive will not

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8
Q

major way to determine contamination in urinalysis

A

presence of moderate-numerous squamous cells

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9
Q

clues to UTI on urinalysis

A

cloudy color, presence of blood/protein, leukocyte esterase, WBCs, RBCs, bacteria, nitrites

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10
Q

most common UTI pathogen

A

e coli

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11
Q

which UTI pathogen is associated with struvite stones

A

proteus

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12
Q

risk factors for pseudomonas uti

A

chronic catheter, hospitalized patients

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13
Q

risk factors for enterococcus uti

A

debilitated/hospitalized patients

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14
Q

risk factors for group b strep (agalactiae) uti

A

diabetes

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15
Q

risk factor for staph saprophyticus uti (coagulase negative)

A

young, sexually active women

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16
Q

mechanism and pathogen in descending UTIs

A

staph aureus, hematogenous spread to kidneys

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17
Q

when to treat asymtpomatic bacteriuria

A

pregnant women, before invasive urologic procedures

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18
Q

simple cystitis ssx

A

frequency, urgency, dysuria, suprapubic pain, hematuria

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19
Q

pyelonephritis ssx

A

simple cystitis plus CVA tenderness, fever, flank pain, N/V

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20
Q

simple cystitis tx

A

nitrofurantoin, cephalexin, bactrim, cipro

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21
Q

pyelonephritis tx

A

empiric coverage for suspected GNR, consider pseudomonas if hospitalized patient

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22
Q

which STI cannot use PCR for diagnosis and what does it use instead

A

treponema pallidum, dark field microscopy or RPR/VDRL

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23
Q

gonorrhea morphology

A

gram negative diplococci

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24
Q

chlamydia morphology

A

intracellular gram negative rods

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25
Q

trichomonas morphology

A

parasite - flagellate

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26
Q

BV pathogen

A

gardnerella vaginalis

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27
Q

gardnerella vaginalis morphology

A

gram variable rod

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28
Q

candida albicans morphology

A

budding yeast

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29
Q

treponema pallidum morphology

A

spirochete

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30
Q

which STI is characterized by clue cells on wet mount

A

gardnerella (BV)

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31
Q

what does the vaginal pathogens panel consist of?

A

candida, BV, trichomonas

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32
Q

treatment for gonorrhea

A

ceftriaxone 500 mg IM x 1 and azithromycin 1 gram PO x 1

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33
Q

treatment for chlamydia

A

doxycycline x 7 or azithromycin x 1 and ceftriaxone x 1

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34
Q

treatment principle for gonorrhea/chlamydia

A

treat for co-infection with both organisms

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35
Q

gonorrhea sequelae

A

PID, neonatal conjunctivitis, bacteremia, septic arthritis, tenosynovitis

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36
Q

chlamydia sequelae

A

PID, conjunctivitis, trachoma, ectopic pregnancy, chronic pelvic pain, infertility, reactive arthritis

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37
Q

causes of prostatitis

A

bacteria leaking into prostate gland from urinary tract, direct extension/lymphatic spread from rectum, STIs

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38
Q

prostatitis ssx

A

dysuria, urinary hesitancy/urgency, painful ejaculation, abd/groin/low back pain

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39
Q

epididymitis causes

A

UTI/STI

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40
Q

epididymitis ssx

A

swollen, red, warm scrotum, testicle pain/tenderness of gradual onset

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41
Q

balanitis definition

A

inflammation of the glans penis most common in uncircumcised men

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42
Q

balanitis causes

A

candida, irritation from soaps

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43
Q

treatment principle for prostatitis/epididymitis

A

in younger sexually active males, screen and treat for gonorrhea/chlamydia. In older males suspect UTI organisms

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44
Q

prostatitis/epididymitis treatment

A

cipro or bactrim x 1-2 weeks

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45
Q

why is cipro often used for prostatitis

A

it can achieve high concentrations in prostate

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46
Q

non-infectious causes of vaginitis

A

atrophic (post menopausal), allergies to condoms/spermicides/washes

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47
Q

most common vaginitis pathogens

A

candida, bacterial vaginosis pathogens, trichomonas

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48
Q

vaginitis treatment challenge

A

if due to BV, pathogens form biofilm leading to high rates of recurrence

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49
Q

candida vaginitis tx

A

monistat cream or PO diflucan

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50
Q

bacterial vaginosis ssx

A

vaginal pain/itching, dyspareunia, thin grayish milky discharge, fishy odor

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51
Q

trichomonas ssx

A

vaginal itching/pain, thin grayish frothy discharge

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52
Q

bacterial vaginosis diagnosis

A

PCR, clue cells on wet mount

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53
Q

trichomonas diagnosis

A

PCR, moving protozoa on microscopy

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54
Q

BV/trichomonas tx

A

PO metronidazole, vaginal metronidazole, vaginal clindamycin

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55
Q

syphilis tx

A

PCN

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56
Q

non-treponemal antibody detection

A

RPR, VDRL: Quantitative, titers go down with treatment, false positives and negatives

