ID Flashcards
1
Q
what is a carrier
A
person or animal that harbors the infectious agent/disease and can TRANSMIT TO OTHERS but does not demonstrate signs of the disease
- COVID living dormant in your body
2
Q
what is a contact
A
exposure to a source of an infection but does not imply infection, just possibilty of infection
3
Q
what is a host
A
an organism that harbors a parasitic, mutualistic, or commensalism guest. the host is the house, the parasite is the freeloader
- ex. human
4
Q
what is a pathway into the host that gives an agent access to tissue that will allow it to multiply or act
A
portal of entry
5
Q
what is a pathogen that is transmissible from non-human animals (typically vertebrates) to humans
A
zoonosis
6
Q
what is a population of organisms or the specific environment in which an infectious pathogen naturally lives and reproduces; usually a living host of certain species
A
reservoir
7
Q
what is the constant presence of an agent or health condition within a given geographical area or population
A
endemic
8
Q
what is an increase, often sudden, in number of cases of a disease above what is normally expected in that population and area
A
epidemic
ex. opiod epidemic in the US
9
Q
what carries the same definition of epidemic but is often used for a more limited geographical area
A
outbreak
ex. mississippi
10
Q
what is any of a group of viruses that are transmitted between hosts by mosquitos, ticks, and other arthropods
A
Arbovirus (arthropod-borne virus)
11
Q
what is when a majority of a given group is resistant or immune to a pathogen. For example protection to an unvaccinated or susceptible individuals/group by reducing the likelihood of infection or spread.
A
Herd immunity
12
Q
what is transfer of active humoral immunity of ready-made antibodies produced by another host or synthesized. When there is a high risk of infection and insufficient time for the body to develop its own immune response. Short term
A
passive immunity
- example: Rabies IG, Tetanus IG, Crofab (rattlesnake antivenin)
13
Q
what is transmission occurring between an infected person and a susceptible person via direct physical contact with blood or body fluids
- person to person
A
direct contact -infection
14
Q
what is transmission occurs when there is no direct human to human contact
- vehicle borne: person to contaminated surface/object to person
A
indirect contact
15
Q
what type of protozoa group is found in giardia, leishmania. The flagellates
A
mastigophora
16
Q
what type of protozoa group is non motile adult stage organisms (ex. plasmodium, cryptosporidium)
A
sporozoa
17
Q
what are the three classes of human parasites
A
protozoa
helminths
ectoparasites
18
Q
what is the time interval from a person being infected to the onset of symptoms of an infectious disease
A
incubation period
19
Q
what is resistance delevoped in response to an antigen characterized by the presence of antibody produced by host
A
active immunity
20
Q
what are examples of ectoparasites
A
ticks, fleas, lice and mites that burrow into the skin and remain there for weeks to months
21
Q
how is west nile virus transmitted
A
primary the cullex mosquito; blood transfusion/organ donation, or mother to child
22
Q
what is the incubation period for west nile
A
2-6 days but can range from 2-14 days
23
Q
what is the most prevalent mosquito borne disease in the US
A
West nile virus
24
Q
Patient presents to medical following a recent camping trip (JULY) he states he has felt febrile for the last 4 days but mostly noticed a transient maculopapular rash. He said he did not use bug spray and did notice some annoying mosquito bites prior to the rash. What might be the cause
A
west nile virus
25
what lab diagnosis is used to confirm WNV
Diagnosis via identifying IgM in serum or CSF
- ELISA is used to detect IgM
note: CBC is NOT A RELIABLE INDICATOR
26
What is the treatment for someone with WNV
no specfic treatment
- vigorous supporitve measures are the first line management protocol
patients with meningial sx often require pain control for headaches, antiemetic, and rehydration
patients with encephalitis require close monitoring
27
when would WNV be a MEDEVAC
warranted if there are signs of encephalitis, meningitis, or paralyisis
28
what are the subtypes of malaria
P. Falciparum
P. vivax
P. ovale
P. Malariae
29
how is malaria transmitted
via the female anopheles mosquito
30
what is the incubation period for malaria
7 to 30 days depending of the species of malaria infection
31
what is the most lethal malaria
P falciparum
32
patient reports to medical with flu like symptoms such as malaise, chills, headache and a fever that comes and goes for over a week now. He states the only thing he noticed was that he was bit by a mosquito recently but didnt think mosquito bites could make you feel this sick. what might be the diagnosis
malaria
33
how will malaria be diagnosed
clinical findings consistent with malaria infection
RAPID DIAGNOSTIC TESTING OR LABRATORY CONFIRMATION VIA BLOOD SMEAR
34
what is the downfall of using rapid malaria testing on board
gives qualitative result but no quantitative information regarding parasite density
both positive and negative results must always be confirmed by micorscopy
35
what is the treatment for malaria
uncomplicated: Chloroquine phosphate
treatment of P. ovale = Add primaquine
36
how is dengue fever transmitted
aedes aegypti mosquito
37
what is dengue fever known as
breakbone fever
38
what are the three phases of dengue fever
febrile phase
critical phase
convalescent phase
39
which phase of dengue does most patients clinically improve during and it lasts about 24-48 hours
critical phase
40
what are the two hallmark symptoms of severe dengue
capillary permeability (leaky capillaries) and disordered/diminished blood clotting
41
what is a positve tourniquet test result
10 or more petechiae per 1 square inch
42
what is the tourniquet test used to diagnose
dengue fever
43
what is the treatment for dengue fever
eure patient stays well hydrated and avoid aspirin containing drugs/NSAIDS
Avoid invasive procedures such as NG tube intubations, IM injections, arterial punctures
- treat symptomatically
44
patients who have mild dengue fever, what is their disposition?
