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5th Time I've made a new class > ID > Flashcards

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
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2
Q

what is a contact

A

exposure to a source of an infection but does not imply infection, just possibilty of infection

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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
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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

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5
Q

what is a pathogen that is transmissible from non-human animals (typically vertebrates) to humans

A

zoonosis

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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

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7
Q

what is the constant presence of an agent or health condition within a given geographical area or population

A

endemic

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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

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9
Q

what carries the same definition of epidemic but is often used for a more limited geographical area

A

outbreak

ex. mississippi

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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)

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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

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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)
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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

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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

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15
Q

what type of protozoa group is found in giardia, leishmania. The flagellates

A

mastigophora

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16
Q

what type of protozoa group is non motile adult stage organisms (ex. plasmodium, cryptosporidium)

A

sporozoa

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17
Q

what are the three classes of human parasites

A

protozoa
helminths
ectoparasites

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18
Q

what is the time interval from a person being infected to the onset of symptoms of an infectious disease

A

incubation period

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19
Q

what is resistance delevoped in response to an antigen characterized by the presence of antibody produced by host

A

active immunity

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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

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21
Q

how is west nile virus transmitted

A

primary the cullex mosquito; blood transfusion/organ donation, or mother to child

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22
Q

what is the incubation period for west nile

A

2-6 days but can range from 2-14 days

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23
Q

what is the most prevalent mosquito borne disease in the US

A

West nile virus

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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

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25
Q

what lab diagnosis is used to confirm WNV

A

Diagnosis via identifying IgM in serum or CSF
- ELISA is used to detect IgM

note: CBC is NOT A RELIABLE INDICATOR

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26
Q

What is the treatment for someone with WNV

A

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

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27
Q

when would WNV be a MEDEVAC

A

warranted if there are signs of encephalitis, meningitis, or paralyisis

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28
Q

what are the subtypes of malaria

A

P. Falciparum
P. vivax
P. ovale
P. Malariae

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29
Q

how is malaria transmitted

A

via the female anopheles mosquito

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30
Q

what is the incubation period for malaria

A

7 to 30 days depending of the species of malaria infection

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31
Q

what is the most lethal malaria

A

P falciparum

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32
Q

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

A

malaria

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33
Q

how will malaria be diagnosed

A

clinical findings consistent with malaria infection
RAPID DIAGNOSTIC TESTING OR LABRATORY CONFIRMATION VIA BLOOD SMEAR

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34
Q

what is the downfall of using rapid malaria testing on board

A

gives qualitative result but no quantitative information regarding parasite density

both positive and negative results must always be confirmed by micorscopy

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35
Q

what is the treatment for malaria

A

uncomplicated: Chloroquine phosphate

treatment of P. ovale = Add primaquine

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36
Q

how is dengue fever transmitted

A

aedes aegypti mosquito

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37
Q

what is dengue fever known as

A

breakbone fever

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38
Q

what are the three phases of dengue fever

A

febrile phase
critical phase
convalescent phase

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39
Q

which phase of dengue does most patients clinically improve during and it lasts about 24-48 hours

A

critical phase

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40
Q

what are the two hallmark symptoms of severe dengue

A

capillary permeability (leaky capillaries) and disordered/diminished blood clotting

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41
Q

what is a positve tourniquet test result

A

10 or more petechiae per 1 square inch

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42
Q

what is the tourniquet test used to diagnose

A

dengue fever

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43
Q

what is the treatment for dengue fever

A

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
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44
Q

patients who have mild dengue fever, what is their disposition?

A

MEDEVAC.

for severe, med advice on further management while waiting for the medevac

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45
Q

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

A

Rocky mountain spotted fever

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46
Q

what is the treatment for rocky mountain spotted fever

A

doxycycline 100mg BID for 5-7 days

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47
Q

how can you help prevent ticks?

A

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

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48
Q

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

A

lyme disease

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49
Q

what is the causitive bacteria of lyme disease

A

B. Burgdorferi

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50
Q

what areas do ticks usually attach to?

