ID Flashcards
distribution of histoplasmosis
mississippi and ohio river valleys
spelunkers, caves, bat and bird droppings- disease
histoplasmosis (fungal)
treatment for histoplasmosis
amphotericin
treatment for vibrio
fluoroquinolone or doxycycline (more serious-> cephalosporin)
management of possible rabies bite
Day 0- 20Iu/kg rabies IG around wound and in site distant from vaccine (or in deltoid/quad if not bite), vaccine
Days 3,7,14- rabies vaccine
how are HAV and HEV transmitted
oral-fecal (vowels hit your bowels)
anti-HBS
recovered or immunized
anti-HBc IgM
early marker of infection, positive in window period
anti-HBc IgG
best marker for prior HBV
HBeAg
high infectivity
Anti-HBeAb
low infectivity
fever, myalgia, headache, diarrhea, little vomiting, MC in kids 1-5 years old
shigella
two bacteria that may mimic appendicitis
campylobacter, shigella
bacteria associated with HUS
enterohemorrhagic e. Coli 0156:H7
mycobacterial infection with skin lesions and neuropathy
leprosy
mycobacterium with CD4<50, TB-like disease
mycobacterium avium intracellulare
mycobacterium with TB-like disease
mycobacterium kansasii
mycobacterium with fish contact, skin lesion, uncommon lymphadenopathy
mycobacterium marinum
mycobacterium with ulcerative skin lesions, rural tropical environment
mycobacterium ulcerans
additional coverage needed for meningitis >age 50
ampicillin (listeria)
brudzinskis sign
bend the brain- flex neck (causes flexion of hip and knees)
kernig’s sign
Knees- inability to extend the knees when hips are flexed
MC cause of meningitis
s. pneumo
MC pathogens in brain abscess
staph and strep species
new seizures and history of eating undercooked pork
cysticercosis
treatment for cysticercosis
albendazole
bug in neurocysticercosis
taenia solium
treatment of toxoplasmosis
sulfadiazine and pyrimethamine (with leucovorin for treatment with pyrimethamine)
treatment for preseptal cellulitis
dc with augmentin x7d, f/u in 48 hours
indications for lateral canthotomy in orbital cellulitis
- decreased visual acuity
- intraocular pressure >40
- significant proptosis
spirochete borrelia burgdorferi causes
lyme disease
erythema migrans- diseae
lyme disease
petechiae involving palms and soles before spreading centrally
RMSF
treatment for lyme disease in pregnant women or kids >8 needing to be treated for more than 21 days
amoxicillin (<21d, kids can take doxy)
treatment for lyme disease with neuro or cardiac manifestations
admission for IV rocephin
two conditions that are associated with jarish herxheimer
lyme disease
syphilis
negative birefringent crystals
gout
MCC viral otitis media
RSV
MCC lung abscess
aspiration (anaerobic)
MCC of septic joint
s. aureus
extra bacteria that should be considered in septic joint in sexually active young adults
gonorrhea
crystals in pseudogout are composed of
calcium pyrophosphate
MCC flexor tenosynovitis
S. aureus (also consider disseminated gonorrhea)
treatment for h. pylori
- PPI
- clarithromycin
- amox or flagyl
how long does tick have to be attached to transmit lyme
48 hours
indications for post-exposure ppx from tick bite
tick was attached for > 36 hours based on certainty of time of exposure or degree of engorgement, the local rate of infection is greater than 20% and doxycycline is not contraindicated (single dose of doxy)
post-exposure prophylaxis after exposure to neisseria meningitidis
- rifampin 600mg BID x2d 2. single dose of cipro
MC protozoal cause of liver abscess
entemoeba histolytica (from contaminated water)
treatment of amebic liver abscess
flagyl 750mg TID x 7days
h/o camping in midwest US now with RUQ pain, fever, cramps, bloody diarrhea
amebic liver abscess, entemoeba histolytica
complications of amebic liver abscess
Pleural effusion, pneumonia, peritonitis, erosion into the pericardium.
