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Clin med 2 > ID exam 2 > Flashcards

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
Q

is trichomas vaginalis sexturally transmitted? what are the SX, DX and TX? what is the PH

A
  1. YELLOW GREEN GREY DISCHARGE WITH FISHY ORDER
  2. STRAWBERRY CERVIX
  3. PH&raquo_space;> 4.5
  4. SEXALLY TRASMITTED
  5. on the vaginal smear, you will see motile trichomonads
  6. TX: oral metro only
26
Q

Risk factor of bacterial vaginosis, SX, DX, TX?

A
  1. bad bacteria overflowing casued by garnerella vaginalis
  2. RF: new sex partner, douching :(
  3. WHITE GRAY DISCHARGE, CERVIX IS NORMAL
  4. PH&raquo_space;» 4.5
  5. smear will show clue cells
  6. TX: oral metro and vagina metro
27
Q

what is the SX DX TV for candida vaginitis?

A
  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
Q

how would u dx HSV and TX?

A
  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
Q

what are the 3 stages of syphillis?

A
  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
Q

how would u DX syphillis?

A

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
Q

how would u TX syphyllis?

A

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
Q

what causes chancroid, what is the SX and TX?

A
  • haemophilis ducreyi (gram neg coccbacillus) casues chancroids
  • SX: PAINFULL gential ulceration with lymphadenopathy
  • TX: azithro or ceftriaxone, ciprofloxcin, erythro
33
Q

what is lymphogranulma venerum? what is the SX and TX?

A

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
Q

what is MONO, what is the SX And DX?

A
  • 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
Q

what is EBV non infectious risk for?

A

oral hairy leukoplakia HIV, nasopharyngeal CA, Burkitt’s lymphoma

36
Q

when do sx start for HIV and how long does it last?

A

SX - begins 1-4 weeks after infection

Duration: 10-14 days, can be severe and last up to 10 weeks

37
Q

how does HIV happen?

A
  • 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
Q

what are the SX for HIV?

A

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
Q

how would u dx HIV?

A

primary HIV - you will have detectable HIV-RNA in plasma
- HIV AB /western blot

40
Q

what is the CD4 count for acute HIV infection?

A

CD4 count LESS THAN 200

41
Q

what is the TX for HIV? what are the risk groups? what labs would you do after PREP?

A

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
Q

what is non hodgkins lymphoma? what is the CD4 count?

A

is a co infection with EBV
- it has difusse LARGE B cells lymphoma
- CD4 LESS THAN 100, VL more than 100l

43
Q

what is primary CNS lymphoma? DX? TX?

A
  • non infectious differnetial for CNS in pt with advanced HIV/AIDS
  • DX: CT or MRI of brain
    TX: HAART
44
Q

what is kapsoi sarcoma, where is it found, what does it promote? ? what is the TX and two ass?

A
  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
Q

what is HZS? what type of infection is it?

A
  • Caused by varicella zoster virus (VZV), DNA virus, increases RATE if immunocomprised
  • Primary infection  respiratory route
46
Q

what is the SX DX TX for HZS?

A

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
Q

what is the diff between candida eso and oral hairy cell leukoplakia? what is the TX for both?

A
  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
Q

what is pneuocystic penumonia (PCP)? what is the CD4 count? SX DX TX?

A
  • 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
Q
A

Clin med 2 (7 decks)

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