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Infectious Disease > HIV, animal-borne diseases, tick borne diseases > Flashcards

HIV, animal-borne diseases, tick borne diseases Flashcards

1
Q

HIV: What are four situations in which you start therapy

A
  1. CD4 count < 500
  2. Symptomatic patients
  3. Pregnant women
  4. Needle stick scenario
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2
Q

What are the common side effects of the classes of medications

A
  1. NRTI: Lactic acidosis
  2. NNRTI: Drowsiness
  3. Protease inhibitors: Hyperglycemia, hyperlipidemia
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3
Q

What are medication specific side effects of HIV medications

A

Zidovudine - anemia
Didanosine & stavudine - pancreatitis, peripheral neuropathy
Indinavir: Kidney stones

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4
Q

What is the treatment for needle stick injuries for HIV

A

HAART for a month

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5
Q

What is the pregnancy treatment if they are HIV therapy

A

Use HAART immediately

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6
Q

What are three medications used for pneumocystic jivoveci PROPHYLASIX

A
  1. Bactrim - best
  2. Atovaquone
  3. Dapsone - don’t use in G6PD deficiency
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7
Q

What is the best initial test for PCP and best accurate test

A

Initial test: CXR

Best test: Broncheolar lavage

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8
Q

What is the treatment for ACUTE PCP

A
  1. IV Bactrim
  2. IV pentamidine - especially if there is rash
  3. Atovaquone - only mild cases

Pentamidine replaced dapsone for acute treatments

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9
Q

When are steroids indicated in a PCP infection

A

When pO2 < 70 or A-a gradient > 35

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10
Q

What are four brain conditions that can be caused by immunosuppression/HIV infections and how do they present

A
  1. Toxoplasmosis: Headache, nausea, vomiting, focal neurological findings
  2. Cytomegalovirus: Blurry vision
  3. Cryptococcus: Fever and headache
  4. Progressive multifocal leukoencephalopathy: Focal neurological deficits
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11
Q

What is the diagnosis methods for toxoplasmosis, cytomegalovirus, Cryptococcus, and progressive multifocal leukoencephalopathy

A
  1. Toxoplasmosis: Head CT with contrast showing ring contrast-enhancing lesion
  2. Cytomegalovirus: Diagnose with dilated ophthalmological exam
  3. Cryptococcus: Perform a lumbar puncture showing lymphocytes, best test Cryptococcus antigen
  4. PML: Head CT or MRI
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12
Q

What is the treatment for toxoplasmosis, cytomegalovirus, Cryptococcus, and progressive multifocal leukoencephalopathy

A
  1. Toxoplasmosis: Pyrimethamine and sulfadiazine for two weeks and repeaet CT - if smaller then confirmed, if not then it is lymphoma and requires brain biopsy
  2. Cytomegalovirus: Ganciclovir or foscarnet
  3. Cryptococcus: Amphotericin first, then fluconazole for prophylaxis
  4. PML: No treatment, use HAART
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13
Q

What is mycobacterium avium intracellulare (MAI)

A

Happens with CD4< 50, has weight loss, fever, fatigue, and anemia

Diagnosis: Bone marrow biopsy or liver biopsy

Treatment: Clarithomycin and ethambutal

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14
Q

What are the tick borne diseases

A
  1. Lyme disease
  2. Babesiosis
  3. Ehrlichia
  4. Malaria
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15
Q

What is lyme disease and how does it present

A

Tick bite with rash appearing with target in a pale center and red ring - erythema migrans - happens 7-14 days after tick detaches

In northeast and Midwest

Skip to treatment, no need for serology, treat with doxycycline

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16
Q

What are the different manifestations of lyme disease

A
  1. Late manifestation: Joint involvement
  2. Cardiac manifestation: AV conduction block/defect
  3. Neurologic: 7th cranial nerve palsy (bells palsy)
17
Q

What is the treatment for lymes disease if CNS or cardiac is involved

A

IV ceftriaxone

18
Q

Tick bites: What is babesiosis

A

Also caused by Ixodes tick (like lyme disease) and happens in same area, but gets hemolytic anemia

Diagnosis: Peripheral blood smear

Treatment: Azithromycin or atovaquone

19
Q

Tick bites: What is ehrlichia

A

Symptoms: No rash, but get elevated ALT and AST, thrombocytopenia, and leukopenia

Diagnosis: Peripheral blood smear

Treatment: Doxycycline

20
Q

Tick bites: What is malaria

A

Not domestic, usually a traveler

Presents with hemolytic anemia and GI complaints always

Diagnosis: Peripheral blood smear

21
Q

Tick bites: What is the treatment for malaria

A

Acute disease: Quinine and doxycycline
Prophylaxis: mefloquine, atovaquone/proguanil

Note: Mefloquine causes bradycardia and QT prolongation

Infectious Disease (3 decks)

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