MEDEVAC.
for severe, med advice on further management while waiting for the medevac
45
Patient reports to medical following his return from leave. He recently went home to Arizona and reports he was camping for about 3 days and believes he was bit by a tick because of a rash he has on his wrists, forearms, ankles and is starting to spread to his chest. He reports being febrile.
INSPECTION: small pink macules on wrists and forearms
what might be the cause
Rocky mountain spotted fever
46
what is the treatment for rocky mountain spotted fever
doxycycline 100mg BID for 5-7 days
47
how can you help prevent ticks?
treat gear and clothing with 0.5% permethrin
use EPA insect repellant (DEET)
Wear long pants, long sleeves, long socks.
- light colored clothing also helps identify ticks
perform tick checks at 12 hour intervals
48
Patient reports to medical after returning from a backpacking trip in europe. He reports having flu like symptoms such as malaise, headache, fever. But is mostly concerned about a red ring like rash that appeared one week after returning from leave.
PE: lymphadenopathy, Homogenous expanding rash and the present appears to have some facial drooping on the right side
what might this be
lyme disease
49
what is the causitive bacteria of lyme disease
B. Burgdorferi
50
what areas do ticks usually attach to?
any part but prefer the groin, axilla and scalp
51
in the late disseminated stage of lyme disease what is the presenting symptoms
same as acute but with rheumatologic manifestations
- transient, migratory arthritis and effusion in one or more joints
52
when would you NOT perform serologic testing for lyme disease
asymptomatic patient in endemic area
asymptomatic patient after an Ixodes tick bite
Patient with non specific symptoms (subacute myalgias, arthralgias, fatigue)
53
if performing a serolgic testing on a patient suspected to have lyme disease, what tests do you perform
acute/early disseminated: 2 ELIZA tests
LATE: 2 ELIZA or 1 ELIZA and 1 Western blot (shows specific antigens of B. Burgdorferi are reacting with serum antibody)
54
what is the treatment for lyme disease
early (Erythema migrans) 14 days of Doxycycline
early disseminated (bells palsy) 14 days of doxycycline
Late disseminated (arthritis) - 28 days of doxycycline
55
what can be used as a post-exposure prophylaxis for lyme
doxycycline 200mg PO 1 dose
56
prophylaxis can be started within what time frame of tick removal?
72 hours
57
what are the two subtypes of leishmaniasis
old world (eastern hemisphere)
new world (western hemisphere)
58
what are the predisposing factors of leishmaniasis
chronic sand fly exposure, poverty, proximity to dogs/cats/rodents
59
how is leishmaniasis trasnmitted
bite of infected female phlebotomine sand flies
60
what is the incubation period for leishmaniasis
2 weeks to several months and in cases up to 3 years; some >20 years
61
what is the most common manifestation of leishmaniasis
cutaneous leishmaniasis which is characterized by gradual onset cutaneous lesions
- begins as pink colored papule that enlarges to a plaque like lesion, lesion ulcerates with indurated border and may have thick white-yellow fibrous material
-lesions are often painless
62
how is cutaneous leishmaniasis diagnosed
clinicians maintain high suspicion in any patient with chronic (nonhealing) skin lesions
confirmed through lab confirmation and achieved by detecting the parasite or their DNA in infected tissue
lesions should be scraped gently with a sterile scalpel blade, lancet, or cytology brush
63
what is the treatment for cutaneous leishmaniasis
ulcer should be debrided and kept clean to avoid secondary infection
bandage and wrap
they need to go to infectious disease at some point
64
what medications can be used to treat cutaneous leishmaniasis
orally administered "azoles" and topical formulations for CL
65
what is the prevention for leishmaniasis
avoidance of being bitten by sand flies in endemic areas
- sleep in screened areas
- they feed at night
- less active at hottest time of day
- they dont buzz
- fans or ventilators
- spray quarters
- protective clothing and topical application DEET
66
what are the subtypes of methicillin-resistant staphylococcus aureus (MRSA)
community associated (CA-MRSA)
Health care associated (HA-MRSA)
67
what conditions predispose someone to MRSA
hospitals
prisons
close living quarters
military
athletes
weakened immune systems
68
patient presents to medical due a spider bite that has recently started "oozing" what might be the cause
MRSA
69
what is the treatment for MRSA
I&D is the mainstay therapy for any FLUCTUANT LESION, followed by proper packing of the wound.
