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ID exam 2 Flashcards

1
Q

what is the leading cause of death world wide? describe it

A

MTB - acid fast bacilli, obligate aerobe

resistance to ABX, complement, acidic/alkaline compounds

macrophages eat but cannot kill MTB

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2
Q

what is the SX and DX for MTB?

A

SX - fever, cough, night sweats, weight loss
DX: sputum smear/culture GOLD TEST , NAAT, PCR

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3
Q

what is the clinical dx and tx for MTB?

A
  • miliary seeds in CXR = cavitary disease
  • osteomyletisis = pott’s disease
  • meningitis, brain absces, pericarditis, renal dysnfunction

TX:RIPE
- rifampin, isoniazid, pyrazinamide, ethambutol + pyridone B6

remember that TB can be resistant to many drugs

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4
Q

which non-tuberculous mycobacteria is the M/C in US and m/c in texas/florida

A

m/c US = m. kansaii

m/c texas + florida = m. abscessus

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5
Q

what is the transmission, RF, clinical dx and dx for NTM?

A

transmission = via aerosol and water source, NOT PERSON TO PERSON

RF: COPD, bronchiestasis, CF, prior disease,

clinical dx: cough, dyspnea, weight loss, fatigue, “HOT TUB LUNG”

DX: CXR = upper lobe cavitary infiltrates, nodular infiltrates
- 2/3 sputum culture + OR
- 1 bronchoscopy culture + OR
- transbronchial BX culture +

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6
Q

what is the TX For NTM?

A

M.avium intracellular (MAI) (CER) = clarithroymycin + ethambutol +/- rifampin

M.Kansaii (RIPE) = isonizaid + rif + ethambutol + pyridoxine

M.abscesses ( CA)= claritthroymcin +/- amikacin

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7
Q

what is the non pulmonary non tuberculous mycobacteria? where do u get it? whats the dx?

A
  1. mycobacterium marinum - SLOW GROWING PIGMENTED ACID FAST BACILLUS
  2. FROM fresh or salt water
  3. FISH TUBERCULOSIS, soft tissues on hands, forearms, osteomyletitis
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8
Q

what is the m/c/c of cold viruses?

A

rhinovirus!

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9
Q

what is influencza, what is the SX, complication and TX?

A
  1. RNA virus - influenca A (H1N1) or infleunca B
  2. M/C myalgias involving leg and lumbosacral area, fever, fatigue, rhinorreha
  3. comp: infuenenza penumonia
  4. TX: neuraminidase inhibator –> oseltamivir

do nasopharngeal swab to determine this

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10
Q

what is rabies, what is the SX, DX, TX?

A
  1. Rabies is caused by rhabdovirus infection of the CNS
  2. SX: fatal encephalitis :(, neuro phase and hydrophobia
  3. DX: negri bodies in the animals
  4. TX: human rabies immune globin at the site, then rabies vaccine
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11
Q

what is rotavirus, where is it M/C in, SX, TX, transmission?

A
  1. rotavirus is a contagious virus M/C in infants + young children without vaccination –> can casue gastroenteritis
  2. transmission via fecal oral route
  3. SX: severe WATERY diarrhea, vomitting, fever, abd pain
  4. TX: rehydration + vaccine
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12
Q

what is parvovirus B19, M/C where, SX, TX?

A
  1. Erythema infectiosum 5 disease
  2. M/C in children
  3. SX: slapped cheeks, circumoral pallor maculopapular rash on extremities
  4. TX: supportive care lol
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13
Q

what is roseola, m/c where, SX and TX?

A
  • Roseola infantum (6th disease)
  • HHV 6 (humanherpes virus-6)
  • Usually in children < 2 years
  • SX: RASH on trunk, neck then face
    o **Viral exanthem STARTS on the trunk **
  • TX: Mainstay supportive care
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14
Q

what is measles, SX, compicaltion, and TX?

A
  • RNA virus with 1 serotype = measles virus part of genus morbillivirus: paramyxoviruses
  • ## SX: fever, malaise, THREE Cs: COUGH, CORYZA, CONJUCTIVITIS, Kolpik Spots (buccal mucosa), RASH morbilliform (maculopapular) on face and feet
  • Comp: pneumonia M/C/C of measles related death
  • TX: Mainstay supportive care
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15
Q

what is congenital varcella, SX, when does it happen during pregnancy?

A
  • RARE, happens during 1st trimester
  • happens at birth from mother to fetus if she has chickenpox
  • abnormabilites to birth weight, fucked up skin, brains, eyes extremies
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16
Q

where does ZIKA virus come from, when does it happen during preg, transmission, what is the SX TX DX?

