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clin med > ID > Flashcards

ID Flashcards

1
Q

where does staphaureus colonize

A

groin, axilla, nasal passages/resp tract

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2
Q

HA MRSA can be ____ or ____

A

hospital (over 24 hrs after hospitalization)or community onset (within 12 mo of exposure to HC)

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3
Q

CMV is caused by and spread via

A

cytlomegalovirus and is spread from person to person by sex, breastmilk, congenital, transplant

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4
Q

CVM signs and sx

A

similar to mono, but no exudate on tonsils and lymphadenopathy

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5
Q

CMV infects _____ ppl

A

immunocompetent

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6
Q

dx of CMV

A

CMV IgM

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7
Q

trmt CMV

A

ganciclovir + forcarnet

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8
Q

presentation is diff in CMV for immunocompromised bc…

A

sx are retinitis and encephalitis

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9
Q

2 diff strains of flu

A

A and B

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10
Q

incubation period of flu

A

1-4 days… doesnt spread after that

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11
Q

signs and sx of flu

A

fever nonprod cough, fatigue, myalgia, rhinitis, HA, sore throat

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12
Q

sx of flu

A

clinical; but can do rapid nasal swab

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13
Q

when do we test for the flu

A

if itll change trmt

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14
Q

who getts the trmt for the flu?

A

high risk pop

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15
Q

trmt for flu

A

antiviral Tamiflu which shorterns sx 1-3 days and dec risk of complications

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16
Q

who is flu vaccine recommended for

A

6 mo +

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17
Q

3 fungal infections

A

cryptococcus, pneumocystis, histoplasmosis

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18
Q

cryptococcus organism

A

cryptococcus neoformans… a yeast

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19
Q

transmission of cryptococcus

A

inhaled from pigeon poop in soil

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20
Q

signs and sx of cryptococcus

A

asymptomatic, but can cause lung disease in immunocompromised and spread to look like meningitis

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21
Q

dx cryptococcus

A

lung: sputum culture
meningitis: LP and gram stain CSF

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22
Q

MCC of fungal meningitis

A

cryptococcus

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23
Q

if you see cryptococcus, you may susspect the pt has ____

A

AIDS

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24
Q

pneumocystis organism and transmission

A

pneumocystis jirovecii; unknown maybe airborne

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25
Q

pneumocystis is usually seen in

A

immunocompromised

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26
Q

signs and sx of pneumocystis

A

asymptomatic, but im immunocompromised interstitial pneumonia with fever, SOB, nonprod cough

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27
Q

pneumocystis dx

A
  1. chest x ray shows diffuse infiltrate

2. Ct if infiltrate seen

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28
Q

trmt pneumocystis

A

PPX; trimethoprim/TMP for 14-21 days`

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29
Q

MC opportunistic infection of AIDS

A

pneumocystis

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30
Q

histoplasmosis organism and transmission

A

histoplasma capsulatum; bat/bird poop in soil we inhale

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31
Q

histoplasmosis areas affected

A

ohio and mississippi

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32
Q

coin like lesions on cxr are in

A

histoplasmosis for iimmunocompetent

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33
Q

if someone has pneumonia/pericarditis with mediatstinal/hilar mass/lymphadenopathy suspect this

A

histoplasmosis

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34
Q

sx of histoplasmosis

A

mild flu like sx to severe pneumonia

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35
Q

histoplasmosis usually affects this popul.

A

immunocompromised

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36
Q

dx of histoplasmosis

A

bronchoscopy

culture and sensitivity

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37
Q

trmt for histoplasmosis in immunocompetent

A

none

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38
Q

distinguish histoplasmosis from this condition

A

sarcoidosis

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39
Q

risk factors for NF

A

IVDA, immunocompromised, ETOH abuse

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40
Q

NF caused by?

A

usually GAS strain with exotoxin

41
Q

ss of NF

A

pain out of proportion, crepitus, systemically ill, compartment syndrome, anesthesia of area, cellulitis appearance, necrosis

42
Q

dx of nf

A

CT scan

43
Q

only way to definitiely dx nf

A

surgical exploration, biopsy, and debridement

44
Q

if nf is suspected, start this right away

A

broad spectrum ATB, but then change based on what culture shows

45
Q

fourniers gangrene?

