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clin med > ID slide 77- > Flashcards

ID slide 77- Flashcards

1
Q

Tetanus organisms and transmission

A

clostridium tenant when spores inthe soil enter a wound

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2
Q

incubation Tetanus

A

8-12 days

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3
Q

ss Tetanus

A

tingling at site, pain, muscle spasticity THEN jaw stiffness and spasm, irritability, hyperreflexia, painful convulsion… pt is awake and alert (not paralyzed)

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4
Q

dx Tetanus

A

clinical

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5
Q

trmt Tetanus

A

tetanus immune globulin IM + immunization. Sedation, ventilation, paralytic medications. PCN IV to prevent toxin production

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6
Q

tetanus has a _____

A

vaccine

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7
Q

what would types are highest risk for tetanus

A

puncture

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8
Q

listeria monocytogenes is a ______

A

gram + rod

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9
Q

transmission listeria

A

ingesting contaminatedunpasteurized dairy/ deli meat

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10
Q

ss listeria

A

fever, chills, FUO in pregnancy or neonates

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11
Q

if pregnant women get listeria while pregnant, there is a _____ risk for fetus

A

high

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12
Q

dx listeria

A

culture

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13
Q

trmtlisteria

A

IV ampicillin or gentamicin

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14
Q

transmission botulism

A

ingestion of contaminated food/ drink usually home canned or smoked foods EX: church picnic

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15
Q

ss botulism

A

sudden onset weakness if healthy person 72hrs after ingestion: blurred vision, unreactive pupils, dry mouth, paralysis

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16
Q

botulism dx

A

toxins in pts serum and food

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17
Q

botulism trmt

A

trivalent antitoxin

pts usually need to be admitted and need ventilation

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18
Q

avoud swollen or dented canned foods, cracked vaor, milky/off odor or else you might get this

A

botulism

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19
Q

transmission cholerae

A

ingestion of contaminate food/water

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20
Q

ss cholerae

A

endemic travel, rice water stool, HUGH dehydration; 15 L a day

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21
Q

dx cholerae

A

stool culture and agglutination of vibrios

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22
Q

trmt cholera

A

remove contamination, give fluids, ATB: tetracycline, ampicilllin, cipro, azithromycin

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23
Q

transmission salmonellosis typhi

A

humans eat contaminated food/drink then spreads it by poop

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24
Q

salmonellosis typhi incubation

A

5-21 days

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25
Q

ss salmonellosis typhi

A

Typhoid fever. Malaise, HA, abdominal pain/distention, N/V, constipation or diarrhea, rose spots (2nd week), fever plateau at 7-10 days and patient is more ill, may have splenomegaly

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26
Q

salmonellosis typhi dx

A

Blood culture (+50-70%), stool culture (+30-40%), widal test-serology, positive can mean previous or current infection

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27
Q

salmonellosis typhi trmt

A

Ciprofloxacin

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28
Q

carriers of this disease shouldnt handle food

A

salmonellosis typhi

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29
Q

salmonellosis typhi complication

A

intestinal hemorrhage, shock, death

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30
Q

salmonellosis nontyphoid transmission

A

food contaminated with human or bird, farm animal ,reptil, or pet fecal matter

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31
Q

ss salmonellosis nontyphoid

A

gastroenteritis

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32
Q

causes of salmonellosis nontyphoid

A

eating raw eggs and raw chicken

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33
Q

incubation salmonellosis nontyphoid

A

6 hrs- 3 days… shorter than salmonellosis typhi

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34
Q

shigellosis transmission

A

fecal oral

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35
Q

body area affected in shigellosis

A

GI system

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36
Q

incubation shigellosis

A

6 hrs-7 days

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37
Q

ss shigellosis

A

sudden severe abdominal cramping, fever, NV, watery stool then bloody stool

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38
Q

dx shigellosis

A

stool culture- will have organism, RBC and WBC

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39
Q

trmt shigellosis

A

hydration, usually resolves after 7 days if unreated, if severe give cyprofloxacin

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40
Q

camplobactr organism

A

camplobactr jejuni

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41
Q

campylobactr incubation

A

2-5 days

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42
Q

campylobactr host

A

dairy cattle and poultry

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43
Q

transmission campylobactr

A

eating contaminated food/ drink from undercooked poultry or raw unpaasteurized milk

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44
Q

ss campylobactr

A

fever abd pain, bloody, watery, or loose diarrhea

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45
Q

dx campylobactr

A

stool culture

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46
Q

trmt campylobactr

A

usually resolves without trmt, but can give ciprofloxacin if needed

47
Q

MCC diarrheal illnesses in US

A

campylobactr

48
Q

cat scratch disease organism

A

bartonella henselae, gram - rod

49
Q

transmission cat scratch disease

A

caat bite or scratch

50
Q

incubation cat scratch disease

A

3-10 days

51
Q

ss cat scratch disease

A

papule/pustule with pus that is red and tender at site that lasts 1-3 wks
may have malaise, fever, HA, sore throat, regional lymphadnopathy