where should pertussis samples be otbained from
nasopharynx
MC complication of pertussis in infants
apnea
treatment of pertussis
azithromycin
how many colony forming units are necessary for a positive urine culture
100,000
MCC UTI
e. coli
how long to refrain from contact sports after mono infection
4 weeks
generalized maculopapular rash after treatment with amoxicillin
mono
MC bacteria in nec fasc
b. fragilis and e. coli
3 causes of atypical PNA
- myocoplasma
- chlamydia
- legionella
MCC pneumonia
s. pneumo
MC abdominal CT finding in HSP
“thumbprinting” due to submucosal hemorrhage
age group for HSP
4-12
first line treatment for bacterial rhinosinusitis
augmentin or doxycycline
MC cause of viral pneumonia in adults
influenza
MC viral cause of rhabdo
influenza
multiple cavitary lesions suggestive of what viral infection
influenza (causing s. aureus lung infection)
how should lice be treated
permethrin followed by repeat treatment nine days later to kill any remaining eggs
what lice treatment should be avoided in infants and patients <50kg and why
lindane, causes seizures
typical agent that causes malignant otitis externa
pseudomonas
treatment of malignant otitis externa
surgical debridement and antipseudomonal abx
test that should be sent if concern for PJP pneumonia
LDH
which PCP PNA patients get steroids
PaO2 <70 or A-a gradient >35
MCC pneumonia in HIV positive patients
s. pneumo
mosquito in dengue fever
aedes aegypti
sudden onset of high fever, breakbone fever, retro-orbital headache
dengue fever (several days of fever followed by resolution then a period of resumption of symptoms)
reduviid bug is associated with
chagas disease
diagnosis of fever > 101.4 in any patient with a fever who recently traveled
malaria
MC organism from respiratory cultures in CF
pseudomonas
purulent drainage from a child eye that re-accumulates after it is wiped off
bacterial conjunctivitis
bacteria associated with bacterial conjunctivitis
s. aureus, s. pneumo, h. influenzae, moraxella
treatment for bacterial conjunctivitis in contact lens wearer
fluorquinolone
CD4 in PCP pnuemonia
<200
lab value that should be obtained in PCP pneumonia
LDH
painful pustules that develop into painful ulcers with purulent bases one week after sexual exposure
h. ducreyi (chancroid)
treatment for chancroid
azithro, rocephin, or cipro, should also consider empiric treamtent for syphilis
what is a bubo
a large painful lymph node that can develop with h. ducreyi
symptoms of latent/primary TB
asymptomatic
CXR primary TB
ghon focus
diagnosis of latent TB
PPD
diagnosis of active/reactivation TB
sputum smears for AFB, sputum tissue culture for AFB
treatment for latent TB
INH for 9 months, rifampin for 4 months, or INH/rifapentine for 3 months
PPD cutoffs
15 mm: no ↑ risk
10 mm: high-risk, homeless, health-care workers, IVDU, foreign-born
5 mm: immunosuppressed, recent TB contact, abnormal CXR, steroid use
what is the strongest risk factor for conversion of latent TB to active
coinfection with HIV
treatment of secondary syphilis
single dose of IM penicillin
when does rash from secondary syphilis occur
5-8 weeks after resolution of ulcer; trunk to extremities
exudative pharyngitis with palatal petechiae and posterior cervical lymphadenopathy
mono (EBV)
pruritic annular lesion in athletes without lymphadenopathy
tinae corporis
bacteria that most commonly causes acute mastoiditis
s. pneumo
benefit of linezolid over vancomycin
linezolid inhibits bacterial toxin production
tick bite defined by abrupt onset of fever, headache, myalgias and shaking chills
ehrlichiosis
haemophilis ducreyi gram stain
gram negative coccobacillus
neisseria gonorrhea graim stain
gram negative diplococcus
chlamydia trachomatis gram stain
obligate intracellular gram negative
lesions in secondary phase of syphilis
condyloma lata
most common viral infection associated with erythema multiforme
HSV
most common bacteria that causes erythema multiforme
mycoplasma
erythema multiforme minor
no mucosal involvement
erythema multiforme major
mucoal involvement
perioral numbness, heat/cold confusion, bradycardia, hypotension from what fish ingestion
ciguatera
treatment for cigatuera
fluids, iv emetics, atropine for bradycardia, mannitol for neuro instability
bacteria most responsible for foodborne illness in US
s. aureus
most common bacterial cause of paronychia
s. aureus
nail plate infection due to Pseudomonas aeruginosa, related to prolonged water exposure
green nail syndrome, or chloronychia
most common precipitant of guillan barre
c. jejuni
treatment of erysipelas
with systemic symptoms- IV abx
without systemic symptoms- oral abx
bacteria associated with RMS
rickettsia rickettsi
hyponatremia and thrombocytopenia should make you think of
RMSF
lung disease after exposure to rat
hantavirus
treatment for hantavirus
supportive care
most common complication of meningococcemia
myocarditis and AV block
best diagnostic test for primary syphilis
dark field microscopy from lesions
best test for secondary syphilis
RPR or or VDRL
best test for tertiary syphilis
fluorescent treponemal absorption test
rash that overlaps with secondary syphilis
pityriasis rosea
MCC traveler’s diarrhea from S. America/Mexico
e. coli (ETEC)
