ID Flashcards
Farm animals/rodent urine
1.flulike
2.subconjunctival haemorrhage
3.CK high = myalgia
_________
Temp SPIKE/ TWICE daily
- Ulcer @ lip
- NasoPharynx involvement
-HSM-ANT
-South American
__________
Flulike syx
Worse Better worse
COUNCILmen inclusion bodies
________
Facial Flushing!!!! Classssssic
- HIGH AF fever #Saddleback-fever
- comes goes comeback
Low WCC
Low Plts
High ALT
________
Rose spot rash
SplenoMegaly+Bradycardia
CONSTIPATION=inflamed PeyerPatch \_\_\_\_\_\_\_\_ a. Dermatitis Arthritis Tino synovitis b. Perihepatitis Endocarditis Arthritis septic \_\_\_\_\_\_\_
Meningitis/CN palsy
Erythema migrans
Heart block myocarditis
- E.Migrans+No other dx?
- NO E.Migrans
- Syx+TickBiteHx?
Treatment? Treatment at disseminated?
Leptospirosis
-Doxy+Penicillin
_______
Leishmaniasis=Kala Azar 7-21d
-Similar to Histoplasmosis
________
Yellow fever 2 - 14 days
________
Dengue
-hemorrhagic manifestations
-4-10d
_______
Typhoid - culture
RRickettsii on the wRRists,
TTyphus on the TTrunk.
_______
a. Disseminated gonorrhoea infection
b. Fitzhugh Curtis
________
Lyme disease blood zero ology
E.Migrans+No other dx?
- Doxy / Amoxi
- Ceftriaxone disseminated
NO E.Migrans -Syx+TickBiteHx? Test antibodies: \+ = Abx - = Repeat+Refer
Temp SPIKE/ TWICE daily
- Ulcer @ lip
- NasoPharynx involvement
- HSM-ANT
- South American
Leishmaniasis
-Kala Azar
7-21d
Similar to Histoplasmosis
Flulike syx
Worse Better worse
COUNCILmen inclusion bodies
Yellow fever 2 - 14 days
Facial Flushing!!!! Classssssic
Low WCC
Low Plts
High ALT
HIGH AF fever
Saddleback fever
-comes goes comeback
Dengue
-hemorrhagic manifestations
4-10d
Rose spot rash
SplenoMegaly+Bradycardia
CONSTIPATION=inflamed PeyerPatch
Typhoid - culture
Rickettsii on the wRists,
Typhus on the Trunk.
Dermatitis
Arthritis
Tino synovitis
Perihepatitis
Endocarditis
Arthritis septic
Disseminated gonorrhoea infection
Fitzhugh Curtis
Meningitis/CN palsy
Erythema migrans
Heart block myocarditis
- E.Migrans+No other dx?
- NO E.Migrans
- Syx+TickBiteHx?
Treatment? Treatment at disseminated?
Lyme disease blood zero ology
E.Migrans+No other dx?
- Doxy / Amoxi
- Ceftriaxone disseminated
NO E.Migrans -Syx+TickBiteHx? Test antibodies: \+ = Abx - = Repeat+Refer
Gross loss of vision
Globe rupture of eye
Mono ocular vision blur
Blood in ant chamber
Diagnosed on inspection apparently.. looool
_________
Difficulty opening mouth
NO visual changes
________
Blowout fracture of the orbit
________
Binocular vision + facial trauma
Step deformity @orbital margin
Depressed CHEEEEK contour
Hyphaema = Red
Hypopyon = pus
_______
Ramus fracture
______
Comminuted MAXillary fracture ->
maxillary ANTRUM rupture
______
Depressed zygomatic fracture
Difficulty opening mouth
NO visual changes
Ramus fracture
Blowout fracture of the orbit
Comminuted MAXillary fracture ->
maxillary ANTRUM rupture
Binocular vision + facial trauma
Step deformity @orbital margin
Depressed CHEEEEK contour
Depressed zygomatic fracture
Pupils:
Bilaterally constricted
Unilat const + preserved light response
Unilateral dilated?!
Pupil constrict mechanism?