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57
Q

treponemal antibody detection

A

TPPA, MHA-TP, FTA: Qualitative, stays positive for life, more specific than non-treponemal

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58
Q

stages of syphilis

A

primary, secondary, latent, tertiary

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59
Q

primary syphilis timeline and characteristics

A

2-3 weeks after infection, chancre at entry site, regional lymphadenopathy, serology may or may not be positive

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60
Q

secondary syphilis timeline and characteristics

A

6-12 weeks after infection: rash, joint pain, hepatitis, general lymphadenopathy

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61
Q

latent syphilis characteristics

A

positive blood test with no ssx

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62
Q

tertiary syphilis characteristics

A

CNS damage, aortitis, gumma

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63
Q

when does neurosyphilis occur

A

can happen at any stage

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64
Q

how is congenital syphilis transmitted

A

through placenta

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65
Q

genital ulcers differential diagnosis

A

HSV II, syphilis, chancroid, HPV, Behcet’s, drug reaction

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66
Q

HSV II ssx

A

painful vesicular lesions

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67
Q

chancroid ssx

A

painful necrotic lesions

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68
Q

chancroid pathogen

A

haemophilus ducreyi

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69
Q

HPV ssx

A

wart-like lesions

70
Q

Behcet’s ssx

A

sores in mouth and genitals

71
Q

HSV II tx

A

acyclovir

72
Q

chancroid tx

A

azithromycin, ceftriaxone

73
Q

HPV tx

A

imiquimod, condylox

74
Q

Behcet’s tx

A

prednisone, immunosuppressants

75
Q

how long to refrain from sexual activity after STI treatment initiation

A

7 days

76
Q

major diagnosis principle for STIs

A

always evaluate for other STIs including HIV

77
Q

zoonoses definition

A

infections normally found in non-humans that may infect humans

78
Q

when to consider zoonoses

A

fever of unknown origin with recent travel history

79
Q

differential for fever within one week of return from African, South America, SE Asia

A

malaria, dengue, chikungunya, zika, yellow fever

80
Q

zoonoses from cats

A

pasteurella, bartonella

81
Q

pasteurella morphology

A

small gram negative coccobacilli

82
Q

pasteurella ssx

A

acute onset of cellulitis, lymphangitis, purulent drainage from wound 12-24 hours after bite/scratch

83
Q

pasteurella tx

A

surgical drainage and PCN

84
Q

Bartonella morphology

A

fastidious, slow-growing GNR

85
Q

bartonella diagnosis

A

PCR, lymph node culture

86
Q

bartonella mechanism

A

transmitted to cat via infected flea

87
Q

pasteurella mechanism

A

normal oral flora in cats and dogs

88
Q

bartonella ssx

A

fever, fatigue, swollen lymph nodes

89
Q

bartonella tx

A

self-limiting, can use azithromycin or PCN

90
Q

rickettsial infections morphology

A

very small, usually intracellular bacteria

91
Q

rickettsial infections tx

A

doxycycline

92
Q

rickettsial infections ssx

A

fevers, HA, rash, tache noire (eschar)

93
Q

most important rickettsial infection

A

rocky mountain spotted fever

94
Q

RMSF pathogen

A

rickettsia rickettsii

95
Q

RMSF geographic distribution

A

US (NC, OK, TN, Arkansas, Missouri), Canada, Mexico, Central America, Brazil

96
Q

RMSF vector

A

American dog tick

97
Q

RMSF ssx

A

fever, HA, abd pain, maculopapular rash or petechiae that begins on wrists/ankles and progresses towards the trunk - can be seen on palms and soles

98
Q

RMSF diagnosis

A

serology, skin biopsy

99
Q

RMSF treatment

A

doxycycline, chloramphenicol

100
Q

rickettsialpox pathogen

A

rickettsia akari

101
Q

rickettsialpox ssx

A

fever, HA, papulovesicular rash

102
Q

rickettsialpox vector

A

mouse mites

103
Q

rickettsialpox tx

A

doxycycline

104
Q

granulocytic anaplasmosis pathogen

A

anaplasma phagocytophilum

105
Q

cells affected by granulocytic anaplasmosis

A

granulocytes (neutrophils, eosinophils, basophils

106
Q

granulocytic anaplasmosis vector

A

ixodes tick

107
Q

granulocytic anaplasmosis geographic distribution

A

upper midwest, New England, northeast Atlantic states

108
Q

granulocytic anaplasmosis ssx

A

fever, myalgias, HA, GI ssx, no rash

109
Q

granulocytic anaplasmosis tx

A

doxycycline

110
Q

cells affected by monocytic ehrlichiosis

A

blood monocytes, tissue phagocytes

111
Q

monocytic ehrlichiosis vector

A

lone star tick (amblyomma)

