ID 2 Flashcards
Bioterrism:
- Bubo, Hemoptysis, Sepsis without localization symptoms occur in hours.
Dx?
Rx? - Cutaneous, Hilar Lmphdenaopathy + Mediastinitis.
Dx?
Rx?
- Yersinia Pestis
Streptomycin
This requires isolation like TB
- Anthrax
Rx Ciprofloxacin (Respiratory Fluoroquinolone)
From Ticks, Flies, Direct Contact, presents with Inoculation, Hilar lymphadenopathy and Pulmonary infiltrate.
Dx? Rx?
Tularemia (Francisella tularensis)
Streptomycin like Yersinia (bio-terroism)
When to order CT in Meningitis? (Symptoms)
- Papilledema
- Focal deficit
- AMS
- > 60 years
- Immunocompromised,
- CNS disease - higher risk of brain herniation
- When do we give Dexamethasone with meningitis?
- Who should Receive ppx?
- Only with S. pneumonia not with Neisseria.
- Roommates an Only Healthcare Workers who were Suctioning, intubation (Respiratory Therapist)
- New onset LOW IgA, IgM, IgG, SinoPulmonary infections, associated with Hashimotos.
Dx? - Recurrent SinoPulmonary Infections, Ear infections, SLE (Lupus) at early age.
Dx? - Recurrent SinoPulmonary Infections, Gastrointestinal Infections and Anaphylaxis to Blood Products.
Dx?
- Common viable immunodeficiency
- Complement deficiency (C5-C9)
- IgA Deficiency
When to do rapid strept?
What if Rapid Strept is Negative and pt is adolescent?
No Cough, Hoarsness or Runny nose (When 3 Centor Criteria is Met)
Centro Criteria (No cough, Exudates, Lymphadenopathy, Fever)
If Rapid Strept negative and Person is Young do Throat Culture, if positive treat regardless
Management of patient with Syphills if Titers do not Decrease?
LP to test for Neurosyphilis.
Benzathrine penicillin does not get into CSF (Failure to Seroconvert)
Is Metronidazole safe in First trimester?
Fluconazole (Diflucan)?
Yes.
No.
- Management of Shigella ?
- Management of Salmonella, what if co-morbid condition exist?
- Management of E coli 0157:H7?
- Self limited, Levofloxacin if immunocompromised
- Self-limited, Levofloxacin if immunocompromised
- No Treatment needed!!!
Treatment can WORSEN infection because can KILL Bacteria and RELEASE Shiga Toxin
When to give Rabies immunoglobulin + vaccine?
if you can’t observe the dog for 10 days.
Bite from, bat, raccoon, fox, cat, skunk (rodent)
Management of pt presenting with Target Lesion in Northeast?
Management of a patient concerned WITHOUT symptoms?
IgM for lyme, Confirm with western blot
Doxy x 21 d
Observe, Return if symptoms Develop
What is the management of a pt who develops Seizures after eating Food infected with Human Feces.
Why NOT check stool studies?
Neurocysticercosis
CT scan shows Cyst
Give Anti-seizure ppx (Keppra)+ Praziquantel, Albendazole, and Steroids
Do not Check Stool Studies because Humans Ingest Eggs from Human Feces and not the CYST so it would not develop in tape worm in Humans.
Humans Develop Tape worm if they consume CYST from Undercooked Pork.
Cyst create the WORM not the Eggs
Test Genital HSV for Primary?
Treatment for HSV Primary?
Treatment for Recurrence?
Treatment for Suppressive Therapy?
Who gets this treatment?
Vesicular fluid for PCR
Valtrex for 7-10 days
Recurrences treat for 5 DAYS
Suppressive: Daily low dose Valtrex therapy if > 6 episodes a year.
Pt presents with Confusion, Expressive Aphasia, Right Temporal Homonymous Hemianopia.
CSF WBC 112, RBC 2000, Protein 80, Glucose 82, MRI shows left Fronto-Temporal Encephalitis and Edema
Dx?
Test?
Rx?
Dx: HSV
Test: LP for CSF for HSV PCR
Rx: IV acyclovir x 14-21 days
College student with Boyfriend, Sore throat, High Fever 102.2.
Oropharynx has Exudate, Palpable spleen tip, Posterior Cervical Adenopathy, Heterophiles antibody negative, Group A Strept negative.
Dx?
Test?
Rx?
Mono
EBV IgM Capsid Antibody.
The heterophile can take 3 weeks to turn positive