ANTIBIOTICS:
- TMP-SMX
- Clindamycin
- Doxycycline
70
what are two basic categories of human bites
occlusive wounds - similar to dog or cat bites
clenched fist or fight bites - skin surface strikes a tooth
71
how are hand wounds examined
fingers extended and in the clenched fist position, wounds can often disappear with fingers in extension
72
what is the management of a fight bite if no signs or sx of infection present
- exam hand
- initial wound care is primary factor in preventing infection
- assess TDAP/HBV/HIV immz/testing status
- Eval for antibiotics prophylaxes and follow up in 24hr
- clinically uninfected? no culture
73
when would you close a human bite wound
if it involves the face and show no s/s of infection, less than 24 hours, and MO should be consulted
74
when would antibiotics be prophylactically recommended for human bites
- lacerations undergoing partial closure and wounds requiring surgical repair
- wounds on hands, face, or genital area
- wounds near a bone or joint
- wounds in areas of underlying venous or lymphatic compromise
- wounds in immunocompromised host
- wounds with associated crush injury
75
what antibiotics should not be used with MRSA suspected infection
cephalexin
penicillinase-resistant penicillins PRP (dicloxacillin)
macrolides (erythromycin/azithromycin)
76
what is the preferred antibiotics for early prophylaxis for a fight bite
amoxicillin clavulanate 875/125mg PO
77
what does osteomyelitis most often affect
vertebrae of the spine and or the hip
- among younger adults, OM occurs most commonly in the setting of trauma and related surgery
78
how does osteomyelitis present?
gradual onset of symptoms over several days
dull pain at site, with or without movement
systemic symptoms (fever, rigors) may also be present
79
what labs are ordered for someone suspected to have osteomyelitis
CBC may have leukocytosis
blood culture may be positive
ESR elevation
CRP elevation
80
what is an essential component in the evaluation of suspected OM
radiographic imaging
- plain radiograph is typically initial
- most useful are plain radiographs, magnetic resonance imaging, and technetium 99 bone scienitigraphy
81
what is an essential component in the evaluation of suspected OM
radiographic imaging
- plain radiograph is typically initial
- most useful are plain radiographs, magnetic resonance imaging, and technetium 99 bone scintigraphy
81
what is an essential component in the evaluation of suspected OM
radiographic imaging
- plain radiograph is typically initial
- most useful are plain radiographs, magnetic resonance imaging, and technetium 99 bone scintigraphy
82
what is the most common cause of acute OM
S. Aureus
83
what is the cornerstone of treatment for OM
prolonged antibiotic therapy
- IV Vancomyacin
- IV Ceftriaxone
84
what is the disposition of someone with OM
- patient needs to be MEDEVAC to higher level, surgical containment and IV antibiotics isnt possible on deployment
- confirmatory radiographs and studies required for definitive diagnosis
- MO should be contacted to determine starting empiric oral ABX prior to transport
85
what type of organism is tetanus
anaerobic, spore forming, gram positive bacterium
86
what are the predisposing factors of tetanus
inadequate TD immunization, no TD booster within 10 years, puncture wound, penetrating injury with foreign body (step on nail), untreated necrotic tissue, crushing injury
87
how is tetanus transmitted
direct contamination of open wounds and non-intact skin
- widely distributed in soil and the intestines and feces of farm animals
88
patient presents with trismus followed by nuchal rigidity, dysphagia, and rigid abdominal muscles. Patient was seen recently for a puncture wound but didnt know what caused the puncture. patient shows muscle spasms every 10-15 minutes. what might be the cause of the patients symptoms
tetanus
89
how may doses are in a tetanus series
3 doses
90
if the last documented TDAP was more than 5 years ago what will you do
administer booster of TDAP
91
what is the treatment for tetanus
immediate transfer to nearest MTF
clean/debride wound as best as possible
supportive therapy and airway protection
- ANTIBIOTICS = Metronidazole 500mg IV, Pen G 2-4mil units
92
what is inflammation of the meninges (dura mater, arachnoid mater, and pia mater)
