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Clinical Medicine > ID pt 2 > Flashcards

ID pt 2 Flashcards

1
Q

COVID dx

A

PCR/ NAAT

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2
Q

COVID tx

A

paxlovid

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3
Q

what are 4 types of polio?

A
  1. abortive
  2. nonparalytic
  3. paralytic
  4. post-poliomyelitis syndrome
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4
Q

s/s of abortive polio

A

nonspecific illness
- fever
- HA
- constipation
- sore throat
- n/v/d

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5
Q

s/s of nonparalytic polio

A
  • nonspecific illness
  • meningeal irritation and muscle spasms
  • no paralysis
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6
Q

s/s of paralytic polio

A
  • flaccid asymmtric paralysis affecting proximal muscles of lower extremities
  • sensory loss is rare
  • spinal- impacts spinal nerves
  • bulbar- impacts CNs and can lead to respiratory paralysis
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7
Q

s/s of post-polio syndrome

A
  • progressive muscle paresis and atrophy
  • fasiculations and fibrillation
  • restless leg syndrome
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8
Q

dx of poliomyelitis

A

PCR of washings, stools, CSF

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9
Q

tx of polio

A

suportive

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10
Q

polio vaccination schedule for children

A

4 doses
- 2 mo, 4 mo, 6-18 mo, 4-6 yrs old

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11
Q

polio adult vaccination scheudle

A

3 doses
- 1st dose, 2nd dose 1-2 mo later, 3rd dose 6-12 mo after 2nd

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12
Q

s/s of active TB

A
  • fever
  • night sweats
  • weight loss
  • hemoptysis
  • productive cough
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13
Q

a primary TB infection can progress to what 3 stages?

A
  • active/ primary progression
  • latent TB
  • termination
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14
Q

list a few s/s of disseminated TB/ miliary TB

A
  • meningitis
  • Addison’s disease
  • Pott’s disease
  • erythema nodosum
  • hepatitis
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15
Q

CXR of primary or latent TB would show what finding?

A

Ghon focus/ complex

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16
Q

CXR or CT findings in active TB

A

cavitary lesions in lung apices

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17
Q

active TB tx

A

PIER
- pyrazinamide (PZA)
- isoniazid (INH)
- ethambutol (EMB)
- rifampin (RIF)

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18
Q

latent TB tx

A

INH or RIF

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19
Q

s/s of atypical tuberculosis

A
  • skin and soft tissue findings: abscesses, arthritis
  • lymphadenitis: MAC in children
  • eyes: keratitis and retinal lesions
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20
Q

dx of atypical mycobacterial disease

A

culture of sputum, blood or urine

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21
Q

tx of MAC

A

azithromycin or clarithromycin
and
ethambutol
and
rifampin or rifabutin

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22
Q

syphilis cause

A

treponema pallidum

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23
Q

s/s of primary early/ infectious syphilis

A

painless chancre
non-tender regional lymphadenopathy

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24
Q

s/s of secondary early/ infectious syphilis

A

systemic symptoms- generalized lymphadenopathy
rash- non-pruritic, includes palms and soles
condyloma lata
lesions distant from site of inoculation

*most infectious stage

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25
Q

this stage of syphilis is highly infectious and lasts up to 1 yrear after initial infection. Infectious lesions may recur.

A

early latent stage

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26
Q

this stage of syphilis is noninfectious except transplacentally and occurs more than 1 yr after initial infection.

A

late latent

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27
Q

what are 2 types of late syphilis?

A

tertiary or neurosyphilis

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28
Q

major findings of tertiary late syphilis

A

gumma- infiltrative tumor with rapid onset
cardiac syphilis- aortitis and other heart findings

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29
Q

neurosyphilis findings

A
  • meningitis, dementia, HL, psychosis
  • tabes dorsalis–> loss of virbration and proprioception
  • general paresis
  • argyll robertson pupil
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30
Q

argyll robertson pupil

constricts with _______ but not to _____

A

accommodation
light

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31
Q

tx of syphilis

A

IM PCN G
neurosyphilis- IV PCN

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32
Q

lyme disease stage 1 (early localized) s/s

A

erythema migrans
viral like illness- myalgias, fatigue, HA

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33
Q

lyme disease stage 2 (early disseminated) s/s

A

aseptic meningitis
bilateral CN7 palsy
cardiac issues- AV block

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34
Q

lyme disease stage 3 (late persistent) s/s

A

MSK- joint pain/ swelling
neuro findings
AMS, mood changes, ect

35
Q

diagnostic standards for lyme disease

A

1- exposure to endemic area
2- documented erythema migrans within 30 days OR one late manifestation
3- lab confirmation

36
Q

lab confirmation of lyme disease

A

ELISA and western blot
elevated ESR and liver enzymes

37
Q

tx of lyme disease

A

doxycycline

38
Q

4 requirements for lyme disease prophylaxis

A

1- attached for 36 hrs or more
2- started within 72 hrs of removal
3- more than 20% of ticks in area infected
4- no doxy contradictions

39
Q

relapsing fever s/s

A

abrupt onset fever, chills, tachy, severe HA, ect for 3-10 days, then relapse occurs 1-2 wks later

40
Q

dx of relapsing fever

A

blood smear with wright or giemsa stains
PCR

41
Q

tx of relapsing fever

A

IV PCN G or ceftriaxone

42
Q

how long must the tick be attached for lyme disease to be transmitted?

A

24-36 hrs

43
Q

how long does the tick need to be attached for rocky mountain spotted fever to be transmitted?

