Hancock week 1, zoonosis, parasitology, mycosis Flashcards

1
Q

Malaria transmission

A

anapheles mosquitos

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2
Q

Malaria Cause

A

plasmodium falciparum

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3
Q

Severe Malaria SX

A

unarousable coma/cerebral malaria, renal failure no imp with hydration

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4
Q

Peripheral smear findings

A

thick tells you detection of parasites

thin: identification of species

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5
Q

Malaria poor prognosis SX

A

marked agitation, respiratory distress, bleeding spontaneously, anuria, hypothermic,

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6
Q

Chloroquine

A

lots of resistance only use when patient going to Haiti

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7
Q

Mefloquine

A

taken 1x a week start 2-3 wks before to weed of psych effects travel and continue 4 wks after. Use for long travel periods (missionaries)

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8
Q

Doxycycline

A

cheap commonly available take everyday up to 4 wks after return from travel Side effects: photosensitivity/ GI

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9
Q

malarone

atovaquine + proguanil

A

take everyday start 2 days before entering the country and continue for 7 days after leaving the country. EXPENSIVE CI: renal dz and pregnancy. Hancock uses this plus doxy.

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10
Q

Malaria Management

A

therapy based on plasmodium Consult w/ CDC

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11
Q

Uncomplicated Malaria TX

A

Artemether +lumefantrine

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12
Q

Malaria Haiti TX

A

Chloroquine

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13
Q

Primaquine

A

can cause hemolytic anemia d/t G6PD or fava beans.

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14
Q

Severe Malaria TX

A

Artesunate IV

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15
Q

Schistosomiasis causative agents

A

snail fever schistosoma species

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16
Q

Schistosomiasis transmission

A

blood flukes entering skin from contaminated water

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17
Q

Schistosomiasis Katayama fever

A

occurs with S mansoni and S japanicum. bright red poop, vesicular rash

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18
Q

Diagnostic testins Schistosomiasis

A

esonophillia

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19
Q

Tx Schistomisasis

A

Praziquantel

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20
Q

Toxoplasmosis causative agent

A

toxoplasma gondii

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21
Q

Toxoplasmosis transmission

A

cat feces

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22
Q

Toxoplasmosis Congenital vertical transmission

A

highest risk in the third trimesters eye issues

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23
Q

Toxoplasmosis congenital infection early

A

early fetal infections the body makes an abortion,

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24
Q

Congenital infection late

A

Retinochroiditis MC late finding and worse

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25
Q

Management of toxoplasmosis

A

pyrimethamine

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26
Q

Pregnant mom and toxoplasmosis

A

wear a mask and gloves when changing litter box, wash pork and fruits properly

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27
Q

Scabies findings

A

scaroptes scabiei. intense itch, serpentious tract, burrow scabies

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28
Q

flea bite difference from scabies

A

more disctinit lesions

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29
Q

Scabies tx

A

permethirin 5% cream repeat 1-2 wks

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30
Q

lice tx lindane 1% ADE

A

nuerotoxic side effects

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31
Q

pediculosis

A

transmission: hat, towewls, combs

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32
Q

Body lice complication

A

body louse caries epidemic typhus

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33
Q

How can you find lice

A

Woods lamp

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34
Q

how do you know if you have bedbugs?

A

get the bug get the rash

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35
Q

bedbugs management long term

A

malathion

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36
Q

Ascariasis causative agent

A

ascaris lumbricoides

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37
Q

transmission way of ascariasis

A

fecal oral

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38
Q

ascariasis tx

A

ivermectin

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39
Q

Pinworms sx

A

itchy butt

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40
Q

Pinworms mate site

A

adult male and female mate in the terminal ileocecal region tx: scotch tape test

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41
Q

pin worm Tx

A

pyrantel pamoate, proper hygiene treat 2 weeks apart

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42
Q

Hook worm necatoriasis

A

dermal to exposure to fecal contaminated soil

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43
Q

necatoriasis findings

A

iron deficiency micorcytic anemia, loss or protein

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44
Q

necatoriasis tx

A

tx with iron pills d/t deficiency

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45
Q

cysticercosis pork tapewrom

A

taenia slium (pork)