112
Q

monocytic ehrlichiosis geographic distribution

A

Midwest, coastal Atlantic states

113
Q

monocytic ehrlichiosis ssx

A

same as anaplasmosis except 1/3 of patients have rash

114
Q

monocytic ehrlichiosis tx

A

doxycycline

115
Q

monocytic ehrlichiosis vs anaplasmosis on blood smear

A

anaplasmosis: often see morulae. Ehrlichiosis: rarely see morulae

116
Q

Q fever pathogen

A

coxiella burnetti

117
Q

Q fever reservoirs

A

sheep, cattle, goats (placental tissue, feces, urine)

118
Q

Q fever transmission

A

inhalation, unpasteurized dairy, tick bite (rare)

119
Q

Q fever ssx

A

acute or chronic: fevers, chills, myalgia, HA, GI symptoms, chest pain

120
Q

Q fever sequelae

A

culture negative endocarditis, pneumomia, hepatitis, aneurysms, CNS

121
Q

Q fever tx

A

doxycycline

122
Q

Plague pathogen

A

yersinia pestis

123
Q

plague vectors

A

fleas, prairie dogs, rock squirrels, cats/dogs

124
Q

plague morphology

A

gram negative coccobacilli with safety pin appearance

125
Q

plague diagnosis

A

culture, antibody test

126
Q

plague presentation

A

buboes, pneumonic

127
Q

plague season

A

spring, summer, fall

128
Q

plague treatment

A

doxycycline, cipro

129
Q

plague geographic distribution

A

Western US, especially NM

130
Q

Hantavirus geographic distribution

A

Four corners NM

131
Q

Hantavirus mechanism

A

inhalation of deer mouse feces

132
Q

Hantavirus ssx

A

flu-like ssx one week after contact +/- severe respiratory distress

133
Q

Hantavirus diagnosis

A

> 10% immunoblasts on blood smear, antibody test

134
Q

hantavirus season

A

spring, early summer

135
Q

hantavirus treatment

A

supportive care, ECMO

136
Q

west nile geographic distribution

A

continental US

137
Q

West nile vectors

A

mosquitoes, dead birds

138
Q

west nile ssx

A

flu-like, meningitis/encephalitis, paralysis

139
Q

west nile diagnosis

A

IgM serology

140
Q

west nile treatment

A

supportive

141
Q

rabies animals

A

bats, racoons, skunks, cats/dogs, etc

142
Q

rabies tx

A

rabies vaccine, immunoglobulin

143
Q

rabies ssx

A

cerebral dysfunction, anxiety, AMS, usually fatal if ssx develop

144
Q

rabies diagnosis

A

PCR, antibody testing

145
Q

tularemia geographical distribution

A

hunting areas, Arkansas

146
Q

tularemia risk factor

A

hunting and skinning rabbits

147
Q

tularemia vectors

A

lone star tick, deer fly

148
Q

tularemia ssx

A

glandular, oropharyngeal, pneumonic

149
Q

tularemia diagnosis

A

PCR, fluorescent antibody stain, culture

150
Q

tularemia morphology

A

gram negative coccobacilli

151
Q

tularemia season

A

summer, fall

152
Q

tularemia tx

A

doxycycline, cipro

153
Q

Dengue geography

A

tropical regions

154
Q

dengue vector

A

mosquito

155
Q

dengue ssx

A

bleeding, jaundice, elevated LFT/creatinine

156
Q

dengue diagnosis

A

PCR

157
Q

dengue treatment

A

supportive

158
Q

brucellosis risk factors

A

immigrants, ranchers, slaughterhouse/meat packing workers, hunters, vets

159
Q

brucellosis animal

A

ungulate and farm animals (horses, cattle, pigs, goats)

160
Q

brucellosis ssx

A

flu-like

161
Q

brucellosis diagnosis

A

serology

162
Q

brucellosis morphology

A

gram negative coccobacilli

163
Q

brucellosis season

A

spring/summer

164
Q

brucellosis tx

A

doxycycline, cipro

165
Q

lyme disease pathogen

A

borrelia burgdorferi

166
Q

lyme disease geographic distriubtion

A

northeast, upper midwest

167
Q

lyme disease vector

A

deer tick (ixodes scapularis)

168
Q

lyme disease ssx

A

erythema migrans, bell’s palsy

169
Q

borrelia burgdorferi morphology

A

spirochete

170
Q

lyme disease diagnosis

A

serologies

171
Q

lyme disease tx

A

doxycycline

172
Q

lyme disease season

A

summer/early fall

Infectious Disease (5 decks)

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