A
  • **Aedes mosquito **(a.aegypti)
  • MICROCEPHALLY 1ST AND 2ND TRIMESTERS
  • Transmission: bite from infected mosquito, sex, maternal-fetal
  • SX: fever, rash, headache, joint pain, conjunctivitis, muscles pain
  • TX: Mainstay supportive care – hydration, acetaminophen for fever
  • DX: serum or urine ZIKA virus IgM (TOC)
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17
Q

what are the condyloma and oncogenic strain for HPV? describe the condyloma strian

A

condyloma is HPV 6 11. - fleshy gray sessile pedunculated lesion
oncogenic is HPV 16 18

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18
Q

what is the TX For HPV?

A
  1. TX by provider: cyro, Resin, TCA/BCA, surgery
  2. tx by pt: resin solution, imiquimod
  3. Vaccines: Quadrivalent - gardasil - type 6 11 16 18,
    or bivalent - Cervarix - type 16 18
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19
Q

what is the m/c reported bacreiral STI in US and the m/c urethritis in men?

A

chalmydia trachomatis

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20
Q

what is the 3 subsets for chalmydia trachomatis? SX, DX, TX?

A
  1. D-K biovart = genital tract
  2. L-serovars = lymphogranuloma venereum (tender nodes)
  3. A-C biovars = trachoma, eye
  4. SX: mucoprulenent discharge in pee, FITZ hugh curitis syndrome (violin strings sign between liver+diaphragm
  5. DX: urine w pus + leukocyte esterase test,
    - NAAT - TOC
    - culture which is GOLD STANDARD
  6. TX: azithro or doxy
21
Q

what is the 2nd m/c/c of urethritis in US?

A

neisseria gonorrhea

22
Q

how dos N.gonnerhea affect the cells and what does it grow on ? what kind of bacteria is it ?

A

it is a gram negaive diploccoi

it infect columnar epithelial cells of the cervix,urethra,conjunctiva, and it grows on blood + chocolate agar

23
Q

what is the SX, DX and TX for n.gonorreha?

A

SX in men: dysuria, pruluent discharge, epididmyitis most freq comp

SX in women: discharge, dysuria, mucopurulent cervictis, tenderness

often CO INFECTION W CHLAMYDIA

DX: clinical, gram stain, NAAT
TX: ceftriaxone IM, azithro or doxy

24
Q

what are the three vaginitis?