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46
Q

pork tapeworms finidngs

A

seizures, ring enhnced lesions in mri, egggs in teh stool

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47
Q

Pork tapeworms tx

A

Praziquantel prevention: sanitation and proper hygiene

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48
Q

beef tapewrom causative agent

A

taenia saginata

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49
Q

Trichinellosis transmission

A

trichinella spiralis eating uncooked pork

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50
Q

Trichinelosis cause of death

A

myocardidtis rare but causes death

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51
Q

Rocky mountain spotted fever

A

ricketssa richetssi

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52
Q

transmission of spotted fever

A

tick bites animal bites you then you get this rash

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53
Q

Rocky mountain spotted fever rash

A

centripital inward rash starts at wrists then comes in affects soles of feet

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54
Q

Rocky mountain spotted fever to

A

doxycicline 100 mg x7 days

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55
Q

Prevention of rocky mountain fever

A

wear clothes

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56
Q

Lyme Dz causative agent

A

borrelia Bugdoferi spirochete

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57
Q

Vector of Lyme dz

A

tick related

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58
Q

Lyme stages Stage 1

A

bulls eye lesion, erythema migrans

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59
Q

Lyme stage2

A

cranial neuropathy bilateral bell spalsy caridaca AV block

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60
Q

Lyme stage 3

A

neurologic manifestations chronic fatigue, chronic arhtritis

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61
Q

Lyme Diagnosis

A

HX AND TX!!!

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62
Q

lYM dZ CAN TEST POSTIIVE FOR CYPHILIS

A

So do VDRL test

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63
Q

Lyme Dz Tx

A

Oral doxycicline x21 days CI in pregnancy Kids under 8 d/t staining of teeth
amoxocillion and cefuroxime- increase therapy 30-60 days if neuro involvment

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64
Q

causative agents of Tularemia

A

francisella tularensis

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65
Q

Tularemia reservoir

A

rodents parie dogs

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66
Q

Tularemia Ulcerglandular

A

Most common kind of tularemia

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67
Q

oculoglandular tularemia

A

touched ur eye ulcerations in the conjuctiva after you killed the praire dog you touch yourself

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68
Q

Talareumia pnuemonia

A

30% likley hood of death hlar lymphnodanenopathy “lawn mover tularemia” mowed dead rabiit

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69
Q

TX Tularemia

A

streptomyocin, or gentamycin

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70
Q

Tularemia BW agent

A

developed resistant strains for war

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71
Q

Ocular tularemia Hallmark

A

prearicular LAD

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72
Q

Relapsing fever

A

fever comes and goes and fever and come chill and flush phase

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73
Q

Relapsing fevers complications

A

pregnancy complications, iritis, uveitis

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74
Q

Relapsing fever tx

A

Doxycicline

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75
Q

causative agent of Dengue Fever

A

dengue fever, flaviviridae

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76
Q

Dengue fever manifestations

A

retroorbital headache, malaisse, rash, shock, saddleback pattern where it gets better then worse

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77
Q

Dengue phases

A

febrile, critical, recovery

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78
Q

Febrile phase

A

fever, HA, rash, easy bleeidng, + torniquete test petichae

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79
Q

Critical phase Dengue hemorrhagic fever phase

A

massive bullae gi hemmrhage, ulcerations, dengue shock syndrome may occur

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80
Q

Dengue recovery phase

A

rash of white islands in the sea of red

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81
Q

Dengue fever management

A

supportive, avoid NSAIDS D/T Thrombocytopenia

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82
Q

Causative agent of Zika

A

aedes aegypti

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83
Q

Zika manifestations

A

mosquito borne illness, rash starting at teh face and spreading out

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84
Q

Zika clinical manifestations in pregnancy

A

microcephaly shrinking of the head and brain defect

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85
Q

Zika and semen

A

zika can be detected in semen up to 3-6 mo after initial infection

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86
Q

Zika diagnosis

A

serology testing avoid nsaids until dengue is ruled out

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87
Q

Zika prevention

A

avoid mosquitos, sex, use condoms 8 weeks after travel, vertical mom to fetus transtion

