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Clin Med II > ID General > Flashcards

ID General Flashcards

1
Q

When should you start HIV screening?

A

DC- 13-65 yrly

CDC- 15-65

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2
Q

What is the the most common non-tuberculous pulmonary mycobacterial infection?

A

M. kansasii

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3
Q

What is IRIS?

A

Severe decline in clinical status after ART initiation despite improved immune function due to inflammatory response against infectious agent

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4
Q

How often should you do cervical ca screening in HIV infected women?

A

2x a yr when first HIV +

Then yearly if normal and no change in sexual partner, use of safe sexual practices, no history of sexual abuse, and no symptoms

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5
Q

Fever

A

> 37.2 C (98.9 F) in the morning and 37.7 C (99.9 F) in the evening + ↑ hypothal set point

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6
Q

FUP

A

Fever > 38.3 C (101 F) & illness lasting 3 weeks & no known immunocompromise

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7
Q

Endocarditis

A

infection of the endocardial surface of the heart (includes valves, septal defects and mural endocardium)

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8
Q

Endarteritis

A

infection of arterial endothelium (includes infected aneurysms, AV fistulae)

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9
Q

What factors predispose immunocompromised pts to infection?

A

Neutropenia and defects in the phagocytic defenses

Defects in cellular immunity

Defects in humoral immunity

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10
Q

What pt pop typically has neutropenia and defects in the phagocytic defenses

A

pts post chemotherapy or other myelosuppressive therapy

bone marrow transplant recipients

acute leukemics

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11
Q

What ANC level is risk of infection significant?

A

<500

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12
Q

In neutropenia and defects in the phagocytic defense pts, what organisms typically colonize skin?

A

Staph, Gram negatives, fungi

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13
Q

In neutropenia and defects in the phagocytic defense pts, what organisms typically colonize oropharynx?

A

oral candidiasis, HSV

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14
Q

In neutropenia and defects in the phagocytic defense pts, what organisms typically colonize lungs?

A

bacterial/fungal pneumonias

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15
Q

In neutropenia and defects in the phagocytic defense pts, what organisms typically colonize colon/perianal area?

A

abscesses

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16
Q

Pt pop CI to get live vaccines (MMR, varicella, ZVL)

A

preg women and immunosupp pts (Must have CD4 >200)

17
Q

What vaccines should a pt who is 19-49 yrs old have?

A

influenza

Tdap or Td

MMR (if born in 1957 or later)

Varicella

18
Q

What is cut off for MMR requirement

A

if born before 1957 don’t need it (assumed you got the dz)

if born in 1957 or later must get vaccine

19
Q

What pt pop should get high dose and adjuvant vaccine of influenza?

A

> 65 and HIV +

20
Q

Severe egg allergy w/ influenza vac

A

administer in an observed setting

21
Q

HPV vaccine recommendation

A

start age 9-14
female by age 26
male by age 22

22
Q

What vaccines should pts who are 65 and above get?

A

Influenza

Tdap or Td

Varicella

RZV (preferred) OR ZVL

PCV13

PPSV23

23
Q

What vaccines should pts who are 50-64 yrs old get?

A

influenza

Tdap or Td

MMR (if born in 1957 or later)

Varicella

RZV (preferred) OR ZVL

24
Q

What vaccines should preg pts get?

A

influenza and tdap or Td

25
Q

What vaccines should immunocomp pts get?

A 
flu
Tdap
HPV (up to age 26)
PCV 13
PPSV23
Hib
26
Q

What vaccines should HIV pts get?

A 
flu
Tdap
MMR and varicella (unless CD4 <200)
HPV (up to age 26)
PCV 13
PPSV23
Hep B
MenACWY
27
Q

What vaccines should MSM get?

A 
flu
Tdap
MMR and varicella
RZV or ZVL (if >50)
HPV (up to age 26)
PCV 13
PPSV23
Hep A
Hep B
28
Q

What vaccines should health care personnel get?

A 
flu
Tdap
MMR
Varicella
RZV or ZVL (if >50)
HPV (up to 26 female and 21 male)
Hep B
29
Q

What age group can varicella immunity be assumed for even if vaccination status is unknown?

A

born in US before 1980

30
Q

When can you give ZVL?

A

> 60 yo but RZV is preferred

31
Q

What is PCV13 and PPSV23 vaccine recommendation?

A

> 65 yo

PCV13 first then 1 yr later PPSV23

If RF can give PPSV23 <65

32
Q

When is Hib vaccine indicated?

A

Aspenia (if elective surg give 2 wks before)

Hematopoetic stem cell transplant (HSCT)

33
Q

SIRS criteria

A

2 or more of the following:

Fever of more than 38°C (100.4°F) or less than 36°C (96.8°F)

Heart rate > 90/min

Respiratory rate >20/min or arterial carbon dioxide (PaCO2)
< 32 mm Hg

WBC >12,000/μL or < 4,000/μL or >10% immature [band] forms

34
Q

What is the significance of elevated lactate?

A

Lactate is a byproduct of anaerobic metabolism. Cells go into anaerobic metabolism when there is not enough oxygen to complete aerobic metabolism.

Lactic acidosis (inc lactate) is a sign of hypoperfusion and hypooxygenation

Clin Med II (19 decks)

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