52
Q

cat scratch disease hallmark

A

regional lymphadnopathy

53
Q

cat scratch disease common areas affected

A

axillary, epitrochlear, cervical

54
Q

cat scratch disease dx

A

usually clinical but can do serology testins

55
Q

trmt for localized lymphadenitis in cat scratch disease

A

azithromycin

56
Q

who is cat scratch disease usually infecting

A

young, immunocompetent

57
Q

organism in dog bites

A

usually pasteurella spp. (canis) which is gram -

58
Q

trmt dog bites

A

augmentin 5-7 days

59
Q

dog bites are ___ % of er visits

A

1

60
Q

t or f: not many untreated dog bites become infected

A

true

61
Q

most important trmt for dog bites

A

cleaning and irrigation of wound, but do not suture

62
Q

when should we give atb for a dog bite

A

in high risk bite areas

63
Q

cat bites organism

A

pasteurella multocida, a gram - coccobacillus

64
Q

cat bites trmt

A

augmentin

65
Q

___% of cat bites become infected without trmt

A

80

66
Q

what do all catbites need

A

PPX atb

67
Q

why are cat bites hard to clean?

A

they have more narrow and sharp teeth so they can get in wounds easier

68
Q

organism in rabies

A

rhabdovirus

69
Q

what transmits rabies in the US

A

bats, raccoons, skunks, foxes… not many dogs in the US

70
Q

transmission of rabies

A

animal bites human and transmits it through the open wound

71
Q

what area of the body is affected in rabies

A

brain- resulting in encephalitis

72
Q

incubation of rabies

A

3-7 wks but can be years

73
Q

areas affected in rabies

A

asia and africa

74
Q

ss rabies

A

hx of animal bite, pain at site, fever, maliase, NV, CNS sx,

75
Q

dx rabies

A

biting animals are quarantined for 10 days and observed for sx. if animal cant be tested treat ppx. animals can get a brain biopsy and can confirm with viral CSF viral isolation

76
Q

rabies trmt

A

if untreated, fatal within 7 days of onset of sx from respiratory failure. need passive and active vaccination; HRIG + vaccine
ppx trmt is 100% effective!!!

77
Q

what animal is MC assoc with rabies

A

bats

78
Q

how do we prevent rabies

A

vaccinate animals, clean and irrigate bite, do not suture wounds

79
Q

rose spots are in this disease

A

salmonella typhi

80
Q

transmission norovirus

A

fecal oral

81
Q

incubation norovirus

A

24-48 hrs

82
Q

ss norovirus

A

vomiting, watery diarrhea, and cramping that lasts 48-72 hrs

83
Q

dx norovirus

A

usually clinical but can check stool

84
Q

trmt norovirus

A

replace fluids and electrolyte balance

85
Q

common outbreaks of norovirus

A

cruise ships and schools

86
Q

MCC of eppidemic gastroenteritis worldwide

A

norovirus

87
Q

how long is norovirus shed in the stool

A

4 wks

88
Q

varicella zoster is ____ contagious

A

highly

89
Q

transmission of varicella zoster

A

contact with lesion or inhalation of drops

90
Q

incubation varicella zoster

A

2 wks

91
Q

ss varicella zoster

A

primary infection- varicella- pruritic rash (chx pox)

reactivation- zoster- painful dermatomal rash (shingles)

92
Q

dx varicella zoster

A

scrapt base of smear and look for multinucleated giant cell on Tzanck smear

93
Q

varicella (chicken pox) ss

A

pruritic centrifugal papular changing to vesicular, dewdrops on a rose petal

94
Q

trmt varicella (chicken pox)

A

antihistamines, calamine lotion

95
Q

vzv shingles rash

A

tingling, pain, vesicules in a dermatomal distribution evolving to pustules then crusting; pain comes before the rash, only 1 dermatome is affected

96
Q

ramsay hunt synd

A

facial palsy with lesions on the ear, tm, vertigo, dizziness, and deafness

97
Q

hutchinson sign

A

lesions on the tip/side of nose and inner corner of eye involving the trigeminal nerve

98
Q

you can get varicella then zoster then this condition

A

post herpetic neuralgia, a secondary bacterial infection with staph and strep

99
Q

trmt zoster

A

oral antiviral (valacyclovir/famcylovir) or steroids

100
Q

vzv remains ______ in sensory ganglia until reactivation

A

latent

101
Q

the varicella vaccine doesnt protect against ____

A

zoster

102
Q

this is a new vaccine that came out for zoster

A

shingrex

103
Q

ebv is aka

A

the kissing disease or mono

104
Q

transmission EBV

A

saliva thats why its the kissing disease

105
Q

highest prevalence age group of EBV

A

12-19 yo

106
Q

incubation EBV

A

1-2 months; but saliva can be infectious for over 6 months

107
Q

ss EBV

A

maliase, sore throat, can have exudate, palatal petechiae, lymphadenopathy, splenomegaly

108
Q

dx EBV

A

serum monospot (heterophile agglutination test), cbc will show large lymphocytes, may have hemolytic anemia, and thrombocytopenia

109
Q

trmt EBV

A

supportive, rest

110
Q

complications EBV

A

hepatitis, myocarditis

111
Q

why do we avoid PCN in EBV

A

it can cause a maculopapular rash

112
Q

MC body sites affected for HAMRSA are

A

wounds

113
Q

cellulitis is caused by

A

strep

114
Q

purulent abscess in CA MRSA is caused by

A

s aureus

clin med (35 decks)

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