meningitis
93
what is inflammation of the brain itself
encephalitis
94
A patient presents with fever, nuchal rigidity, altered mental status and a severe headache. What might be the cause
meningitis
95
what is the preferred imaging for someone suspected to have menigitis
CT
96
what is the lab required for diagnosis of meningitis
lumbar puncture
97
what is the foundational treatment for meningitis
manage airway
maintain oxygenation
sufficient IV fluids
control fever
- initiate empiric ABx and initiate MEDEVAC
- Ceftriaxone 2g IV or Pen G
98
administering what medication is associated with reduction in rate of hearing loss, neuro compromise and decreased mortality rates of meningitis
IV dexamethasone
99
if there are signs of ICP in meningitis , what can you do
elevate the head of the bed 30 degrees, induce mild hyperventilation in intubated pts and osmotic diuretics
100
what is given to close contacts of someone with meningitis
ceftriaxone 250mg IM one time
or
Ciprofloxacin 500mg PO one time
101
what is mononucleosis also known as
epstein barr virus
102
how is mono transmitted
body fluids, primarily saliva
103
what is the incubation period of mono
4-6 weeks
104
patient presents with a sore throat x 2 days and now has a fever and malaise.
Exam shows cervical lymphadenopathy and exudative pharyngitis. Another two sailors come in with the exact same symptoms, what might be the cause
mononucleosis
105
what is the treatment for mono
bed rest, acetaminophen or nsaids
salt water gargles
avoid antivirals
SIQ TIL ACUTE SYMPTOMS SUBSIDE
LLD FOR 3-4 WEEKS
106
What is the scientific name of rabies
lyssa virus
107
how does rabies present
pain and paresthesia at the site is often first sx
- fever, hydrophobia, pharyngeal spasm, hypersalivation, lacrimation, goose flesh and dilatated pupils
- lose of DTR and Plantar reflexes
108
what is aerophobia
pathognomonic pharyngeal muscle spasms triggered by feeling draft or air, leads to aspiration, coughing, choking
109
how is diagnosis of rabies confirmed
post-mortem evaluation of the brain
110
if an animal is rabid, how long will they be placed in isolation
10-14 days
111
what is < 14 days of diarrhea
acute
112
what is more than 14-30 days of diarrhea
persistent diarrhea
113
what is more than 30 days of diarrhea
chronic diarrhea
114
if there is blood present in loose watery stools and there is a fever what type of diarrhea is this
inflammatory
- bleeding is secondary to tissue damage to lining colon from certain bacteria or toxins
115
if there is watery stools with no blood and no fever, what type of diarrhea is this
non-inflammatory
116
what is primarily transmitted via fecal-oral route, either direct person to person via contaminated food or water and also spreads through aerosols of vomitus and contaminated environmental surfaces. incubation is 24-48 hours
viral infectious diarrhea
117
patient reports to medical with acute onset of abdominal cramps, n/v and non bloody diarrhea. What might be the cause
Norovirus
118
what is the major cause of bacterial infectious diarrhea in lower income countries and commonly seen in young travelers returning from most regions
Enterotoxigenic E. Coli (ETEC) aka travelers diarrhea
119
what is the most common clinical presentation of salmonella (bacterial ID)
gastroenteritis
- usually consists of acute diarrhea, abdominal pain, fever, and vomiting for 4-7 days
120
for someone with severe diarrhea, high fever, or manifestation of extraintestinal infection, what antibiotics will be prescribed
fluroquinalones
cipro 500mg BID
121
what is the most common cause of bacterial diarrheal illness worldwide?
Campylobacter
122
how is campylobacter transmitted
eating contaminated foods(undercooked chicken and foods containing raw chicken), contaminated water, unpasteurized milk, contact with animals, or person to person via fecal-oral route
123
patient reports to medical after a backpacking trip in the mountains. Patient is experiencing abdominal cramps, fatigue, nausea and reports his bowels are foul smelling and greasy. What might be the cause
acute giardiasis
124
what is the treatment for giardiasis
metronidazole (flagyl) 250mg PO TID for 5-7 days
125
what labs can be useful in ruling in or ruling out non-infectious diarrhea etiologies?
