ID Flashcards
HUS
Insult to kidneys caused by shiga toxin (EHEC) pallor, fatigue, bruising, edema Hemolytic anema thrombocytopenia AKI decreased haptoglobin
Tx: Fluids, transfusion, dialysis
Zika Syndrome
Zika virus targets neuroprogenitor cells
Microcephaly, spasticity, seizures, ocular abnormalities
Imagining: Cortical thinning, ventriculomegaly, calcifications
Tetanus prophylaxis
Dirty/Severe wound: Tetanus within 5 years?: Nothing Tetanus at some point?: Single dose Tdap No tetanus: TIG + Single dose Tdap Clean/Minor wound: Tetanus within 10 years?: Nothing Tetanus at some point: Single dose Tdap No tetanus: Single dose Tdap
Syphilis Treatment
Primary and Secondary: Penicillin G 1 dose or Doxycycline for 14 days
Asymptomatic: Penicillin G 3 doses or Doxy for 28 days
Tertiary: Penicillin G 14 days or Ceftriaxone 14 days.
Periventricular Calcifications in the Neonate
CMV
Parenchymal Calcifications in the Neonate
Toxoplasmosis
Neonatal Herpes Simplex
Skin, mouth eyes: keratitis, mucocunatneous lesions
CNS: temporal hemorrage/edema, seizures
Disseminated: Hepatitis, sepsis, pneumonia
Tx: Acyclovir
HIV Associated Neurocognitive Disorder
Cognitive impairments in multiple domains, mood and behavior changes. MRI shows diffuse white matter changes. CD4 <200
Progressive Multifocal Leukoencephalopathy
JC virus, usually in the setting of HIV/AIDS. Altered mental status, motor deficits, ataxia, vision abnormalities. MRI asymmetric white matter changes.
Erysipelas vs Cellulitis
Cellulitis onset over days, deeper layers of the dermis, flat edges of swelling with poor demarcation. +/- drainage.
Erysipelas: Sudden onset, involves more superficial dermis, raised edges of swelling with demarcation.
Lyme Disease
Initial phases: Doxy or Amoxicillin (children less than 8 and pregnant women)
If +Heart Block: IV Ceftriaxone
Cryptococcus neoformans
HA, N/V, confusion, abducens nerve palsy (elevated ICP), scattered umbilicated papules.
Clogs arachnoid vili, increasing intracranial pressure.
Suspected Meningitis Plan
CT, LP, BC, Abx.
Infants do not need CT prior to LP
Causative organisms of diarrhea in AIDS
Cryptosporidium: Low-grade fever, severe watery diarrhea, low-grade fevers
Microsporidium: watery, crampy, weight loss, fever is rare
MAC: Watery, high fever
CMV: Frequent small volume diarrhea, Hematochezia, abdominal pain, low-grade fever, weight loss.
Shigella
Raid onset, high fever
Abdominal pain, watery diarrhea with mucus +/- blood
+/- Seizures in children
Tx: fluids, Abx if immunocompromised, bacteremic, or severely ill.
Early congenital syphilis
HSM, Jaundice, IUGR, snuffles, desquamating/bullous rash, abnormal long bones on X-ray.
Pinworms
Kids, perianal itching, tape test, mature worms can migrate to the vagina and cause vulvovaginitis.
Cryptosporidium diarrhea
Low-grade fever with profuse watery diarrhea
Microsporidium diarrhea
Watery, crampy, weight loss, usually no fever
MAC diarrhea
Watery, high fever
CMV diarrhea
Frequent small volume stools, hematochezia, abdominal pain, low-grade fever, weight loss
Chlamydia trachomatis
Conjunctival injection, inflamed tarsals, and pale follicles.
Spreads in unsanitary and crowded conditions. Can lead to blindness.
Tx: Azithromycin
Bacillary Angiomatosis
Bright red, firm, friable, exophytic nodules in an HIV+ patient. Caused by Bartonella.
Tx: Erythromycin
Bacterial Conjunctivitis tx
Erythromycin, polymyxin, or azithromycin drops
If contacts, fluoroquinolone drops.
Viral Conjunctivitis tx
Warm or cold compresses +/- antihistamine
Allergic Conjunctivitis tx
Antihistamine (+mast cell stabilizer for persistent symptoms)
Fever and splenomegaly in the setting of infection (chole/endocarditis)
Splenic Abscess
More likely in immunocompromised or DM
Nasal mass in a Chinese individual
Nasopharyngeal carcinoma, caused by reactivation of EBV
HIV+ Pregnancy
Triple antiretroviral therapy and neonatal zidovudine
C section if viral load >1000
C diff risks
Abx, PPIs
Treatment of active Toxoplasma encephalitis
Pyrimethamine and sulfadiazine
Puncture wound infection
Pseudomonas
Intense pain to light tough in an elderly or immunocompromised person.
Zoster
Chronic osteomyelitis
following acute phase (fevers, erythema),
persistent pain, swelling, chronic wound, sinus tract, nonunion of fracture.
Surgical debridement and abx
Ecthyma gangrenosum
Rare pseudomonas infection. Found in immunocompromised patients. Rapid onset of indurated macules and papules that can become ulcerated. Due to bacteremia.
Syphilis
Primary: chancre
Secondary: fever, malaise, widespread lymphadenopathy, diffuse maculopapular rash beginning on the trunk and spreading to the extremities including palms and soles. Can have oral lesions.
Dx: serology (nontreponemal (RPR) and treponemal (ELISA))
Otitis externa tx
cipro
Congenital Rubella
PDA, cataracts, sensorineural hearing loss
Congenital CMV
chorioretinitis, periventricular calcifications
Prosthetic joint infections
less than 3mo post op: S aureus, Gm- rods, anaerobes
3-12 months post op: other staph species, enterococci
12+ months post op: S. aureus, Gm- rods, streptococci
Grey watery discharge from a surgical site
Necrotizing surgical site infection
debridement and abx
Varicella post exposure prophylaxis
Previous Hx of Varicella or 2 doses of vaccine? Yes: Observe No: Immunocompetent? Yes: Varicella vaccine No: Varicella Ab
Travelers diarrhea
usually e coli but if prolonged consider C. parvum (even in immunocompetent), cyclospora, and giardia.
Invasive Aspergillosis
Immunocompromised patients Fever, chest pain, hemoptysis Pulmonary nodules with "halo sign" Dx: cultures and cell wall biomarkers Tx: Voriconazole
PCP
Dyspnea, nonproductive cough, fever
Bilateral diffuse ground glass appearance on xray
High lymphocyte count in pleural effusion
possible TB
The greatest risk of TPN
Central line infection
High lymphocytes and protein on CSF
Tuberculosis
Severe diarrhea and rash in a post BMT patient
GVHD
Breast abscess
Presents like a clogged lactiferous duct but more common in the lateral portions of the breast. Fluctuant mass with lymphadenopathy.
Drain and abx
Clogged lactiferous ducts have no LAD.
New born with microcephaly, HSM, jaundice and petechiae.
CMV
Mother likely had a short term illness during pregnancy
periventricular calcification
