ID Flashcards
tx influenza
oseltamivir
what type of bacteria is Neisseria meningitidis
Gram-negative diplococci
what meningitis causing bacteria is a concern in older adults, immunocompromised individuals, and neonates
Listeria monocytogenes
who should not undergo lumbar puncture
Patients with findings of increased intracranial pressure, ongoing anticoagulant therapy, or other bleeding disorders
Lumbar puncture meningitis
elevated opening pressure
decreased glucose concentration, elevated protein level, and elevated white blood cell count with predominant neutrophils
tx meningitis
vancomycin with the addition of ceftriaxone or cefotaxime
tx meningitis in older adults and immunocompromised
Ampicillin should be added
what should be added as adjunctive therapy to reduce inflammation and prevent neurologic complications, such as hearing loss, in meningitis
dexamethasone
Patients with confirmed or suspected meningococcal meningitis should be placed on
droplet precautions
appropriate chemophylaxis for close contacts of n. meningitidis
rifampin, ciprofloxacin, or ceftriaxone
what type of bacteria is salmonella
motile gram-negative bacillus
salmonella outbreaks are most commonly associated w
poultry
eggs
transmission from contact w reptiles and amphibians
sx salmonella
abdominal cramping, diarrhea, nausea, and vomiting
not usually grossly bloody diarrhea
definitive dx salmonella
stool cultures
most important component of therapy for salmonella
replacement of fluids and electrolytes
Which virus is associated with outbreaks of gastroenteritis on cruise ships?
Norovirus
HIV vaccinations
Tetanus and diphtheria vaccination should be performed every 10 years
Hepatitis B vaccination in a three-part series should be given to all patients who are HIV positive who do not demonstrate immunity to hepatitis B
Hepatitis A (2 or 3 doses)
Influenza vaccination in the inactivated or recombinant form should be administered annually
three doses of human papillomavirus vaccination should be administered to those who are ≤ 26 years old
Meningococcal vaccine (A, C, W, and Y type) should be administered in a two-dose series and repeated every 5 years
Pneumococcal vaccination (one dose of either the 20-valent or 15-valent pneumococcal conjugate vaccine) should also be administered to adult patients between the ages of 19 and 64 who are HIV positive and have never been vaccinated with pneumococcal vaccine. If the 15-valent pneumococcal conjugate vaccine is administered, a dose of the 23-valent pneumococcal polysaccharide vaccine should be given, typically at least 1 year later.
labs recs HIV
complete metabolic panel and complete blood count every 3 to 6 months
lipid panel and glycosylated hemoglobin are also recommended at least yearly
An annual Pap test with human papillomavirus testing should be performed as well as annual testing for syphilis, gonorrhea, chlamydia, and trichomoniasis in patients who are sexually active
baseline purified protein derivative test for tuberculosis should be performed for patients who are HIV positive, with annual testing of those whose initial test was negative and who continue to have ongoing risk factors
cause of Lyme disease
Borrelia burgdorferi (gram-negative spirochete)
how is Lyme disease spread
Ixodes (deer) ticks
how long must tick in Lyme disease stick to transmit bacteria
24 to 48 hours
when and where does Lyme disease commonly occur
It most commonly occurs during summer months and is typically concentrated in the northeast and north central United States
what type of rash do people with Lyme disease present with
erythema migrans
common sx Lyme disease
erythema migrans
flu-like sx
AV block
cranial nerve palsy
arthritis
encephalopathy
polyneuropathy
during the time erythema migrans is present,
serologic testing is negative
tx Lyme disease
doxycycline twice per day for 10–21 days
amoxicillin in pregnant patients, lactating patients, and children younger than 8 years of age
IV ceftriaxone if severe
prophylactic tx Lyme disease
one-time dose of doxycycline within 72 hours of tick removal
acute mononucleosis is caused by
Epstein-Barr virus
mono is commonly known as
the kissing disease
MC sx mono
low-grade fever, sore throat, and posterior lymphadenopathy
dx mono
rapid mononuclear spot test, which detects the presence of heterophile antibodies and is very specific for Epstein-Barr virus
CBC will show leukocytosis
tx mono
refrain from contact sports for 4 weeks due to the risk of splenic rupture
supportive
Shigella species
nonmotile facultative anaerobe gram-negative rods that contain enterotoxins, such as Shiga toxin
how do you get shigella
person to person contact
contaminated food and water
daycare centers
residential institutions
Shigella predominantly infects the
colon
sx shigella
frequent, small volume diarrhea with stools occurring 8–10 times per day. Fever, abdominal cramping, tenesmus, and bloody and mucoid diarrhea can also be present
Stool microscopy shigella
leukocytes and red blood cells
preferred testing shigella
Stool culture
tx shigella
oral rehydration
fluoroquinolone antibiotic, azithromycin, or third-generation cephalosporin (such as cefixime or ceftriaxone)
azithromycin is first line for kids (they should not take fluoroquinolone)
Which Shigella species is associated with the development of reactive arthritis?
Shigella flexneri.