CBC
UA
126
what is the general treatment for infectious diarrhea
rule out more serious pathologies
oral or IV rehydration
BRAT diet
Patient education on hand washing practices
127
what medications can be given for someone who has mild/mod ID in the absence of fever or bloody stools
loperamide
bismuth subsalicylate
128
what is the criteria for considering antibiotics for infectious diarrhea
fever plus
> 10 stools a day
significant or complete loss of operational effectiveness
129
when would you consider medadvice or medevac for someone with diarrhea
fever >101.3F
Episodes of bloody with positive hemoccult
Severe dehydration (inability to hydrate)
Multiple patients with similar symptoms
inability to control nausea and vomiting with antiemetics and pepto
130
how is influenza spread
primarily through respiratory droplets
131
when is influenza considered to be most infectious
infectiousness is highest within 3 days of onset and correlated with fever
132
what is the treatment for influenza
typically resolves within 1-7 days but treatment of goal is to alleviate and control symptoms while preventing spread to other personnel
133
patient reports to medical with cc of a fever/chills, headache, malaise, nonproductive cough, sore throat and nasal congestion. What might be the cause
uncomplicated influenza
134
how is hep A transmitted
consumption of contaminated water, food, fecal oral route
- vaccines are available to prevent
135
how is hep B trasmitted
through exposure to infective blood, semen, body fluids, blood products or IV drug use
-poses risk to healthcare workers
- vaccine is available
136
how is hep C transmitted
through exposure to infective blood. HCV contaminated blood products and blood, iv drug use. Sexual transmission is possible but less common
- there is no vaccine
137
how is hep E transmitted
through consumption of contaminated water or food.
- common cause of hepatitis outbreaks in developing nations
- vaccines exist but not widely available
138
patient presents with fatigue, fever, muscle/joint pain, abdominal pain, nausea and vomiting.
your PE shows a low grade fever, RUQ tenderness, dark colored urine and grey colored stool. What might be the cause
hepatitis
139
what is the treatment for hepatits
med advice for further reccomendations, patient will require MEDEVAC
Ensure proper hydration and nutrition and place patient SIQ
140
what is the organsim type associated with tuberculosis
Rod Shaped
141
how is tuberculosis transmitted
when contagious patient coughs, spreading bacilli through the air
- recirculated air could still spread this, like on an airplane
142
what is the leading infectious cause of death world wide
tuberculosis
143
what is the vaccine against TB that is routinely given to children in countries with high prevalence of TB but isnt used in the US due to low risk of infection
Bacille Calmette-Guerin (BCG)
144
what must be completed during the evaluation of a postive TB test
Document Hx on NAVMED 6224/7
Chest Radiograph
Sputum radiograph
145
what is the treatment for LTB infection
The provider must rule out active TB via Labs and CXR before LTBI treatment can be initiated
Isoniazid and rifapentine PO once a wk x 12wk
Rifampin 1 PO QD x 16wk
Isoniazid and rifampin x 12 wks
- short course is preferred
146
what is the gold standard lab for confirming LTBI and ATB
Sputum test - acid fast bacillus (AFB) with NAAT
147
what instruction is for routine testing and screening guidelines for TB
BUMEDINST 6224.8C
148
what type of organism is cutaneous anthrax
aerobic, gram positve, spore forming rod shaped bacterium
149
how is anthrax transmitted
handling B. anthracis- infected animals, carcasses, meats, hides, or wool. Or products derived from infected animals
150
who is anthrax more common in
ranchers
leather workers
vets
wildlife researchers
151
what is a zoonotic disease primarily affecting ruminant herbivores that become infected by ingesting contaminated vegetation, water or soil.