____
- diabetic / prostitue
BILAT small pupils
Accomodate WELL,
NOT constrict to light
________________
- Light is SWUNG from
UNaffected –> Affected eye
pupils constrict LESS + appear to dilate
___________
3. Unilat dilated pupil = UNresponsive 2 light oCCULOMOTOR compression IPSI-lat Mass/tumour/Hematoma \_\_\_\_\_\_\_\_\_
4. Tonically dilated pupil UNILAT Absent knee/ankle jerk VIRAL/BACT infection \_\_\_
- Ptosis, Anhydrosis, Miosis-constricted
Bilat const=
- Metabolic encephalopathy
- Argyll Robertson
- Pontine dx/opiates
Unilat const + preserved light response =
-Symp pathway dx
Unilateral dilated =
-Marcus Gunn RAPD = optic nerve dx
Light on retina -> CN2 -> LGNuc -> -PreTectal ->B/L EdWestPhal -> -PSnerves+CN3 b/L -> -Ciliary Ganglion-Nerve -> -Pupil constrict \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
- Argyll-Robertson pupil
____ - Marcus-Gunn RAPD
-AION/Optic Neuritis MS/DM/Syph
___ - Hutchinson sign
_______ - Holmes-Adie Pupil
___ - Horner
Fever (alternating/diurnal on - off between days),
HeadAche, myalgia,
Hepatomegaly + Foreign travel hx
Dx? Ix?
_____________
Parasaitemia = 999+PHE:
> 2% - severe/cx?
> 10% ?
<2% non-severe/UnCx:
-?* > ?
ACT =
- ?
- ?
Non-falciparum
-?
-Tx vivax/ovale -> dormant HYPNOZOITES @Liver?
Avoid what drugs with following:
- HA - ?
- Seizures - ?
- GI dx - ?
- Folate dx - ?
- Psych dx - ?
Malaria!!!
Giesma thick and thin blood films
___________
Parasaitemia = 999+PHE:
> 2% - severe/cx
-IV Artesunate > Quinine
> 10% - exchange transfusion
<2% non-severe/UnCx:
-ACT* >
Atovaquone-proguanil
Doxy-Quinine
ACT = AL-ArM:
- ArteMether+Lume
- ARteSunate+Mefloquine
Non-falciparum
-oral ACT / Chloroquine
-Tx vivax/ovale -> dormant HYPNOZOITES @Liver?
Primaquine-G6PD beware
Avoid what drugs with following:
- HA - chloroquine
- Seizures - chloroquine/Mefloquine
- GI dx - proguanil
- Folate dx - proguanil
- Psych dx - Mefloquine
Tet: Clean v TetProne v HRWound ??? : Non-penetrating <6hrs ??? : Puncture, Fract/FB, Burn/Bite ??? : Contaminated/FUCKED Ask pts what?
5Vacc <10yr + Clean = ???
5Vacc <10yr + TetProne = ???
5Vacc <10yr + HRWound = ???
-5Vacc <10yr + any wound = ???
5Vacc >10yr + Clean = ???
5Vacc >10yr + TetProne = ???
5Vacc >10yr + HRWound = ???
?/Not vacc + Clean = ???
?/Not vacc + TetProne = ???
?/Not vacc + HRWound = ???
___________
bVacc @:
1a) ???
1b) ???
Tet Ig + bVacc @:
2a) ???
2b) ???
2c) ???
Tetanus: Clean: non-penetrating <6hrs TetProne: Puncture, Fract/FB, Burn/Bite HRisk: Contaminated/FUCKED Ask pts 5vacc <10yrs OR 5vacc >10yrs OR ?/Not vacc ?
5Vacc <10yr + Clean = CLEAN+CHILL
5Vacc <10yr + TetProne = CLEAN+CHILL
5Vacc <10yr + HRWound = CLEAN+CHILL
-5Vacc <10yr + any wound = CLEAN+CHILL
5Vacc >10yr + Clean = CLEAN+CHILL
5Vacc >10yr + TetProne = bVacc
5Vacc >10yr + HRWound =
-bVacc + Tet Ig
?/Not vacc + Clean = bVacc ?/Not vacc + TetProne = -bVacc + Tet Ig ?/Not vacc + HRWound = -bVacc + Tet Ig \_\_\_\_\_\_\_\_\_\_\_
bVacc @:
1a) Clean wound + ?/Not vacc
1b) TetProne + 5Vacc >10yr
bVacc + Tet Ig @:
2a) TetProne + ?/Not vacc
2b) HRWound + 5Vacc >10yr
2c) HRWound + ?/Not vacc
Toxoid inactivation toxins?
Inactivated preps?
Live attenuated
Rabies:
Animal in UK - ? risk =
-???
Animal bite elsewhere - ? risk = ??? + ... -Already immunised: ??? -Not prev immunised: ??? \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
PEP:
Hep A: ?? / ??