A
  1. trichomonas vaginalis
  2. bacterial vaginosis
  3. candida vaginits
25
is trichomas vaginalis sexturally transmitted? what are the SX, DX and TX? what is the PH
1. YELLOW GREEN GREY DISCHARGE WITH FISHY ORDER 2. STRAWBERRY CERVIX 3. PH >>> 4.5 4. SEXALLY TRASMITTED 5. on the vaginal smear, you will see motile trichomonads 6. TX: oral metro only
26
Risk factor of bacterial vaginosis, SX, DX, TX?
1. bad bacteria overflowing casued by garnerella vaginalis 2. RF: new sex partner, douching :( 3. WHITE GRAY DISCHARGE, CERVIX IS NORMAL 4. PH >>>> 4.5 5. smear will show clue cells 6. TX: oral metro and vagina metro
27
what is the SX DX TV for candida vaginitis?
1. SX: white thick clumped/curd discharge 2. PH <<< 4.5 3. smear shows budding yeast neg 4. TX: oral fluconazole, vagina azole supp
28
how would u dx HSV and TX?
1. DX: clincial, tissue culture, tzanck smear, serology 2. first episode: acyclovir, valcyclovir, or famiclovir - suppressive therapy: acyclovir, famicyclovir, valacyclovir - reccurent supressive therapy: decreases recurrence by 70-80%
29
what are the 3 stages of syphillis?
1. primary: painless chancree highly infectious disease 2. 2nd: macular rash on feet and sole, condyloma lata 3. latent: AXS, can relapse 4. granuloma lesions, neurosyphillis, arotitis neurospyhillis: congnititve decline, tabes dorsalis, ocular problems
30
how would u DX syphillis?
DX: serology: - RPR, FTA-ABS primary RPR will be negative 2nd/3rd RPR wil be 100% senstiive, FAT-ABS 100% DX: dark feild microscopy
31
how would u TX syphyllis?
TX: 1st/2nd = Benzathine PCN G single dose, doxy for 2 weeks if theres allergy 3rd/latent = benzathine PCN G every week for 28 days if pt has neurosphyillis, give aqueos crystallines PCN G
32
what causes chancroid, what is the SX and TX?
- haemophilis ducreyi (gram neg coccbacillus) casues chancroids - SX: PAINFULL gential ulceration with lymphadenopathy - TX: azithro or ceftriaxone, ciprofloxcin, erythro
33
what is lymphogranulma venerum? what is the SX and TX?
LGV is gential ulcer disease caused by chlamydia trachomatis L1 L2 L3 - PAINLESS ULCERS - 2nd stage: painfull tender inguinal and femoral lymphadenopathy that is unilateral TX: doxy
34
what is MONO, what is the SX And DX?
- MONO is epistein barr virus HHV4 - sx: throat sore, fever, SKIN RASH, SPLEEN ENLARGEMENT, chills, PHARYNGITITS, rash esp given ampicillin - - DX: Heterophile AB + 90% (TOC) - EBV capsid IGM and IGG + = means acute infection - EBNA + = old infection - CBC = lymphocytosis, thombocyotpenia
35
what is EBV non infectious risk for?
oral hairy leukoplakia HIV, nasopharyngeal CA, Burkitt's lymphoma
36
when do sx start for HIV and how long does it last?
SX - begins 1-4 weeks after infection Duration: 10-14 days, can be severe and last up to 10 weeks
37
how does HIV happen?
- viral entry via mucosal surface like genital and oral - R4/R5 macrophages tropic virus binds to dendritic cells and passed to CD4 - VIRAL LOAD IS HIGH MORE THAN 105-106 COPIES
38
what are the SX for HIV?
mononucleosis like syndrome - RASH 2-3 days after fever , rash on the face collar region, upper thorax - mucocutanous ulcers PAINFUL ITCHY in the esophagus, anus, mouth, genital
39
how would u dx HIV?
primary HIV - you will have detectable HIV-RNA in plasma - HIV AB /western blot
40
what is the CD4 count for acute HIV infection?
CD4 count LESS THAN 200
41
what is the TX for HIV? what are the risk groups? what labs would you do after PREP?
1.HAART 2. PEP - start iwthint 72 hours for 28 days 3. PREP - truvada! - LAB: HIV test and creatinine after 3 months - hiv high risk groups are methylsulfonylmethanasse (MSM), IV drug
42
what is non hodgkins lymphoma? what is the CD4 count?
is a co infection with EBV - it has difusse LARGE B cells lymphoma - CD4 LESS THAN 100, VL more than 100l
43
what is primary CNS lymphoma? DX? TX?
- non infectious differnetial for CNS in pt with advanced HIV/AIDS - DX: CT or MRI of brain TX: HAART
44
what is kapsoi sarcoma, where is it found, what does it promote? ? what is the TX and two ass?
1. it is ass w receptive and sex and # of partner 2. found in saliva and semen 3. promotes spindle cell proliferation and angiogeneiss= tumor forms :( 4. HIV ASS: cutanoeus violacous vascualr purple lesion on mucus memebrnae or skin 5. non HIV ASS: skin and mediterrannean and eastern europen 6. TX: localized is cryto systemitc: HAART
45
what is HZS? what type of infection is it?
- Caused by varicella zoster virus (VZV), DNA virus, increases RATE if immunocomprised - Primary infection  respiratory route
46
what is the SX DX TX for HZS?
SX: 3 or more dermotmal unilateral eruption, facial and ocular infection M/C throacolumbar region DX - TZANK SMEAR OF VESICLE which will show multinucleated syncytical giant cell and intracellular inclusion bodies TX: acyclovir for host cell immunosupression pt - IV acyclovir zoster vaccine
47
what is the diff between candida eso and oral hairy cell leukoplakia? what is the TX for both?
1. candida esophagus - CD4 less than 350 - CAN BE EASILY SCRAPED OFF TX: fluconazole or nystatin 2. Oral hairy cell leukoplakia - CD4 less than 350 maybe? - CANNOT be scrapped off tx: Acyclovir (since it has viral orgin such as from EBV, HIV, HPV)
48
what is pneuocystic penumonia (PCP)? what is the CD4 count? SX DX TX?
- PCP is caused by peumocystic jirovecii - CD4 count is LESS than 200 - infect rat - interingly enough, it infect alot of ppl we just dont know ! SX: dry cough, NO SPUTUM , dyspnea, hypoxemia DX: CXR you will see bilateral intersitial infiltrates TX: BACTRIM (sulfamethoxate + trimethoprim)
49

Clin med 2 (7 decks)

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