Anthrax
- humans are generally incidental hosts
152
patient presents with a small, painless, pruritic papules that emerged after working on his ranch three days ago. He wants to be seen because the papules are enlarging rapidly and turning into vesicles/blisters. One of the blisters has began to erode and now there is a black necrotic ulcer on his right hand. what might this be
cutaneous anthrax
153
what is the treatment for cutaneous anthrax
ciprofloxacin 500mg
Levofloxacin 750 mg
Doxycycline 100 mg
154
if left untreated, what can cutaneous anthrax result in
sepsis
meningitis
155
how is cutanous anthrax diagnosed
vesicular fluid and ulcers should be swabbed for gram stain and culture and PCR
- eschar edge should be lifted and swabbed
156
what are the 4 main clinical presentations of anthrax and what is the most common form in humans
cutaneous
ingestion
injection
inhalation
- cutaneous is the most common form in humans
157
what is the screening frequency for chlamydia
women <25 tested annually
women > 25 with risk factors tested annually
158
if you have a positive tst/ppd or blood test but a normal xray, negative sputum and remains asymptomatic what might they have
latent TB
159
who can evaluate a newly positive IGRA/TST
MO
NP
PA
IDC
160
when would you obtain baseline LFTs before beginning TB treatment
patients with elevated risk for liver disorder
such as regular/heavy etoh use
161
what monitoring will be completed by the IDC once latent TB is suspected
evaluate compliance, possible side effects and indications of active TB
document monthly evaluations on NAVMED 6224/9
162
what is the clinical manifestation of chlamydia in men and women
women- Cervicitis (increased d/c, intermenstrual bleeding, dyspareunia)
Men- Urethritis (clear/watery d/c, dysuria (most common) and scant d/c on underwear in morning)
163
what is the gold standard diagnosis for chlamydia
nucleic acid amplification testing (NAAT)
- usually obtained via UA, Vaginal or urethral d/c
164
what is the treatment for chlamydia
doxycycline 100mg is preferred treatment
abstain from sexual activity for 7 days
contact recent sexual partners
165
how soon after lab confirmed chlamydia should the patient be retested
within 3 months
166
what is the scientific name for anthrax
bacillus anthracis
167
what is the hallmark of cutaneous anthrax
eschar
168
who should anthrax be transferred to
refer to infectious disease specialist
169
what is the most frequently reported bacterial STI and nationally notifiable disease
chlamydia
170
male reports with dysuria and white/green discharge from his urethra. What might be the cause
gonorrhea
171
female reports with dysuria, increased vagnial discharge and lower abdominal pain. you ruled out a bladder infection as well as vaginosis. what might this be
gonorrhea
- females are usually asymptomatic or symptoms are so mile it may be difficult to diagnose
172
what is the treatment for gonnorhea
ceftriaxone 500mg IM single dose and doxycycline 100 mg BID for 7 days
173
What labs are ordered for an STI screening
gonorrhea
chlamydia
HIV
RPR
HPV vaccine counseling
174
what are the subtypes of syphilis
T. pallidum (causes syphilis)
T.p. Endemicum (causes bejel)
T.p. Pertenue (causes yaw)
T. Carateum (causes pinta)
175
what are the three distinct phases of infection of syphilis
primary
secondary
tertiary
176
what phase of syphilis begins as a painless papule that proceeds to ulcerate into a 1-2cm painless ulcer with raised ulcers. This chancre lasts 3 to 6 weeks and heals regardless of treatment
primary
177
what phase of syphilis is skin rashes, and or mucous membrane lesions and the rash is non-pruiritc maculopapular erupton on the trunk and extremities. Patient may also have fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue
secondary
178
what phase of syphilis is rare and appears 10-30 years after infection and symptoms may vary from cardiovascular, neurosyphilis and gummatous
tertiary syphilis
179
what is the standard used to diagnose syphilis
serologic test
180
what lab is used to confirm syphilis
treponemal test (FTA-ABS)
181
what is the standard treatment for syphilis
parental penicillin G for all
- treatment should be initiated if there is a high suspicion
182
what can be given for patient with a pcn allergy and there is suspicion for syphilis
doxycycline 100mg for 14 days
183
what can occur within 24 hours after initiation for therapy of syphilis and is an acute febrile reaction accompanied by a headache, myalgia, fever, rigors, diaphoresis, hypotension, and worsening rash than intially present
jarisch-herxheimer reaction
- typically resolves 12-24 hours, nsaids for symptomatic relief
184
what is the most common protozoan STI
Trichomoniasis
- Trichomonas vaginalis
185
patient reports with purulent, malodorous d/c, burning, pruritis, dysuria, and dyspareunia. Physical exam shows erythematous vulva, petechiae cervix (strawberry cervix), green-yellow frothy d/c. what is it
trichomoniasis
186
what lab diagnosis is used for trichomoniasis
wet mount prep of genital secretion but sensitivity is low.
NAAT is recommended due to high sensitivity/specificity
187
what is the treatment for trichomoniasis
metronidazole 2g orally in single dose or 500mg orally twice a day
abstain from sex for 7 days
counsel on safe sex practices as well as avoiding alcohol while taking metronidazole to reduce the possibility of DISULFIRAM-LIKE reaction and for 24 hours after completion
188
patient presents with severe painful genital ulcers, dysuria, fever and local inguinal lymphadenopathy. what might be the cause
HSV
189
how is HSV diagnosed
cell culture and pcr are the preferred HSV tests for genital ulcers or other mucocutaneous lesion
190
what is the treatment for HSV
all patients with first episode of genital herpes should receive antiviral therapy
- acyclovir 800mg po bid for 5 days
- valacyclovir 1g orally once daily for 5 days (you have this underway)
Effective episodic treatment requires initiation of therapy within one day of lesion onset or during prodromal period
191
what are the subtypes of HPV
type 6&11 - low risk but most common
type 16&18 high risk for developing cervical cancer
192
what is HPV also known as
genital warts
condyloma acuminata
193
how does HPV present
usually asymptomatic but patients are generally more concerned about appearance.
