ID, derm, and immunology Flashcards
syphilis: tx
- primary through early latent (< 1y of disease) = PCN G x 1 dose
- early tertiary (gummas, neuro deficits, CV effects) or late latent (> 1y of disease) = weekly PCN G x 3 wks
Jarisch-Herxheimer reaction
systemic inflammatory response 2/2 dying spirochetes when syphilis is treated
N. meningitides meningitis prophylaxis
rifampin
H. ducreyi tx
ceftriaxone or azithromycin
SBP definition
WBC > 100 cells/mm3 and neutrophils > 50%
tularemia tx
streptomycin
serum sickness
type III hypersensitivity w/onset 1-3 wks after exposure or 12-36h after re-exposure > flulike sx, rash, arthralgia
- tx: withdraw agent, sx control
most common viral cause of rhabdomyolysis
influenza
2 types of nec fasc
type 1: polymicrobial
type 2: group A strep
malaria tx
Central America/Caribbean: chloroquine
other places: artesunate
rheumatic fever: tx
PCN
alternative: erythromycin
rash w/central clearing: don’t forget
erythema marginatum (rheumatic fever) not always erythema migrans (Lyme)
transplant rejection: hyperacute vs acute vs -chronic
hyperacute (mins-hrs): irreversible, 2/2 preformed antibodies
acute (weeks-3m): CD8+ T-cell-mediated (type IV hypersensitivity) reaction = WBCs infiltrate graft vessels, impairing perfusion
- tx: steroids
chronic (months-years): CD4+ T-cell-mediated (types II/IV hypersensitivity) reaction = vascular intimal proliferation and renal vessel fibrosis > luminal narrowing
dysuria w/urethral discharge in a male
urethritis (STI until proven otherwise)
STI empiric tx
ceftriaxone 25 mg IM + azithromycin 1 g PO (or doscy 100 mg BID x 7d)
What kind of organism is Borrelia burgdorferi?
spirochete
bilateral facial nerve palsy
Lyme
What infectious organism is associated with intussusception?
rotavirus
pemphigus vulgaris is associated with
myasthenia gravis and thymoma
DRESS syndrome
potentially fatal complication of AED therapy started 2-6 weeks prior: rash 1-2 weeks after nonspecific sx which initially spares mucous membranes > multi-organ system failure and death
triad: fever, rash, internal organ involvement
tx: IVIG, steroids, stop drug
ITP
if PLT < 50 and active bleeding = steroids and IVIG
if PLT < 20 = steroids and IVIG regardless of bleeding/not
if life-threatening bleeding = PLT transfusion to 10
how to differentiate: SSSS from SJS and TENS
SSSS spares mucous membranes
thrush vs oral hairy leukoplakia: which scrapes off?
thrush…like vaginal Candida
common drugs that cause EM
Sulfa, Oral hypoglycemics, Anticonvulsants, Penicillin, NSAIDs (SOAPS)
EM minor vs major
minor = localized eruption of the skin with minimal or no mucosal involvement
major = one or more mucous membranes are involved
erysipelas
systemic symptoms > red, demarcated rash (often malar) 2/2 S. pyogenes
balanitis tx
topical clotrimazole