A

nf of the perineum, destroys gluteal muscles, scrotum area remember that NF is from GAS and this is polymycrobial

46
Q

fourniers gangrene is mc in

A

old men

47
Q

group b strep/ s agalactiae

A

newborns have pneumonia, meningitis, bacteremia, and sepsis

48
Q

group b strep/ s agalactiae sx

A

fever, lethargy, trouble breathing/feeding, irritability,

49
Q

how is group b strep/ s agalactiae prevented

A

its screened for in pregnancy and the mother gets iv atb suring pregancy

50
Q

vancomycin resistant enterococci is gram ___ ___

A

+ cocci

51
Q

common uti pathogen

A

VRE

52
Q

vre primary risk

A

hospitalization, primarily spread by HC workers

53
Q

risks for vre

A

prevoius vancomycin, chronic disease, hospitalization, contaminated surfaces

54
Q

ss of vre

A

uti and bacteremia

55
Q

vre prevention

A

wash hands, ppe, clean rooms well, change catheters, isolate infected pt

56
Q

dx vre

A

C and S via rectal swab

57
Q

vre trmt

A

remove catheter if uti and often resolved. if not, treat with atb

58
Q

diphtheria transmission

A

respiratory secretions

59
Q

diphtheria ss

A

sore throat, rhinorrhea, hoarseness, malaise, fever, cervical lymphadnopathy, gray pseudomembrane on throat that cant be scraped off

60
Q

diphtheria can lead to

A

upper airway obstruction

61
Q

dx diphtheria

A

nose and throat culture

62
Q

diphtheria trmt

A

remove membrane, PCN or erythromycin, antitoxin if severe

63
Q

this diptheria is MC

A

laryngeal

64
Q

pertussis transmission

A

resp secretions, very contagious

65
Q

pertussis incubation

A

1-3 wks

66
Q

ss pertussis

A

whoop cough and forceful cough that lasts 6 wks, emesis

67
Q

is there a vaccine for pertussis

A

yes Tdap

68
Q

stages of pertussis

A

catarrhal, paroxysmal, convalescent

69
Q

most contagoius stage of pertussis

A

catarrhal

70
Q

paroxysmal stage of pertussis

A

rapid coughing bursts that may cause broken ribs

71
Q

dx pertussis

A

PCR nasal swab and culture

72
Q

trmt pertussis

A

azithromyacin, clarithromyacin

73
Q

consider this if someone has a cough for over 2 wks

A

pertussis

74
Q

“spider bite”

A

CA MRSA

75
Q

ss CA MRSA

A

warm, tender, draining/necrotic lesion that looks like a spider bite, maliase, fever (not common)

76
Q

if no palpacle fluctuance is felt but you suspect an abscess, you must do this

A

bedside US or CT/MRI

77
Q

_____ and abscesses

A

ID

78
Q

abscess trmt

A

ID, ATB if recommended (clindamycin, bactrim, doxycycline) and cephalexin if cellulitis is present along with the abscess

79
Q

____ alone is NOT enough trmt for an abscess

A

atb

80
Q

CA MRSA pt education

A

warm compresses on abscess/cellulitis, use hibiclens body wash if recurrent infections, use bactroban nasal cream f

81
Q

GAS is aka streptococcus _____

A

pyogenes

82
Q

group B strep is streptococcus_____

A

agalctiae

83
Q

pharyngitis is AKA ____ and is MC in

A

strep throat and kids ages 5-14

84
Q

transmission pharyngitis

A

droplets

85
Q

ss pharyngitis

A

sudden onset fever, sore throat, tender cervical lymphadenopathy, tonsillar enlargement/exudate, NV, dec appetite, palatal petechiae rash

86
Q

centor criteria pharyngitis

A

tonsillar exudate, tender cervical adenopathy, fever, no cough, one extra pt given if btwn 3-14 yo

87
Q

centor criteria btwn 0-2

A

unlikely to have gas, dont get a strep test

88
Q

centor criteria btwn 3+

A

get a rapid strep test

89
Q

if the strep test is - you can get this, but its only 80-90% sensitive

A

throat culture

90
Q

if streo test is +, what is the trmt

A

atb

91
Q

cause of scarlet fever

A

strain of GAS that produces erythrogenic toxin

92
Q

ss scarlet fever

A

sandpaper feel, sunburn look, pastias lines, desquamation, strawberry tongue

93
Q

trmt GAS

A

PCN or amoxicillin

94
Q

trmt for GAS with pcn allergy

A

cephalosporin, azithromycin, biaxin

95
Q

is empirical atb trmt for gas recommended

A

no

96
Q

peritonsillar abscess is often____

A

polymicrobial

97
Q

gas complications

A

tonsillar abscess, rneumatic fever, PSGN, PANDAS

98
Q

slide 40

A

1

clin med (35 decks)

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