A

any part but prefer the groin, axilla and scalp

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51
Q

in the late disseminated stage of lyme disease what is the presenting symptoms

A

same as acute but with rheumatologic manifestations
- transient, migratory arthritis and effusion in one or more joints

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52
Q

when would you NOT perform serologic testing for lyme disease

A

asymptomatic patient in endemic area
asymptomatic patient after an Ixodes tick bite
Patient with non specific symptoms (subacute myalgias, arthralgias, fatigue)

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53
Q

if performing a serolgic testing on a patient suspected to have lyme disease, what tests do you perform

A

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)

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54
Q

what is the treatment for lyme disease

A

early (Erythema migrans) 14 days of Doxycycline

early disseminated (bells palsy) 14 days of doxycycline

Late disseminated (arthritis) - 28 days of doxycycline

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55
Q

what can be used as a post-exposure prophylaxis for lyme

A

doxycycline 200mg PO 1 dose

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56
Q

prophylaxis can be started within what time frame of tick removal?

A

72 hours

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57
Q

what are the two subtypes of leishmaniasis

A

old world (eastern hemisphere)
new world (western hemisphere)

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58
Q

what are the predisposing factors of leishmaniasis

A

chronic sand fly exposure, poverty, proximity to dogs/cats/rodents

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59
Q

how is leishmaniasis trasnmitted

A

bite of infected female phlebotomine sand flies

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60
Q

what is the incubation period for leishmaniasis

A

2 weeks to several months and in cases up to 3 years; some >20 years

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61
Q

what is the most common manifestation of leishmaniasis

A

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
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62
Q

how is cutaneous leishmaniasis diagnosed

A

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

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63
Q

what is the treatment for cutaneous leishmaniasis

A

ulcer should be debrided and kept clean to avoid secondary infection
bandage and wrap

they need to go to infectious disease at some point

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64
Q

what medications can be used to treat cutaneous leishmaniasis

A

orally administered “azoles” and topical formulations for CL

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65
Q

what is the prevention for leishmaniasis

A

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

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66
Q

what are the subtypes of methicillin-resistant staphylococcus aureus (MRSA)

A

community associated (CA-MRSA)
Health care associated (HA-MRSA)

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67
Q

what conditions predispose someone to MRSA

A

hospitals
prisons
close living quarters
military
athletes
weakened immune systems

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68
Q

patient presents to medical due a spider bite that has recently started “oozing” what might be the cause

A

MRSA

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69
Q

what is the treatment for MRSA

A

I&D is the mainstay therapy for any FLUCTUANT LESION, followed by proper packing of the wound.

ANTIBIOTICS:
- TMP-SMX
- Clindamycin
- Doxycycline

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70
Q

what are two basic categories of human bites

A

occlusive wounds - similar to dog or cat bites
clenched fist or fight bites - skin surface strikes a tooth

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71
Q

how are hand wounds examined

A

fingers extended and in the clenched fist position, wounds can often disappear with fingers in extension

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72
Q

what is the management of a fight bite if no signs or sx of infection present

A
  • 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
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73
Q

when would you close a human bite wound

A

if it involves the face and show no s/s of infection, less than 24 hours, and MO should be consulted

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74
Q

when would antibiotics be prophylactically recommended for human bites

A
  • 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
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75
Q

what antibiotics should not be used with MRSA suspected infection

A

cephalexin
penicillinase-resistant penicillins PRP (dicloxacillin)
macrolides (erythromycin/azithromycin)

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76
Q

what is the preferred antibiotics for early prophylaxis for a fight bite

A

amoxicillin clavulanate 875/125mg PO

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77
Q

what does osteomyelitis most often affect

A

vertebrae of the spine and or the hip
- among younger adults, OM occurs most commonly in the setting of trauma and related surgery

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78
Q

how does osteomyelitis present?

A

gradual onset of symptoms over several days
dull pain at site, with or without movement
systemic symptoms (fever, rigors) may also be present

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79
Q

what labs are ordered for someone suspected to have osteomyelitis

A

CBC may have leukocytosis
blood culture may be positive
ESR elevation
CRP elevation

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80
Q

what is an essential component in the evaluation of suspected OM

A

radiographic imaging
- plain radiograph is typically initial
- most useful are plain radiographs, magnetic resonance imaging, and technetium 99 bone scienitigraphy

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81
Q

what is an essential component in the evaluation of suspected OM

A

radiographic imaging
- plain radiograph is typically initial
- most useful are plain radiographs, magnetic resonance imaging, and technetium 99 bone scintigraphy