- usually a raised, skin colored, fleshy papule that ranges from 1-5mm in size but they can be broad/flat, pedicled or occasionally have cauliflower appearance
194
what is the treatment for HPV
topical therapy, cryotherapy, and surgical excision are common treatment modalities.
- topical: PODOPHYLLOTOXIN SOLUTION
- clinician applied = cryotherapy by derm
- surgical excision by derm
195
who should get the HPV vaccine
females and males 11-26 years old
27-45y/o can request but less benefit because more people have been exposed to HPV
196
what was the leading cause of cancer deaths in women
cervical cancer which is the now the most preventable with HPV vaccine and screening
197
is HIV reportable
yes `
198
what is the untreated survival timeframe for someone with HIV
9-11 years
199
what is the acute phase of hiv called
acute retroviral syndrome (ARS)
200
how does ARS present
THE PRESENCE OF FEVER AND RASH HAVE THE BEST POSITIVE PREDICTIVE VALUE
fever
maculopapular rash
arthralgia
myalgia
malaise
lymphadenopathy
oral ulcer
pharyngitis
weight loss
201
What is the screening test for HIV
OraQuick ADVANCE Rapid HIV1/2 antibody test
202
what is the confirmatory testing for HIV
4th Gen HIV immunoassay
203
what must be done prior to initiation of PrEP
not initiated on deployment
requires:
- negative 4th gen test within 7 days if infection not suspected
- negative 4th gen AND NAAT within 7 days if infection suspected
204
who manages a patient with HIV
managed by infectious disease and clinical evaluations are required by them at least every 6 to 12 months after diagnosis
205
what can reactivate a recurrent hsv infection
triggered by stress, menstration, anxiety, etc
206
what is the most common STI worldwide
HPV - human papilloma virus
207
HIV INFECTION OCCURS WORLDWIDE IN EVERY COUNTRY/CONTINENT EXCEPT
ANTARCTICA
208
who is nonoccupational post-exposure prophylaxis given to
sexual assault
unprotected sexual contact with high risk contact
209
is there a cure for HIV
no, but they have a near-normal life expectancy thanks to antiretroviral medications (ART)
210
who is occupational post exposure prophylaxis of HIV given to
healthcare workers due to needle sticks or health care related exposures
211
what is the leading cause of waterborne disease in the US
cryptosporidium
212
what is an example of helminths
flatworms - reside in GI tract
Thorny-headed worm - GI tract
Round worms - GI tract, blood, lymph and SubQ tissue
213
what are examples of ectoparasites
ticks
fleas
lice
mites that burrow and remain there for weeks to months
blood sucking Arthropods (mosquito)
214
what phase of the malaria cycle is the patient symptomatic
Erythrocytic phase - Asexual reproduction in RBCs
- matured parasite released from liver attach to red blood cells in the blood stream
215
which phase of the malaria cycle is the asexual cycle in human liver.
Exoerythrocytic phase
- parasites make its way to the liver via lymph system and blood stream
216
what is the most important protective measures for malaria prevention
proper clothing
awareness
217
patient presents to medical for a headache x 3 days. 4 days ago he was on an underway in hawaii and now has a rash, bone and joint pain. what might be the cause
dengue fever
218
how is a TQ test performed
obtain baseline BP, let arm rest for 90-120 seconds, inflate to midway point of baseline BP, keep cuff inflated for 5 minutes then deflate and wait 2min, count petechiae at AC fossa.
- postive test is 10 or more petechiae per 1 square inch
219
how is rocky mountain fever transmitted east of the rockies and pacific coast
american dog tick
- rocky mountain region/worldwide = brown dog tick
220
what is the scientific name for MRSA
staphylococcus aureus
221
what is the most common viral etiology of meningitis or encephalitis
enteroviruses
222
what test is used as a TB screen for those who received the bacille calmette guerin vaccine
quantiferon Gold
(QFT-GIT)
223
what is most common viral STI
HPV
224
what is the most common bacterial STI
Chlamydia
225
a sailor presents to medical n/v/d after eating from a food cart in thailand. You prescribed a BRAT diet, imodium and oral hydration already. What antibiotics would you give
azithromycin
ciprofloxacin
levofloxacin
226
what medication is given for infectious diarrhea caused by a protazoan such as giardia?