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88
Q

Ebola Hemorrhagic fever causative agent

A

ebola virus reservoir fruit bats

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89
Q

Geographic area of Ebola

A

africa west and central

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90
Q

Transmission of ebola

A

humans and primates w/ high mortality

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91
Q

Ebola transmission

A

consuming bushmeats, bats, gorillas, chimps, shrew, dead bodies

92
Q

Ebola resvoir

A

fruit bats

93
Q

Ebola sx

A

turns internal organs in to garbage, if a hole, bleeds

94
Q

Ebola tx

A

supportive

95
Q

Western nile virus

A

vector mosquitos

96
Q

manifestations Western nile

A

fevers, ha, encephalation less than 1 %

97
Q

western nile mortallty

A

will have neurologica sequela if they get encephalitis

98
Q

west nile tx

A

supportive

99
Q

Wester equine virus

A

encephalitis mostly in kids.

100
Q

western equine tx

A

supportive

101
Q

mosquito japanese encephalitis

A

asia and western pacific regions and common after heavy rainfall mortality 30%

102
Q

Japanease encephalitis tx

A

vaccines and supportive

103
Q

Mosquitos borne eastern equine encephalitis

A

the most sever mosquitos borne illness in the US, progresses from mental status change, seizures and coma

104
Q

eastern equine tx

A

supportive

105
Q

Hantavirus pulmonary syndrome reservoir

A

deer mice sin nombre virus inhalation from mice saliva, poop.

106
Q

Hantavirus prodromal, cardiopulmonary, convalescent

A

Three phases

107
Q

Cardiovascular collapse hanta virus

A

pulmonary edema, dyspnea, cardiovascular collapse

108
Q

convalescent phase hanta virus

A

onset of massive diuresis

109
Q

Hantavirus TX

A

antiviral ribavirin ICU may help

110
Q

Plagues causative agent

A

Yersina pestis

111
Q

Vector of plague

A

rat flea

112
Q

plagues reservoir

A

rats, mice, rodents, foxes, coyotes, wild cats

113
Q

Bubonic plague

A

MC form of the dz by bite of infected flea big lymph-nodes

114
Q

Bubos are ?

A

open ulcers

115
Q

Bubonic plague named black bc

A

blood clots leading to arteriolar obstruction and gangrene

116
Q

Pneumonic plague

A

inhaled into lungs peron to person or BW

117
Q

Pneumonic plague

A

1-6 days after exposure pneumonia occurs

118
Q

Pneumonic plague

A

high mortality rapid decline respiratory failure

119
Q

Septisemic plague

A

gets into the blood sudden insent of fever no bullae high high mortality rate

120
Q

Plague testing

A

leukocytosis with immature neutrophils sample the fluid

121
Q

Plague TX

A

Streptomyocin and gentamyocin

122
Q

Rabies causative agent

A

rhabdoviridae

123
Q

Rabies

A

bats and doggos

124
Q

Rabies and severity/ development

A

Wound severity wound location in relation to the nerves and relative distance to the brain

125
Q

Rabies

A

fatal viral encephalitis

126
Q

Rabies and corneal transplant

A

CAN GIVE YOU RABIES

127
Q

Rabies manifestation

A

Rabies treated right away you are good. vaccine tx and rabies immunoglobin if in first 72 hours. if not then your screwed

128
Q

Rabies manifestation

A

hydrophobia inability to drink, laryngeal spasm

129
Q

Two types of rabies

A

furious rabies more common the second type paralytic rabies

130
Q

Furious rabies

A

aggressive, agitaion, hypertension, tachy, hydrophobia

131
Q

Paralytic rabies

A

confusion, loss of coordination, stupor, ascending paralysis

132
Q

Rabies dx

A

virus antigen and PCR indetification of virus in the NEGRI BODIES

133
Q

Rabies tx

A

clean wound soap and water capture animal if possible destroyed and send evaluation of brain tissue