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81
Q

what is an essential component in the evaluation of suspected OM

A

radiographic imaging
- plain radiograph is typically initial
- most useful are plain radiographs, magnetic resonance imaging, and technetium 99 bone scintigraphy

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82
Q

what is the most common cause of acute OM

A

S. Aureus

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83
Q

what is the cornerstone of treatment for OM

A

prolonged antibiotic therapy
- IV Vancomyacin
- IV Ceftriaxone

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84
Q

what is the disposition of someone with OM

A
  • 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
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85
Q

what type of organism is tetanus

A

anaerobic, spore forming, gram positive bacterium

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86
Q

what are the predisposing factors of tetanus

A

inadequate TD immunization, no TD booster within 10 years, puncture wound, penetrating injury with foreign body (step on nail), untreated necrotic tissue, crushing injury

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87
Q

how is tetanus transmitted

A

direct contamination of open wounds and non-intact skin
- widely distributed in soil and the intestines and feces of farm animals

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88
Q

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

A

tetanus

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89
Q

how may doses are in a tetanus series

A

3 doses

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90
Q

if the last documented TDAP was more than 5 years ago what will you do

A

administer booster of TDAP

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91
Q

what is the treatment for tetanus

A

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
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92
Q

what is inflammation of the meninges (dura mater, arachnoid mater, and pia mater)

A

meningitis

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93
Q

what is inflammation of the brain itself

A

encephalitis

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94
Q

A patient presents with fever, nuchal rigidity, altered mental status and a severe headache. What might be the cause

A

meningitis

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95
Q

what is the preferred imaging for someone suspected to have menigitis

A

CT

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96
Q

what is the lab required for diagnosis of meningitis

A

lumbar puncture

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97
Q

what is the foundational treatment for meningitis

A

manage airway
maintain oxygenation
sufficient IV fluids
control fever
- initiate empiric ABx and initiate MEDEVAC
- Ceftriaxone 2g IV or Pen G

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98
Q

administering what medication is associated with reduction in rate of hearing loss, neuro compromise and decreased mortality rates of meningitis

A

IV dexamethasone

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99
Q

if there are signs of ICP in meningitis , what can you do

A

elevate the head of the bed 30 degrees, induce mild hyperventilation in intubated pts and osmotic diuretics

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100
Q

what is given to close contacts of someone with meningitis

A

ceftriaxone 250mg IM one time
or
Ciprofloxacin 500mg PO one time

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101
Q

what is mononucleosis also known as

A

epstein barr virus

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102
Q

how is mono transmitted

A

body fluids, primarily saliva

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103
Q

what is the incubation period of mono

A

4-6 weeks

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104
Q

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

A

mononucleosis

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105
Q

what is the treatment for mono

A

bed rest, acetaminophen or nsaids
salt water gargles
avoid antivirals
SIQ TIL ACUTE SYMPTOMS SUBSIDE
LLD FOR 3-4 WEEKS

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106
Q

What is the scientific name of rabies

A

lyssa virus

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107
Q

how does rabies present

A

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
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108
Q

what is aerophobia

A

pathognomonic pharyngeal muscle spasms triggered by feeling draft or air, leads to aspiration, coughing, choking

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109
Q

how is diagnosis of rabies confirmed

A

post-mortem evaluation of the brain

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110
Q

if an animal is rabid, how long will they be placed in isolation

A

10-14 days

111
Q

what is < 14 days of diarrhea

A

acute

112
Q

what is more than 14-30 days of diarrhea

A

persistent diarrhea

113
Q

what is more than 30 days of diarrhea

A

chronic diarrhea

114
Q

if there is blood present in loose watery stools and there is a fever what type of diarrhea is this

A

inflammatory
- bleeding is secondary to tissue damage to lining colon from certain bacteria or toxins

115
Q

if there is watery stools with no blood and no fever, what type of diarrhea is this

A

non-inflammatory

116
Q

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

A

viral infectious diarrhea

117
Q

patient reports to medical with acute onset of abdominal cramps, n/v and non bloody diarrhea. What might be the cause

A

Norovirus

118
Q

what is the major cause of bacterial infectious diarrhea in lower income countries and commonly seen in young travelers returning from most regions

A

Enterotoxigenic E. Coli (ETEC) aka travelers diarrhea

119
Q

what is the most common clinical presentation of salmonella (bacterial ID)

A

gastroenteritis
- usually consists of acute diarrhea, abdominal pain, fever, and vomiting for 4-7 days

120
Q

for someone with severe diarrhea, high fever, or manifestation of extraintestinal infection, what antibiotics will be prescribed

A

fluroquinalones
cipro 500mg BID

121
Q

what is the most common cause of bacterial diarrheal illness worldwide?