Hep B - risk of needlestick transmission - ??????? %
look at source - ?? OR ??
- HBsAg Pos+ :
- known responder = ???
- non-responder = ???
- being vacc = ??? - Unknown source:
- known responders = ???
- non-responders = ???
- being vacc = ???
Hep C -
??? / monthly –>
@seroconversion = ???
Exp to Varicella @ preggers:
- NOT had chickenpox = ???
- IC = ???
Toxoid = DTaPertussis
Inactivated = R A-H IMflu
-Rabies/A-Hep/IMflu
Rest live attenuated
Rabies:
Animal in UK - NO risk =
-WASH + ?CoAmox
Animal bite elsewhere - HR = -WASH + ... -Already immunised: 2 further doses -NotPrevImmunised: HRIg+Fullcourse \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
PEP:
Hep A: HNIg / HepA vaccine
Hep B - risk of needlestick transmission - 20-30%
look at source - HBsAg Pos+ OR unknown?
- HBsAg Pos+ :
- known responder = booster
- non-responder = HBIg + vaccine
- being vacc = HBIg + vaccine - Unknown source:
- known responders = booster
- non-responders = HBIg + vaccine
- being vacc = accHBV vaccine - Booster @ known responders
- HBIg + Vacc:
@non-responders+beingVaccHBsAgPOS - AccHBV+Vacc:
@unknown+beingVacc
Hep C -
PCR/monthly –>
@seroconversion = IFN +/- Ribavirin
Exp to Varicella @ preggers:
- NOT had chickenpox = VZIg
- IC = VZIg
Fever, WL
RUQ pain
Blood diarrhoea
USS=liver ascessssss
Colon biopsy = Aask-shaped ulcers
Tx?
_________
Coxsackie/Polio/Rhino - ?
MeaslesMumps - ?
ParaInfluCroup - ?
Influenza - ?
Viral warts - HPV ?
Hepatits - ?
HIV - ?
-Riskiest way to get it?
______
Skin dx and periph Neuropathy
HypoEsthetic, Hairless skin plaques
- low Bact load
- Th 1-type response
- high cell-mediated immunity
Lion-like Lethal
- high Bact load
- Th2 response
- low cell-mediated immunity
Tx?
________
South Atlantic states - North Carolina.
Classic triad
- headache,
- fever,
- rash - palms/soles(vasculitis).
You drive CARS using?
wRists ?
Trunk ?
___________
OroPharyngeal Ulcers
SMeg-ANT
Mid/Upper Zone pneumonia
LUNG inflamm dx ->
- Skin = Verrucas -> SCC
- Bone = Granulomatous Nodules
LUNG inflamm dx ->
- Skin = Verrucas -> SCC
- Bone = Granulomatous Nodules
-Males>Females
Meningitis
Arthralgia
Diss 2 BONE/Skin
ENodosum
Amoebiasis entamoeba histolytica
-fecal-oral
USS->CT
Metronidazole
______
Coxsackie/Polio/Rhino - Picorna
MeaslesMumps - ParaMyxo
CroupParaInflu - ParaMyxo
Influenza - OrthoMyxo
Viral warts - HPV Papova-Virus
Hepatits - Hepad-virus
HIV - retro
-receiving anal sex
________
- Tuberculoid
- Lepromatous
Tx:
-Dapsone + Rifampin @tuberculoid form;
- +CloFaziMine @lepromatous
_________
Rocky Mountain Ricketsia
-spotted fever
Palms and soles rash @:
- CoxsackieA (hand, foot, mouth)
- Rocky Mountain Ricketsia
- Syphilis 2°
(you drive CARS using your palms and soles).
Rickettsii on the wRists,
Typhus on the Trunk.
________
Histo
-similar 2 leishmaniasis TWICE daily SPIKEs
Blasto
ParaCoccidio
Coccidio
Coxsackie/Polio/Rhino - ?
MeaslesMumps - ?
ParaInfluCroup - ?
Influenza - ?
Viral warts - HPV ?
Hepatits - ?
HIV - ?
-Riskiest way to get it?
Coxsackie/Polio/Rhino - Picorna
MeaslesMumps - ParaMyxo
CroupParaInflu - ParaMyxo
Influenza - OrthoMyxo
Viral warts - HPV Papova-Virus
Hepatits - Hepad-virus
HIV - retro
-receiving anal sex
FLAT pink and blotchy #vascular
Since BIRTH -> disappears by 2yr
-forehead/eyelids/neck nape
BLANCHES
Naevus ?
