ID (Pearls of Wisdom) Flashcards by Heather Michelle

What is the mciroscopic appearance of Candida albicans?

either as a singular oval budding yeast or as pseudohyphae

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A M pt w/ AIDS (CD4 160), presents w/ substernal odynophagia, GER, & nausea. His tongue & buccal mucosa have thickly coated white plaques that are removable when scraped w/ a tongue blade. What is his dx?

Esophageal candidiasis 2ndary to immune compromised state

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What would a pt’s CXR reveal during the early stages of a Cryptococcus infxn?

A SOLITARY nodule or diffuse noncalcified infiltrates

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What is the DOCs for the tx of Cryptococcus?

Amphotericin B for 2 wks followed by fluconazole for 6 wks

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What is the DOC for the tx of a histoplasmosis infxn?

Amphotericin B

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What is the DOC for the tx of pneumocystis infxn?

Oral Bactrim

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A 32 yo M has an insidious onset of fever, fatigue, & nonproductive cough x 4-wk period. He reports h/o intermittent IV drug abuse for 10 yrs. CXR shows bilateral diffuse interstitial infiltrates & labs indicate LDH of 450. Dx?

Pneumocystis PNA

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What is the MCC of STD in the U.S.?

Chlamydia trachomatis infxns

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A sexually active 17 yo F presents w/ complaint of vague pelvic pain, dysuria, freq., & urgency. Pelvic is (+) for cervicitis, & cervical motion tenderness. UA is (+) for >5-10 WBC/hpf & 3+ leukocyte esterase. Most likely pathogen?

Chlamydia trachomatis

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DOC for the tx of sexually transmitted Chlamydia?

Azithromycin

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As a medical relief aid assigned to an encampment for victims of the Haitian earthquake, over a 3-day period, you observe several members of the camp develop diarrhea that has the appearance of colorless “rice water” stools. NO abd p!, but many are dehydrated. dx?

Vibrio cholera outbreak

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Family presents w/ their 4 yo child who has a cough, sore throat, & worsening hoarseness x5-7d. On PE she is febrile (101.8) & has multiple throat exudates that coalesce into a gray film covering most of the tonsils & pharynx. cause of sx?

Diptheria caused by Corynebacterium diptheriae

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Neisseria gonorrhea is confirmed by what type of laboratory test?

Gram stain

- see Gram neg. diplococci

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A 10 yo F presents w/ a H&P that is consistent w/ vaginitis producing thick, purulent yellow discharge. What is the most likely pathogen?

Neisseria gonorrhea

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What is the recommended initial tx for cases of gonorrhea?

3rd-gen. cephalosporin (Rocephin) + Azithromycin or doxycycline

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What is the MCC of bacterial entercolitis in the U.S.?

Salmonella infxn

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What is the 1st-line tx for salmonella entercolitis?

fluid & electrolyte replenishment

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What is the pharmacological tx for persistent salmonellosis?

Ampicillin, TMP-SMX, cipro

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What is the microscopic makeup of Shigella sp?

facultative anaerobe, gram-neg. bacillus

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What is the tx for Shigella sp?

TMP-SMX or cipro

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What causes tetanus?

Clostridium tetani

Gram pos. anaerobic rods

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What is the MC infectious dz complication of both measles & influenza?

Pneumococcal PNA

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What is the tx for persistent E. Coli?

TMP-SMX

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What is the tx for Giardia lamblia?

Tinidazole, metronidazole

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What type of bacteria is TB?

acid-fast bacillus

What is the MC nonadverse SE of rifampin?

orange discoloration of urine & tears

What is the MC intestinal parasite in the U.S.?

Giardia

Which parasite may be found in 25-50% of women, causes a watery, foul-smelling vaginal discharge, & has the microscopic appearance of a pear-shaped org. w/ 4 flagellates anteriorly?

Trichomonas vaginalis

What is the abx of choice for Trichomonas vaginalis?