A

Campylobacter

122
Q

how is campylobacter transmitted

A

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
Q

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

A

acute giardiasis

124
Q

what is the treatment for giardiasis

A

metronidazole (flagyl) 250mg PO TID for 5-7 days

125
Q

what labs can be useful in ruling in or ruling out non-infectious diarrhea etiologies?

A

CBC
UA

126
Q

what is the general treatment for infectious diarrhea

A

rule out more serious pathologies
oral or IV rehydration
BRAT diet
Patient education on hand washing practices

127
Q

what medications can be given for someone who has mild/mod ID in the absence of fever or bloody stools

A

loperamide
bismuth subsalicylate

128
Q

what is the criteria for considering antibiotics for infectious diarrhea

A

fever plus
> 10 stools a day
significant or complete loss of operational effectiveness

129
Q

when would you consider medadvice or medevac for someone with diarrhea

A

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
Q

how is influenza spread

A

primarily through respiratory droplets

131
Q

when is influenza considered to be most infectious

A

infectiousness is highest within 3 days of onset and correlated with fever

132
Q

what is the treatment for influenza

A

typically resolves within 1-7 days but treatment of goal is to alleviate and control symptoms while preventing spread to other personnel

133
Q

patient reports to medical with cc of a fever/chills, headache, malaise, nonproductive cough, sore throat and nasal congestion. What might be the cause

A

uncomplicated influenza

134
Q

how is hep A transmitted

A

consumption of contaminated water, food, fecal oral route

  • vaccines are available to prevent
135
Q

how is hep B trasmitted

A

through exposure to infective blood, semen, body fluids, blood products or IV drug use

-poses risk to healthcare workers
- vaccine is available

136
Q

how is hep C transmitted

A

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
Q

how is hep E transmitted

A

through consumption of contaminated water or food.

  • common cause of hepatitis outbreaks in developing nations
  • vaccines exist but not widely available
138
Q

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

A

hepatitis

139
Q

what is the treatment for hepatits

A

med advice for further reccomendations, patient will require MEDEVAC
Ensure proper hydration and nutrition and place patient SIQ

140
Q

what is the organsim type associated with tuberculosis

A

Rod Shaped

141
Q

how is tuberculosis transmitted

A

when contagious patient coughs, spreading bacilli through the air

  • recirculated air could still spread this, like on an airplane
142
Q

what is the leading infectious cause of death world wide

A

tuberculosis

143
Q

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

A

Bacille Calmette-Guerin (BCG)

144
Q

what must be completed during the evaluation of a postive TB test

A

Document Hx on NAVMED 6224/7
Chest Radiograph
Sputum radiograph

145
Q

what is the treatment for LTB infection

A

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
Q

what is the gold standard lab for confirming LTBI and ATB

A

Sputum test - acid fast bacillus (AFB) with NAAT

147
Q

what instruction is for routine testing and screening guidelines for TB

A

BUMEDINST 6224.8C

148
Q

what type of organism is cutaneous anthrax

A

aerobic, gram positve, spore forming rod shaped bacterium

149
Q

how is anthrax transmitted

A

handling B. anthracis- infected animals, carcasses, meats, hides, or wool. Or products derived from infected animals

150
Q

who is anthrax more common in

A

ranchers
leather workers
vets
wildlife researchers

151
Q

what is a zoonotic disease primarily affecting ruminant herbivores that become infected by ingesting contaminated vegetation, water or soil.

