ID- Popcorn Flashcards
The following is the general “criteria” for what?
- Fever >38.3degC (100.9F)
- At least 3wks duration
- No dx after 3 outpt visits or 3 days of hospitalization
Fever of unknown origin
What are the 3 MC etiologies of Fever of Unknown Origin (FUO)?
- Infection
- Malignancy
- Connective Tissue Disease
What is the #1 MC malignancy to cause FUO (fever of unknown origin)?
Lymphoma, especially non-hodgkins
What is the main site of colonization of staphylococcal infections?
Nose
Is staph aureus coagulase negative or positive
positive
(Staph epidermidis and staph saprophyticus are both coag neg)
- Which staphylococcal strain is a frequent skin contaminant of blood cultures?
- What do you do to confirm whether a contaminant or a true cause of bacteremia?
- Staph epidermidis
- May have to draw from 2 sites
Which bacteria causes infections of:
- Urine catheters
- IV lines
- Prosthetic joints/heart valves
- Dialysis catheters
Staph epidermidis
Which staphylococcal strain is coagulase negative and is a leading cause of UTIs?
Staphylococcus saprophyticus
What is the etiology of TSS?
Staph aureus
Clinical presentation of what?
- Abrupt onset high fever
- Vomiting & watery diarrhea
- Sore throat, myalgias, h/a
- Hypotension with kidney and heart failure
- Diffuse macular erythematous rash and nonpurulent conjunctivitis
- Desquamation, esp. of palms & soles (late finding)
TSS
Lab findings in TSS are consistent with what?
shock and organ failure
What is empiric antibiotic tx for TSS?
Clindamycin + Vanco
(Also needs rapid rehydration–> 3L)
What condition is caused by Staph aureus and is primarily in neonates 3-15 months old?
Staph Scalded Skin Syndrome (SSSS)
Clinical presentation of which condition?
- Prodrome: fever, irritability
- Erythematous patches with large superficial fragile blisters
- When blisters rupture, skin appears red and scalded
- Nikolsky sign (only the first layer)
Staph Scalded Skin Syndrome (SSSS)
Diagnosis of what?
- Clinical with cultures
- Skin biopsy shows intraepidermal cleavage without necrosis**
Staph Scalded Skin Syndrome (SSSS)
What type of abx should be used to tx SSSS? If there is no response, what 2 meds should you consider?
- Penicillinase-resistant beta-lactam agents (Nafcillin)
- If no response, consider MRSA & tx with vancomycin
Etiology of Anthrax?
Bacillus anthracis
T/F: there has been bioterrorism w/ anthrax spores
True
Hallmark of what condition?
- Painless eschar with extensive surrounding edema
(will be on exam)
Cutaneous clinical syndrome of Anthrax
What causes:
- hemorrhagic mediastinitis
- occasionally necrotizing pneumonia
- Bacteremia
Inhalation clinical syndrome of Anthrax (the most dangerous form)
Which clinical syndrome has a prodrome including sxs like hemoptysis and dyspnea and can resultmin death within days
INHALATION clinical syndrome of Anthrax
What is seen on CXR of the inhaled form of Anthrax?
(will be on exam)
Widened mediastinum
What is the GI form of Anthrax from?
consumptom of undercooked, infected meat from animals infected with anthrax
Which infectious disease causes:
- Necrotic ulcers surrounded by extensive edema of infected intestinal segment and adjacent mesentery
- Can cause GI hemmorrhage
GI tract clinical syndrome of Anthrax
How do you tx anthrax if it is systemic w/ meningitis?
- Report/consult public health department
- Cipro + meropenem + Linezolid
- Antitoxin
- etc.
How do you tx Anthrax that is systemic WITHOUT meningitis?
- Report/consult public health department
- Cipro + Clinda
- Antitoxin
- etc.
How do you treat cutaneous Anthrax?
- Report/consult public health department
- _Ciprofloxacin**_
- Antitoxin
- etc.
***definitely know abx- will be on exam***
Which type of anthrax has the highest mortality rate? (cutaneou, injection, GI, inhalation or anthrax meningitis)
- Anthrax meningitis- even with treatment, mortality is 100%
- Inhalation is also very deadly with mortality rate of 45%
What is post-exposure prophylaxis for patients exposed to aerosolized B. anthracis (anthrax)?
Start Cipro w/in 48hrs- treat for 60 days
+
3 dose series of Anthrax vaccine
What is usually transmitted by the infected saliva of a bat, raccoon or skunk?
Rabies (caused by rhabdovirus)
Which infectious disease?
- Virus travels in nerves to the brain, multiplies in brain, then travels along efferent nerves to salivary glands
- Forms cytoplasmic inclusion bodies – site of viral transcription & replication
Rabies
What infectious disease causes percussion myoedema (mounding of the muscle at the percussion site)?
Rabies
What are the two types of CNS presentations of Rabies? What do both forms progress to?
•“furious” – encephalitic
•“dumb” – paralytic
*both forms progress to coma, ANS dysfunction, death
“Furious” (encephalitic) or “dumb” (paralytic) form of rabies?
- MC
- paranoia, terror
- Hydrophobia
- unquenchable thirst
- oversalivating
- Death by cardiac arrest
Furious (Encephalitic) rabies
“Furious” (encephalitic) or “dumb” (paralytic) form of rabies?
- gradual coma
- NO hydrophobia
- paralysis
- muscle weakness and loss of sensation
- death
Paralytic rabies
(this is less dramatic and usually longer course than furious rabies)
How do you diagnose rabies? (4)
- test animal if possible
- PCR of saliva
- viral culture of saliva
- Full thickness skin biopsy from posterior region of neck at hairline
How do you prevent rabies? (this is the main tx)
Immunize household pets and ppl w/ signifcant animal exposure
What is PEP and PrEP for rabies?
PEP= Human rabies immune globulin, Rabies vaccine
PrEP= Human diploid cell vaccine