Metronidazole

What is the most deadly form of malaria?

Plasmodium falciparum

How is malaria diagnosed?

Visualization of parasites on Giemsa-stained blood smears.

What is the DOC for treating Plasmodium vivax, Plasmodium ovale, & Plasmodium malariae?

Chloroquine

A 5-yo M presents w/ his mother complaining of anal itching esp. at night for the last 3 d. After performing the "Scotch tape" test, small whitish worms are stuck to the tape when viewed under a microscope. Dx?

Pinworms

What is the MC helminth in the U.S.?

Enterobius (pinworms)

What is the MC physical complaint in individuals w/ an Enterobius infxn?

Perianal pruritus

What is the tx for pinworms?

Mebendazole

Name the MC form of transmission for toxoplasmosis?

ingestion of cysts via uncooked or cured meats or feline feces

What is the most frequently transmitted tick-borne dz?

Lyme dz | -caused by the spirochete Borrelia burgdorferi

During which months are the incidence of RMSF the highest?

April through September

A pt presents a 40C fever & a erythematous, macular, & blanching rash which becomes deep red, dusky, papular, & petechial. The pt is vomiting & has a HA, myalgias, & cough. Where did the rash begin?

on the flexor surfaces of the ankles & wrists & spreads centrally to the arms, leg, & trunk

Which Abx are prescribed for the tx of RMSF?

tetracycline or chloramphenicol

A 24 yo M pt presents w/ a PAINLESS ulcer to the glans penis. He reports that his last sexual encounter was approx. 3 wks ago. What is the most likely dx assoc. w/ this lesion?

Primary chancre from syphillis

What is the MC lesion that is seen in secondary syphillis?

Condyloma lata

A pt is infected w/ Treponema pallidum. What is the tx?

benzathine PCN G or doxycycline

What is the recommended tx for neurosyphilis?

IV PCN G

In U.S., CMV is the MCC of what type of infxn?

Congenital infxns

What is the tx for CMV infxns?

Ganciclovir

What causes infectious mononucleosis?

EBV

What is the tx for EBV?

Mainly supportive care, hydration, pain meds for sore throat, APAP for fever, & prevention of injury of spleen

What causes erythema infectiosum?

parvovirus B19

What is the main transmission of HSV-1 & HSV-2?

HSV-1: Contact w/ oral secretions or lesion, oral genital contact HSV-2: sexual contact

What is the tx for pts w/ HSV?

acyclovir

What is the MC opportunistic infxn in AIDS pts?

Pneumocystis carinii (PCP)

What strain of influenza is more common in adults? In children?

Adults: Influenza A Children: Influenza B

What strain of influenza is most virulent?

Influenza A

Influenza epidemics & pandemics are generally assoc. w/ which strain of influenza?

Influenza A

Name 2 drugs approved for the tx of influenza.

Oseltamivir (Tamiflu) & zanamivir (Relenza)

Amantadine is 70-90% effective in preventing which strain of influenza?

influenza A

What is a potential resp. complication to influenza?

bacterial PNA

What is the MC pathogen for this PNA assoc. w/ influenza?

S. aureus

What is the MC clinical finding on exam in a pt w/ mumps?

parotid gland swelling

What is a key exam that must be done in a male pt w/ mumps?

you must examine the scrotum to look for acute orchitis

What is the tx for mumps?

none

The hallmark lesion of CNS rabies is:

Negri bodies

What is the etiology of roseola infantum?

human herpes virus 6

What are the hallmark features of roseola?

high-spiking fevers up to a wk followed by a rose-pink maculopapular rash

What is the characteristic of a rash caused by measles?

it is a maculopapular rash

Which vitamin deficiency will cause a worsening of the measles virus?

vitamin A

What is the MCC of foodborne viral gastroenteritis?

Norwalk virus commonly found in shellfish

What is the MC presentation of cryptococcosis?

Fungal meningitis w/ Cryptococcus neoformans