MCC traveler’s diarrhea from southeast asia
c. jejuni, salmonella, shigella
MCC diarrhea in the US
norovirus
treatment for traveler’s diarrhea
cipro or azithromycin
MCC nec fasc
polymicrobial
treatment of dacrocystitis
oral abx (clindamycin if mild) and topical abx
treatment of epididymitis in >35
levaquin or bactrim (targeting e. coli, pseudomonas)
most common presentation of arterial gas embolism in divers
unconsciousncess 10 min after ascent
treatment of CMV retinitis
ganciclovir
what is #1 cause of blindness in AIDs
CMV retinitis
cotton wool exudates and retinal hemorrhage in AIDs
CMV retinitis
most common causes of hand, foot, mouth disease
enterovirus, coxsackie virus
ANUG is associated with what bacteria
prevotella intermedia
treatment for prostatitis with high risk sex behavior
IM rocephin and 10 days of doxycycline
treatment of acute prostatitis without high risk sex havriour
bactrim or fluqoroquinolone x 4-6 weeks
most common location for zoster to occur
thorax, followed by face (trigeminal nerve)
MCC infectious diarrhea
c. jejuni
MCC malignant otitis externa
pseudomonas
treatment of malignant otitis externa
ciprofloxacin
CN that can be involved in malignant otitis externa
CNVII
most common form of extrapulmonary TB
lymphadenitis
MCC spinal epidural abscess
s. aureus
what is the cervical lymphadenitis of TB called
scrofula
gold standard for diagnosis of rabies
histologic evaluation of the white matter- negri bodies
treatment of tularemia
streptomycin (add chloremphenicol for meningeal involvement)
ulcerated skin and regional lymphadenopathy in patient with rabbit exposure
tularemia
first line treatment for toxoplasmosis
pyrimethamine (also leucovorin), sulfadiazine
CD4 for primary CNS lymphoma
<50
side effects of pyrimethamine
bone marrow suppression, rash, nausea
chronic watery diarrhea in HIV
cryptosporidium
ring enhancing lesions+focal deficits in HIV patient
toxoplasmosis
irremovable lesions on the tongue in HIV patient
hairy leukoplakia
ring enhancing lesion + progressive AMS in patient with HIV
primary CNS lymphoma
Focal neurologic deficits, non-enhancing white matter lesions, CD4 < 200
PML (JC virus)
organism that is most likely to cause osto after a dog bite
pasteurella multocida
MC organism that causes osteo
s. aureus
how is osteo most commonly spread in adult
contiguous
how is oste most commonly spread in kids
hematogenous
SW united states exposure causing chest pain, dyspnea, rash, myalgias
coccidiomycosis
treatment for coccidiomycosis
fluconazole or ampho (severe)
4 cancers that are considered AIDS-defining
- cervical cancer
- kaposi’s sarcoma
- burkitt’s lymphoma
- primary CNS lymphoma
treatment of amebic abscess
IV flagyl
most common cause of amebic abscess
entomaeba histolytica
treatment of pyogenic liver abscess
third/fourth gen cephalosporin + flagyl or clinda
what mosquito spreads malaria
anopholes
most lethal form of malaria
p. falciparum
two species of malaria that have a long dormant phase
p. vivax, p. ovale
cerebral malaria, blackwater fever
p. falciparum
uncomplicated malaria, in low resistance area- treatment
chloroquine
treatment of complicated p. falciparum
quinidine + doxycycline
Most common pathogen in dog bite
Pasteurella
Organism that causes cat scratch
Bartonella
intracellular gram negaitve bacilius
yersinia pestis
ebola-type of virus
RNA virus
tender pustules, tenosynovitis, septic arthritis, rash, fevers/chills consistent with dissemination of what STI
disseminated gonorrhea
MCC septic arthritis in patients less than 35yo
gonorrhea
treatment of disseminated gonorrhea
ceftriaxone x7days + single dose azithromycin
Organism that causes tinea versicolor
Malasezzia
Treatmnet of tinea versicolor
Selenium sulfide, oral fluconazole, or topical imidazole
Headache, periorbital edema, and ophthalmoplegia- think
Cavernous venous thrombosis
MCC of erysipelas
S. Pyogenes
MCC external shunt infection
S. Epidermis
Infection from dog bite that causes death
Capnocytophagia canimorsus
what precautions should someone be placed on in the hospital for flu
droplet
tick associated with ehrlichiosis
lone star tick
morulae, or intracellular mulberry-like clusters, on peripheral smear- diagnosis
ehrlichiosis
tick bite that causes abrupt onset headache, fevers, myalgias
ehrlichiosis
What is the name of the phenomenon seen in Rocky Mountain spotted fever when petechiae form after blood pressure cuff inflation
Rumpel-Leede phenomenon
tick that causes RMSF
dermacentor
centripetal rash from ankles/hands to trunk
RMSF
Side effect of didanosine
Pancreatitis
Side effect of efavirinz
Vivid dreams, Headache, severe rash, dizziness
HIV medication that causes radiolucent kidney stones
Indinavir
Hepatitis, nausea, vomiting, hepatitis- HIV medication
Lopinavir
HIV medication that causes bone marrow suppresion
Zinovadine
HIV medications that causes lactic acidosis
NRTIs
HIV medication that causes paresthesias
Ritonavir
Lymphogranuloma venereum- caused by what bacteria
c. trachomatis
enlarged lymph nodes after PAINLESS genital ulcer
LGV
treatment for LGV
doxycycline x21d
treatment for chancroid
250mg IM rocephin
azithromycin causes what cardiac abnormality
prolonged QTc
treatment of severe malaria
IV artesenate