A

Anthrax

  • humans are generally incidental hosts
152
Q

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

A

cutaneous anthrax

153
Q

what is the treatment for cutaneous anthrax

A

ciprofloxacin 500mg
Levofloxacin 750 mg
Doxycycline 100 mg

154
Q

if left untreated, what can cutaneous anthrax result in

A

sepsis
meningitis

155
Q

how is cutanous anthrax diagnosed

A

vesicular fluid and ulcers should be swabbed for gram stain and culture and PCR

  • eschar edge should be lifted and swabbed
156
Q

what are the 4 main clinical presentations of anthrax and what is the most common form in humans

A

cutaneous
ingestion
injection
inhalation

  • cutaneous is the most common form in humans
157
Q

what is the screening frequency for chlamydia

A

women <25 tested annually
women > 25 with risk factors tested annually

158
Q

if you have a positive tst/ppd or blood test but a normal xray, negative sputum and remains asymptomatic what might they have

A

latent TB

159
Q

who can evaluate a newly positive IGRA/TST

A

MO
NP
PA
IDC

160
Q

when would you obtain baseline LFTs before beginning TB treatment

A

patients with elevated risk for liver disorder
such as regular/heavy etoh use

161
Q

what monitoring will be completed by the IDC once latent TB is suspected

A

evaluate compliance, possible side effects and indications of active TB
document monthly evaluations on NAVMED 6224/9

162
Q

what is the clinical manifestation of chlamydia in men and women

A

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
Q

what is the gold standard diagnosis for chlamydia

A

nucleic acid amplification testing (NAAT)
- usually obtained via UA, Vaginal or urethral d/c

164
Q

what is the treatment for chlamydia

A

doxycycline 100mg is preferred treatment
abstain from sexual activity for 7 days
contact recent sexual partners

165
Q

how soon after lab confirmed chlamydia should the patient be retested

A

within 3 months

166
Q

what is the scientific name for anthrax

A

bacillus anthracis

167
Q

what is the hallmark of cutaneous anthrax

A

eschar

168
Q

who should anthrax be transferred to

A

refer to infectious disease specialist

169
Q

what is the most frequently reported bacterial STI and nationally notifiable disease

A

chlamydia

170
Q

male reports with dysuria and white/green discharge from his urethra. What might be the cause

A

gonorrhea

171
Q

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

A

gonorrhea

  • females are usually asymptomatic or symptoms are so mile it may be difficult to diagnose
172
Q

what is the treatment for gonnorhea

A

ceftriaxone 500mg IM single dose and doxycycline 100 mg BID for 7 days

173
Q

What labs are ordered for an STI screening

A

gonorrhea
chlamydia
HIV
RPR
HPV vaccine counseling

174
Q

what are the subtypes of syphilis

A

T. pallidum (causes syphilis)
T.p. Endemicum (causes bejel)
T.p. Pertenue (causes yaw)
T. Carateum (causes pinta)

175
Q

what are the three distinct phases of infection of syphilis

A

primary
secondary
tertiary

176
Q

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

A

primary

177
Q

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

A

secondary

178
Q

what phase of syphilis is rare and appears 10-30 years after infection and symptoms may vary from cardiovascular, neurosyphilis and gummatous

A

tertiary syphilis

179
Q

what is the standard used to diagnose syphilis

A

serologic test

180
Q

what lab is used to confirm syphilis

A

treponemal test (FTA-ABS)

181
Q

what is the standard treatment for syphilis

A

parental penicillin G for all

  • treatment should be initiated if there is a high suspicion
182
Q

what can be given for patient with a pcn allergy and there is suspicion for syphilis

A

doxycycline 100mg for 14 days

183
Q

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

A

jarisch-herxheimer reaction

  • typically resolves 12-24 hours, nsaids for symptomatic relief
184
Q

what is the most common protozoan STI

A

Trichomoniasis

  • Trichomonas vaginalis
185
Q

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

A

trichomoniasis

186
Q

what lab diagnosis is used for trichomoniasis

A

wet mount prep of genital secretion but sensitivity is low.

NAAT is recommended due to high sensitivity/specificity

187
Q

what is the treatment for trichomoniasis

A

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
Q

patient presents with severe painful genital ulcers, dysuria, fever and local inguinal lymphadenopathy. what might be the cause

A

HSV

189
Q

how is HSV diagnosed

A

cell culture and pcr are the preferred HSV tests for genital ulcers or other mucocutaneous lesion

190
Q

what is the treatment for HSV

A

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
Q

what are the subtypes of HPV

A

type 6&11 - low risk but most common

type 16&18 high risk for developing cervical cancer

192
Q

what is HPV also known as

A

genital warts
condyloma acuminata

193
Q

how does HPV present

A

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
Q

what is the treatment for HPV

A

topical therapy, cryotherapy, and surgical excision are common treatment modalities.