_____________
small BRIGHT Red LUMP NOT present @birth --> develops @1st MONTH of life --> Inc SIZE / VASC till 9 months \_\_\_\_\_\_\_\_\_\_
Purple LUMP
Face as a purplish/red macule with irregular contours.
NOTTTTT resolve!!!!!
Assoc with intracranial vascular abnormalities like Sturge-Weber-Syndrome.
Naevus ?
Salmon Stork Patch
-Naevus Simplex
Marks on the neck may persist.
______________
Strawberry naevus
-capillary haemangioma
______________
Port wine stains
-Naevus FLAEMMUS - need cosmetics / laser therapy.
Skin dx and periph Neuropathy
HypoEsthetic, Hairless skin plaques
- low Bact load
- Th 1-type response
- high cell-mediated immunity
Lion-like Lethal
- high Bact load
- Th2 response
- low cell-mediated immunity
Tx?
- Tuberculoid
- Lepromatous
Tx:
- Dapsone + Rifampin @tuberculoid form;
- +CloFaziMine @lepromatous
South Atlantic states - North Carolina.
Classic triad
- headache,
- fever,
- rash - palms/soles(vasculitis).
You drive CARS using?
wRists ?
Trunk ?
Rocky Mountain Ricketsia
-spotted fever
Palms and soles rash @:
- CoxsackieA (hand, foot, mouth)
- Rocky Mountain Ricketsia
- Syphilis 2°
(you drive CARS using your palms and soles).
Rickettsii on the wRists,
Typhus on the Trunk.
OroPharyngeal Ulcers
SMeg-ANT
Mid/Upper Zone pneumonia
LUNG inflamm dx ->
- Skin = Verrucas -> SCC
- Bone = Granulomatous Nodules
LUNG inflamm dx ->
- Skin = Verrucas -> SCC
- Bone = Granulomatous Nodules
-Males>Females
Meningitis
Arthralgia
Diss 2 BONE/Skin
ENodosum
Histo
-similar 2 leishmaniasis TWICE daily SPIKEs
Blasto
ParaCoccidio
Coccidio
Bloating, flatulence,
FOUL-smelling,
FATTY diarrhea
Bloody diarrhoea - (dysentery),
USS liver abscess (“anchovy paste”),
RUQ pain;
Colon biopsy= Aask-shaped ulcers
Severe diarrhea in
AIDS
Giardiasis
Amoebiasis
Crytopsporidum
Cat scratches -> area of skin’s LNodes swells
_________
Diarrhoea:
<6 hrs
<48 hrs
48-72 hrs
> 7 days
Which ones bloody? Except?
_________
Neg Antibody test after ?months =
UNlikely HIV infection
CD4 < 500 CHo
CD4 < 400 SL
CD4 < 350 BEN
- ?ring-enhancing lesions @MRI
- Thallium SPECT ?
CD4 < 200 - DK
- ?ring-enhancing lesions @MRI
- Thallium SPECT ?
CD4 < 100 DC
Bartonella - catch scratch dx
________
<6 hrs ABC
-Aureus/Bacillus/C.perfringens
<48 hrs
-Sally/E.coli
48-72 hrs
-Shiggy/Campy
> 7 days YAG
Yersinia/AmoebiasisAnchhovy/Giardiasis
All blood except
-ABC+Giardiasis
_________
Neg Antibody test after 3 months =
UNlikely HIV infection
CD4 < 500 - Cervical/HodgkinRScells
CD4 < 400 sweats/LNpathy BF -Bact -Fungal = Candida-oral thrush SCRAPable M.furfur-seborrh derm
CD4 < 350 Burkitt EBV NHL High Grade SHEFCOT 1. Shingles 2. HSV 3. EBV HAIRY Leukoplakia UNscrapable EBV->CNS lymphoma -single-ring-enhancing lesions @MRI -Thallium SPECT POS 4. Fungal-CoTrimox/Atovaquone/Pentamadine/Sted @hypoxia
CD4 < 200 Diarrhoea Kaposi
- Crypto Cocc-Meningitis / Sporid-Diarrhiea
- Oesophageal Candidiasis
- Toxo = brain abscess, MULT ring-enhancing lesions, Thallium SPECT neg
- PyriMethAmine+SulfaDiaZine
CD4 < 100 Dementia, Cerebral Lymphoma
- Atyp m.avium
- CMV pneumonitis retinitis conjunctivitis encephalitis
- PML JC virus