metronidazole
227
female presents with a lesion on the genitals that has a cauliflower appearance what is the diagnosis and what is the treatment
HPV - condyloma acuminata
TX: Imiquimod
Podophyllotoxin solution
or Cryotherapy
228
a patient presents with a pianful ulcerative lesion of the genitals and inguinal lymphadenopathy what is the diagnosis and treatment
HSV
TX: Acyclovir
Valcyclovir
SX: Acyclovir or valcyclovir wihin one day
229
pt reports with a chancre lesion 1-2mm in size on the glans penis, it is not painful. what is the dx and what is the tx
syphilis (primary)
TX: Pen G or doxycycline if they have PCN allergy
230
Patient reports with flu like symptoms, anorexia and RUQ pain. He appears to be jaundice. What might be the diagnosis, what labs and what is the tx
Hepatitis
LAB: WBC/UA/LFT
TX: Supportive care and MEDEVAC
231
patient reports to medical with flu like sx x1 day but denies any N/V/D. What might be the cause and what is the tx
Influenza
TX: Osteltamivir (theraflu)
bedrest
hydrate
SIQ 24 hours
232
if the patient has a black necrotic ulcer what might be the cause
cutaneous anthrax
233
if the patient has a raised yellow/white lesion, what might be the cause
cutaneous leishmania
234
patient reports to medical with joint pain. he states he frequently goes running in the back woods. You notice a circular rash what might be the cause
lyme disease
TX: doxycycline x14 days
235
what is the treatment for a patient who was bit by an animal who is suspected to have rabies
rabies immunoglobin (HRIG)
Rabies Vaccine
MEDEVAC
MER within 24 hours
236
what is a common cause of viral gastroentritis
norovirus
237
what is a common cause of parasitic gastroentritis
giardia
238
what is a common cause of bacterial gastroentritis
campylobacter
239
a patient presents with a tick in the left axillary region. what do you do
remove the tick
give doxycycline 200mg one time PO
240
bulls eye with a tick bite what is this associated with
lyme disease
241
what is the prophylactic malaria medications for malaria in a region that is known for P. Ovale
Primaquine
TX: add 52.6mg of primaquine
242
what are the two hosts of malaria
human
female anopheles mosquito
243
what is the oral treatment for cutaneous leishmania
fluconazole
ketoconazole
244
when will you see a positive monspot test in someone who has mono
positive in first 4 weeks
245
what is the treatment for chlamydia
doxycycline 100mg bid for 7 days or alt is azithromycin(must watch patient take it) and add ceftriaxone to also treat gonorrhea
- 50% of cases are infected with both
246
what STI is treponema pallidum
syphilis
247
what is the treatment for primary and recurrent HSV
Primary= acyclovir/valcyclovir for 7 days
Recurrent = acyclovir/valcyclovir for 5 days
248
what is the scientific name for tetanus
clostridium tetani
249
what is the scientific name for meningitis
streptococcus pnemo
250
what is the scientific name for chlamydia
clamydia trachomatis
251
what is the cause of gonnorhea
neisseria gonnorae
252
what is the scientific name for spyhilis
treponema pallidum
253
what is the scientific name for trichomonias
trichomonas vaginalis
254
what is the acute phase of HIV called
acute retroviral syndrome
255
what is another name for HPV
condyloma acuminata
256
what phase of syphilis shows no symptoms
latent
257
for rabies where does most of the virus replicate at
CNS
258
how long will the offending animal with rabies be isolated for
10-14 days
you will not catch the animal
259
is tetanus anaerobic or aerobic
anaerobic
260
can you empirically tx giardia and with what
yes and with metronidazole
261
how long does influenza usually last
7 days
262
what hepatitis is transported by body fluid
b, c and D
263
how does the urine appear in hepatitis
dark yellow
264
how is tb transmitted
resp droplet
265
what lab do you want to order as the gold standard for TB
sputum test
266
what disease is common in farm soil/animals
cutaneous anthrax
267
what is the treatment for anthrax
levofloxacin
ciprofloxacin
doxycycline
268
what sti is a silent infection
chlamydia
269
what sti is known as the great pretender
syphilis
270
who should be tested for chlamydia
sexually active women under 25
sexually active women with risk factors such as multiple partners over 25
271
what is the treatment for syphilis
pen g
pcn allergy = doxycycline
272
who can get Gardasil
boy and girls 11-26
by request 27 to 45
273
when doing the sti screen what do you want to offer/counsel on
HPV vaccine education
274
what is the rapid HIV test
oraQuick fast rapid HIV
275
what is test is used to confirm syphilis
treponemal test (FTA-ABS)
276
can active duty service members remain in the navy if they have HIV
yes, they just require clinical evaluations by infectious disease every 6-12 months