  • topical: PODOPHYLLOTOXIN SOLUTION
  • clinician applied = cryotherapy by derm
  • surgical excision by derm
195
Q

who should get the HPV vaccine

A

females and males 11-26 years old
27-45y/o can request but less benefit because more people have been exposed to HPV

196
Q

what was the leading cause of cancer deaths in women

A

cervical cancer which is the now the most preventable with HPV vaccine and screening

197
Q

is HIV reportable

A

yes `

198
Q

what is the untreated survival timeframe for someone with HIV

A

9-11 years

199
Q

what is the acute phase of hiv called

A

acute retroviral syndrome (ARS)

200
Q

how does ARS present

A

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
Q

What is the screening test for HIV

A

OraQuick ADVANCE Rapid HIV1/2 antibody test

202
Q

what is the confirmatory testing for HIV

A

4th Gen HIV immunoassay

203
Q

what must be done prior to initiation of PrEP

A

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
Q

who manages a patient with HIV

A

managed by infectious disease and clinical evaluations are required by them at least every 6 to 12 months after diagnosis

205
Q

what can reactivate a recurrent hsv infection

A

triggered by stress, menstration, anxiety, etc

206
Q

what is the most common STI worldwide

A

HPV - human papilloma virus

207
Q

HIV INFECTION OCCURS WORLDWIDE IN EVERY COUNTRY/CONTINENT EXCEPT

A

ANTARCTICA

208
Q

who is nonoccupational post-exposure prophylaxis given to

A

sexual assault
unprotected sexual contact with high risk contact

209
Q

is there a cure for HIV

A

no, but they have a near-normal life expectancy thanks to antiretroviral medications (ART)

210
Q

who is occupational post exposure prophylaxis of HIV given to

A

healthcare workers due to needle sticks or health care related exposures

211
Q

what is the leading cause of waterborne disease in the US

A

cryptosporidium

212
Q

what is an example of helminths

A

flatworms - reside in GI tract
Thorny-headed worm - GI tract
Round worms - GI tract, blood, lymph and SubQ tissue

213
Q

what are examples of ectoparasites

A

ticks
fleas
lice
mites that burrow and remain there for weeks to months
blood sucking Arthropods (mosquito)

214
Q

what phase of the malaria cycle is the patient symptomatic

A

Erythrocytic phase - Asexual reproduction in RBCs
- matured parasite released from liver attach to red blood cells in the blood stream

215
Q

which phase of the malaria cycle is the asexual cycle in human liver.

A

Exoerythrocytic phase
- parasites make its way to the liver via lymph system and blood stream

216
Q

what is the most important protective measures for malaria prevention

A

proper clothing
awareness

217
Q

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

A

dengue fever

218
Q

how is a TQ test performed

A

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
Q

how is rocky mountain fever transmitted east of the rockies and pacific coast

A

american dog tick

  • rocky mountain region/worldwide = brown dog tick
220
Q

what is the scientific name for MRSA

A

staphylococcus aureus

221
Q

what is the most common viral etiology of meningitis or encephalitis

A

enteroviruses

222
Q

what test is used as a TB screen for those who received the bacille calmette guerin vaccine

A

quantiferon Gold
(QFT-GIT)

223
Q

what is most common viral STI

A

HPV

224
Q

what is the most common bacterial STI

A

Chlamydia

225
Q

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

A

azithromycin
ciprofloxacin
levofloxacin

226
Q

what medication is given for infectious diarrhea caused by a protazoan such as giardia?