134
Q

Rabies tx

A

passive immunizations administer human rabies to the wound and immunoglobulin

135
Q

Rabies tx active immunizations

A

three IM doses in the deltoid or thigh over a 28 day period

136
Q

Cat scratch DZ

A

bartonella henselae

137
Q

cat thing Vector

A

cat flea

138
Q

cat dz resevoir

A

kitten

139
Q

cat scratch dz

A

linear papules and nodules refelct cat scrathc

140
Q

Cat scrathc dx manifestations rare

A

meningitis, osteomyolitis, endocarditis

141
Q

Cat scratch DZ

A

parinuads oculoglandular syndrome conjuctivitis

142
Q

scrtach cat tx dz

A

azithrmycin

143
Q

Cat Bite Pasteurella multocida

A

encapsulated gram negative rod do not suture these closed

144
Q

Pateurella mulocida hallmark

A

cellulitis near the bite and complicated by osetomyilitis

145
Q

tx pasteruella multocida

A

augementin

146
Q

causative agent Chagas Dz

A

trypanosoma cruzi

147
Q

chagoma

A

localized erythema and edema where parasite entered the skin

148
Q

romana sign

A

painless palpebral edema and conjuctivitis

149
Q

tramsmission Chagas DZ

A

mom to baby, contaminated food water

150
Q

chagas phase acute

A

showing of chagoma and romana sign

151
Q

chagas intermediate/ chronic phase

A

state of latency

152
Q

Chagas chronic

A

dilated cardiomyopathy, megaesophagus,achlasia, megacolon

153
Q

Psittacosis causative agent

A

chlamydia psittaci comes from BIRDS SHIT

154
Q

Psittacosis manifestations

A

atypical pneumonia, sever HA, w /photophobia ,

155
Q

TX Psitttacosis

A

DOXYCICLINE OR TETRACYCLINE RAPID IMPORVEMNT, Z PAK CAN HELP

156
Q

Causative agent of Brucellosis

A

brucella found in sheep

157
Q

Manifestations of Brucellosis

A

effects, lungs, heart, eyes

158
Q

Tx Brucellosis

A

cipro+ rifambin or +doxy

159
Q

Where is HIV the worse

A

Africa hardest hit area

160
Q

Who should get tested for HIV

A

everyone ages 15-65 regardless of risk at least 1 time

161
Q

Healthcare workers how do they get it

A

Needle sticks on accident cries

162
Q

CD4 Count under 200

A

opportunistic infections start to present

163
Q

CD4 count

A

measure status of immune system and dz progression

164
Q

Viral load serology

A

measures efficacy of HAART therapy

165
Q

Viral load vs CD4 count

A

The higher the CD4 count the more response to the virus.

166
Q

HIV initial manifestation

A

mimics mono truncal macular papular rash this phase 3 days 2 wks

167
Q

Seropositive

A

longest HIV phase, no sx of HIV infection phase lasts 4-7 yrs.

168
Q

“Pre Aids” symptomatic HIV infection

A

persistent lymphadenopathy, fungal infections, hairy leukoplakia, molluscum contagious