A

6-10 hrs

44
Q

rocky mountain spotted fever s/s

A

abrupt onset fever and HA
rash- small blanching pink macules that spread into petechiae-> involvement of palms and soles
chills, malaise, hard palate lesions, conjunctival injection

45
Q

dx of rocky mountain spotted fever

A

skin biopsy with immunohistology or PCR

46
Q

tx of rocky mountain spotted fever

A

doxycycline
pregnancy- chloramphenicol

47
Q

ehrlichisosis s/s

A

high fever
rigors
pleomorphic rash- many stages at once

48
Q

tx of ehrlichiosis

A

doxycycline
pregnancy- rifampin

49
Q

amebiasis s/s

A

dysentery- bloody diarrhea, colitis, abd pain
necrotizing colitis- hemorrhage, perforation
extraintestinal- liver abscess, hepatomegaly,** RUQ pain,** weight loss, high fever

50
Q

amebiasis tx

A

metronidazole or tinidazole + luminal agent
- luminal agents: diloxanide, idoquinol, paromomycin

51
Q

this protozoan disease is common in healthy pts who recently went swimming in lakes or heated swimming pools

A

naegleria fowleri

52
Q

naegleria fowleri s/s

A

primary amebic meningoencephalitis (PAM)
- fever, neck stiffness, HA
- photophobia, 3, 4, and 6 CN palsies, AMS
- coma and death

53
Q

tx of naegleria fowleri

A

amphotericin B
rifampin
miltegosine
azithromycin
steroids

probably won’t be on exam via Wil

54
Q

this protozoan disease is common in pts with history of camping and lake water exposure

A

giardiasis

55
Q

s/s of giardiasis

A

explosive, foul smelling nonbloody diarrhea
- stools are frothy/ greasy
- weight loss, malabsorption, vitamin deficiencies

56
Q

dx of giardiasis

A

stool wet mount
stool antigen assays

57
Q

tx of giardiasis

A

metronidazole or tinidazole
pregnancy- paromomycin
treat contacts

58
Q

s/s of malaria

A

HA and fatigue
irregular paroxysms of fever and diaphoresis (sweats)

59
Q

dx of malaria

A

giemsa stained blood smears
rapid antigen tests

60
Q

tx of malaria

A

non-falciparum- chloroquine
* vivax or ovale- add primaquine

falciparum- ACTs: artemether-lumefantrin
severe-** IV artesunate**

61
Q

toxoplasmosis s/s in healthy pts

A

asymptomatic
mono-like illness
* non-tender bilateral lymphadenopathy
* sore throat

62
Q

toxoplasmosis s/s in immunocompromised

A

encephalitis
pneumonitis
chorioretinitis
necrotizing brain lesions

63
Q

congenital infection of toxoplasmosis s/s

A
  1. chorioretinitis
  2. hydrocephalus
  3. intracranial calficiations

blueberry muffin rash
seizures
spontaneous abortion

64
Q

this is the late manifestation of toxoplasmosis that may present years after congenital infection

A

retinochoroiditis
* eye pain
* photophobia
* glaucoma or blindness

65
Q

what does CT scan show for toxoplasmosis

A

ring-enhancing lesions

66
Q

toxoplasmosis tx

A

immunocompetent- self limited
immunocompromised/ congenital/ pregnancy >14 wks- pyrimethamine + sulfadiazine w/ folinic acid
pregnancy <14 wks- spiramycin

67
Q

trichomoniasis s/s

A

copious, purulent malodorous frothy discharge
hemorrhages in vaginal walls
strawberry cervix
dysparenunia
males- minimal discharge

68
Q

trichomoniasis dx

A

wet mount
NAAT

69
Q

tx of trichomoniasis

A

metronidazole
2nd line- tinidazole

70
Q

s/s of hookworm/ round worm

A

rash- pruritic at site of penetration, serpiginous tracts
lungs- cough, wheezing, low fever
GI- epigastric pain, diarrhea
nutritional def- iron deficiency (anemia) and protein loss (hypoalbuminemia, edema, ascites)

71
Q

dx of hookworm/ roundworm

A

stool microscopy
CBC- eosinophilia, anemia, hypoalbuminemia
iron def

72
Q

tx of hookworm/ roundworm

A

albendazole
iron supplements and vitamins

73
Q

this type of tapeworm infection may lead to neurocysticercosis

A

pork- taenia solium

74
Q

this type of tapeworm may lead to megoblastic anemia due to B12 def

A

fish- diphyllobothrium latum

75
Q

this type of tapeworm may lead to pruritis ani, anorexia, weight loss and crampy abd pain and seizures

A

dwarf- hymenolepis nana

76
Q

dx of non-invasive tapeworms

A

proglottids in stool

77
Q

tx of non-invasive tapeworms

A

praziquantel
dwarf requires more than 1 dose

78
Q

s/s of invasive taenia solium

A

neurocysticerosis
* increased ICP
* seizures
* AMS
* psych disease

extraneural cysticerosis- muscle and subcutaneous invovlement

79
Q

dx of invasive taenia solium

A

imaging- CT and MRI
* parenchymal cysts and calcifications

lab
* CSF
* serology

80
Q

tx cysticercosis

A

viable or degenerating parenchymal cysts- albendazole + corticosteroids

if more than 2- add praziquantel

81
Q

echinococcosis s/s

A

abd pain, biliary obstruction, cholangitis, portal HTN, cirrhosis
CP and bronchial obstruction

82
Q

tx of echinococcosis

A

albendazole

83
Q

pinworm s/s

A

nocturnal pruritis ani
insomnia and restlessness
enuresis
severe- abd pain and n/v

84
Q

tx of pinworms

A

albendazole, mebendazole or pyrantel
pregnancy- only treat if severe w/ pyrantel

Clinical Medicine (7 decks)

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