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3rd Year (Step 2) > ID 3 > Flashcards

ID 3 Flashcards

1
Q

Dx?

Infectious bloody diarrhea ass’d w/ poultry

A

Salmonella

Tx = Cipro for S. typhi, others don’t require ABX

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2
Q

Dx?

Infectious bloody diarrhea (most common cause)

A

Campylobacter
(ass’d w/ GBS)

Tx = Erythromycin

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3
Q

Dx?

Infectious bloody diarrhea ass’d w/ Hemolytic Uremic Syndrome (HUS)

A
  • E. coli O157:H7
  • Shigella (2nd most common w/ HUS)

Shigella Tx = TMP/SMX

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4
Q

Dx?

Infectious bloody diarrhea ass’d w/ Shellfish

A

Vibrio

  • Cruiseships –parahaemolyticus
  • Hx of liver disease, skin lesions – vulnificus
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5
Q

Dx?

Infectious bloody diarrhea ass’d w/ High affinity for iron, hemochromatosis, blood transfusions

A

Yersinia

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6
Q

Dx?

Infectious bloody diarrhea ass’d w/ WBCs & RBCs in stool

A

C. dificile

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7
Q

Infectious diarrhea – best initial test?

A

Blood &/or fecal leukocytes

stool lactoferrin has greater sensitivity & specificity than stool leukocytes

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8
Q

Dx?

Nonbloody infectious diarrhea ass’d w/ vomiting

A

Bacillus cereus & Staphylococcus

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9
Q

Infectious diarrhea – Tx of mild & severe disease?

A

Mild = Oral fluid replacement

Severe (high fever, bloody stools, or severe diarrhea)= Cipro (quinolones) & oral fluid replacement

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10
Q

“Severe” infectious diarrhea means what?

A

Hypotension, Tachycardia, Fever, Abdominal pain, Bloody diarrhea, Metabolic acidosis

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11
Q

Cryptosporidiosis – Tx?

A

Treat underlying AIDS – Nitazoxanide

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12
Q

Acute Hepatitis – most common causes?

A

Hepatitis A or B

Hep C rarely presents as acute hepatitis, usually “silent” infection that presents later w/ cirrhosis

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13
Q

Acute Hepatitis – symptoms on presentation?

A
  • Jaundice
  • Fever, weight loss, fatigue
  • Dark urine
  • Hepatosplenomegaly
  • Nausea, vomiting, abdominal pain
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14
Q

Acute Hepatitis Dx tests?

A

Increased:

  • Direct Bilirubin
  • ALT:AST ratio
  • Alkaline Phosphatase
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15
Q

Acute Hepatitis marker that correlates best w/ inc’d likelihood of mortality?

A

Prothrombin time

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16
Q

Best initial Dx test to differentiate type of Hepatitis?

A

Hep A, B, D, & E: IgM antibody for acute infection, IgG for resolution of infection

Hep C: PCR to assess RNA level

17
Q

Serology marker of Hep B vaccination?

A

Positive Surface Antibody

surface- & e-antigen negative, core-Ab negative

18
Q

Serology marker of resolved/past Hep B infection?

A

Positive IgG Core antibody & Surface antibody

19
Q

Serology marker of acute or chronic Hep B infection?

A

Positive surface antigen, e-antigen, core antibody (IgG or IgM)

(negative surface antibody)

20
Q

Serology marker of “window period” of Hep B infection?

A

Positive IgM, then IgG Core antibody

antigens & surface antibody all negative

21
Q

What does positive e-antigen mean in Hep B?

A

High level of DNA polymerase activity — viral replication occurring

e-antigen is the best indication of the need for Tx in chronic disease

22
Q

Acute Hep C – Tx?

A

Interferon (injection), Ribavirin, & Boceprevir or Telaprevir

(dec likelihood of developing chronic infection w/ Hep C)

23
Q

Definition of “chronic” hepatitis B?

A

Presence of Surface antigen > 6 months

24
Q

Interferon – AEs?

A
  • Arthralgia/myalgia
  • Leukopenia & Thrombocytopenia
  • Depression & flu-like symptoms
25
Q

Chronic Hepatitis w/ elevated E-antigen – Tx?

A

Entecavir, Adefovir, Lamivudine, Telbivudine, Interferon, or Tenofovir
(interferon is injection & has most side effects – not best 1st choice)

26
Q

Goal of chronic Hepatitis therapy?

A
  • Reduce DNA polymerase to undetectable levels

- Convert those patients w/ e-antigen to having anti-hepatitis e-antibody

27
Q

Acute Hep B – Tx?

A

None. Hep B becomes chronic in 10% of patients & no Tx has been shown to alter this.

28
Q

Role of liver biopsy in chronic hepatitis management?

A

Fibrosis on biopsy = start Tx for Hep B or C right away

  • if there’s active viral replication, fibrosis will progress to cirrhosis, which is irreversible
29
Q

Are ALT levels a good indication of activity of chronic hepatitis?

A

No, you can have significant infection w/ normal transaminase levels

30
Q

Ribavirin – AEs?

A
  • Hemolytic Anemia

- Severe Teratogen

31
Q

Goal of Hep C Tx?

A

Achieve an undetectable viral load

32
Q

Urethritis vs. Cystitis presentation?

A

Both: Dysuria w/ urinary frequency & burning

Urethritis = Urethral discharge
cystitis does not give this

3rd Year (Step 2) (44 decks)

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