169
Q

AIDS

A

Marked immune suppression malignancies and infections begin CD4 count below 200

170
Q

HIV Transmission

A

male sex, IV drug abuse, hetero sex, perinatal transmission

171
Q

Can I get HIV from saliva and tears

A

no

172
Q

What is the highest risk

A

unprotected anal and receptive intercourse

173
Q

Latex condoms

A

70 to 80% decrease in risk

174
Q

Cocaine injection sex

A

bartering for sex higher risk

175
Q

Vertical Transmission

A

in utero, childbirth, breast feeding

176
Q

Breast feeding

A

50% increase risk with prolonged breast feeding

177
Q

perinatal transmission

A

most common transmission of HIV to children

178
Q

Postexposure prophylaxis for HIV

A

emtricitabine, raltegravir, tenofovir Continue for 4 wks

179
Q

HIv post : efavirenz

A

side effect: CNS

180
Q

hiv post: Indinavir

A

crystal induced nephropathy

181
Q

HIV TX post: protease inhibitors

A

end in navir- inhibits protease

182
Q

Pharmacokinetic enhancers

A

goal to improve efficacy of antivrial agents by affing this agent

183
Q

HIV Pre exposure drug

A

Truvada = emtricitabine and tenofovir

184
Q

Defer Therapy

A

inability to adhere to therapy, high CD4 count

185
Q

CD4 COUNT THRUSH tx

A

nystatin spit and swish

186
Q

Kaposi sarcoma

A

cancer cause by HHV 8 black purple, brown papular lesions

187
Q

Pneumocystis jiroveci

A

aids defininf illness, bat wing pattern on cxr

188
Q

pneumocystitis pneumonia prophylaxis

A

TMP/SMX BACTRIM

189
Q

ISOSPORIASIS

A

AIDS DEFNING DZ

190
Q

Esophageal candidiasis

A

sx- retrosternal cp and pain when swallowing, Diagnostic test upper endoscopy tx: systemic antifungals

191
Q

cd4 count under 100 cryptococcosis

A

yeast causing disseminated dz, meningitis

192
Q

Toxoplasmosis tx

A

pyrimethamine

193
Q

cryptosporiodiosis

A

protozoa infection in small bowel causing diarrhea

194
Q

cytomegalovirus

A

retinitis with scotoma vision floater and esophagitis

195
Q

women and aids

A

9th leading cause of death

196
Q

Gender specific findings women

A

recurrant yeast infections, hpv dysplasia, increased toxicity w/ anitvirals

197
Q

How do children get HIV

A

transplacental

198
Q

Elderly and HIV

A

this population less knowledgeable of HIV and prevention

199
Q

Pre exposure prophalaxis

A

emtricitabine/ tenofovir DF

200
Q

intial assesment before prep

A

HIV test negative r/o previous HIV

201
Q

PReP prescription

A

Emtricitabine/ TDF daily Truvada 1 tablet orally for 90 days

202
Q

How often test for HIV antibody

A

every 3 months

203
Q

causative agent Aspergillosis

A

aspergillus fumigatus

204
Q

asperigilosis Most common found in

A

post transplant children

205
Q

allergic bronchopulmonary aspergillosis

A

attacks patients with chronic lung disease, asthma or cystic fibrosis

206
Q

chronic aspergillosis

A

chronic lung dz but no immunocompromised state

207
Q

Aspergilosis tumor

A

found in cxr ring enhanced lesion

208
Q

invasive aspergillosis found in

A

hematopoitec stem cell transplant patient Most common is pulmonary dz

209
Q

Ct finiding of halo

A

suggests invasive asperigillosis

210
Q

blastomycosis

A

dismorphic fungus

211
Q

blastomycosis yeast

A

at 37 degrees celsius

212
Q

blastomycosis mold

A

at 25 degrees celcius

213
Q

blastomycosis cxr

A

mediastinum w/ LAD

214
Q

blastomycosis Mild moderate DZ

A

itraconazole

215
Q

blastomycosis severe DZ

A

amphotericin B

216
Q

coccidiodomycois

A

aka san joaquin valley fever

217
Q

coccidiodomycosis spread

A

via inhalation due to disturbed soil

218
Q

coccidioidomycosis cxr

A

granulomas

219
Q

cryptococcosis gatti found

A

in pigeon poop definifn aids dz

220
Q

cryptococcosis manifestations

A

nuchal rigidity and meningeal signs less likely in HIV

221
Q

histoplasmosis

A

dismorphic mold at 25 c and yeast 37 c

222
Q

histoplasmosis favors

A

soil and with bird and bat poop

223
Q

histoplasmosis spread to

A

the spleen and liver from the lungs

224
Q

histoplasmosis and fatality

A

not fatal typically

225
Q

cxr finidng of mucormycosis

A

reverse halo