A

metronidazole

227
Q

female presents with a lesion on the genitals that has a cauliflower appearance what is the diagnosis and what is the treatment

A

HPV - condyloma acuminata

TX: Imiquimod
Podophyllotoxin solution
or Cryotherapy

228
Q

a patient presents with a pianful ulcerative lesion of the genitals and inguinal lymphadenopathy what is the diagnosis and treatment

A

HSV

TX: Acyclovir
Valcyclovir

SX: Acyclovir or valcyclovir wihin one day

229
Q

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

A

syphilis (primary)

TX: Pen G or doxycycline if they have PCN allergy

230
Q

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

A

Hepatitis

LAB: WBC/UA/LFT

TX: Supportive care and MEDEVAC

231
Q

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

A

Influenza

TX: Osteltamivir (theraflu)
bedrest
hydrate
SIQ 24 hours

232
Q

if the patient has a black necrotic ulcer what might be the cause

A

cutaneous anthrax

233
Q

if the patient has a raised yellow/white lesion, what might be the cause

A

cutaneous leishmania

234
Q

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

A

lyme disease

TX: doxycycline x14 days

235
Q

what is the treatment for a patient who was bit by an animal who is suspected to have rabies

A

rabies immunoglobin (HRIG)
Rabies Vaccine
MEDEVAC
MER within 24 hours

236
Q

what is a common cause of viral gastroentritis

A

norovirus

237
Q

what is a common cause of parasitic gastroentritis

A

giardia

238
Q

what is a common cause of bacterial gastroentritis

A

campylobacter

239
Q

a patient presents with a tick in the left axillary region. what do you do

A

remove the tick
give doxycycline 200mg one time PO

240
Q

bulls eye with a tick bite what is this associated with

A

lyme disease

241
Q

what is the prophylactic malaria medications for malaria in a region that is known for P. Ovale

A

Primaquine

TX: add 52.6mg of primaquine

242
Q

what are the two hosts of malaria

A

human
female anopheles mosquito

243
Q

what is the oral treatment for cutaneous leishmania

A

fluconazole
ketoconazole

244
Q

when will you see a positive monspot test in someone who has mono

A

positive in first 4 weeks

245
Q

what is the treatment for chlamydia

A

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
Q

what STI is treponema pallidum

A

syphilis

247
Q

what is the treatment for primary and recurrent HSV

A

Primary= acyclovir/valcyclovir for 7 days
Recurrent = acyclovir/valcyclovir for 5 days

248
Q

what is the scientific name for tetanus

A

clostridium tetani

249
Q

what is the scientific name for meningitis

A

streptococcus pnemo

250
Q

what is the scientific name for chlamydia

A

clamydia trachomatis

251
Q

what is the cause of gonnorhea

A

neisseria gonnorae

252
Q

what is the scientific name for spyhilis

A

treponema pallidum

253
Q

what is the scientific name for trichomonias

A

trichomonas vaginalis

254
Q

what is the acute phase of HIV called

A

acute retroviral syndrome

255
Q

what is another name for HPV

A

condyloma acuminata

256
Q

what phase of syphilis shows no symptoms

A

latent

257
Q

for rabies where does most of the virus replicate at

A

CNS

258
Q

how long will the offending animal with rabies be isolated for

A

10-14 days

you will not catch the animal

259
Q

is tetanus anaerobic or aerobic

A

anaerobic

260
Q

can you empirically tx giardia and with what

A

yes and with metronidazole

261
Q

how long does influenza usually last

A

7 days

262
Q

what hepatitis is transported by body fluid

A

b, c and D

263
Q

how does the urine appear in hepatitis

A

dark yellow

264
Q

how is tb transmitted

A

resp droplet

265
Q

what lab do you want to order as the gold standard for TB

A

sputum test

266
Q

what disease is common in farm soil/animals

A

cutaneous anthrax

267
Q

what is the treatment for anthrax

A

levofloxacin
ciprofloxacin
doxycycline

268
Q

what sti is a silent infection

A

chlamydia

269
Q

what sti is known as the great pretender

A

syphilis

270
Q

who should be tested for chlamydia

A

sexually active women under 25
sexually active women with risk factors such as multiple partners over 25

271
Q

what is the treatment for syphilis

A

pen g

pcn allergy = doxycycline

272
Q

who can get Gardasil

A

boy and girls 11-26

by request 27 to 45

273
Q

when doing the sti screen what do you want to offer/counsel on

A

HPV vaccine education

274
Q

what is the rapid HIV test

A

oraQuick fast rapid HIV

275
Q

what is test is used to confirm syphilis

A

treponemal test (FTA-ABS)

276
Q

can active duty service members remain in the navy if they have HIV

A

yes, they just require clinical evaluations by infectious disease every 6-12 months

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