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IDz Flashcards

1
Q

Criteria for FOUO

A

> 38.3/100.9*
3 days admitted w/out Dx
3 OutPT visits
Illness x 3wks

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2
Q

What are the categories of FOUO

A

Nosocomial- admitted PT w/ fever >38.3*C

Neutropenic- in/out PT w/ neutrophils <500 x 3 days no Dx

HIV- PT w/ HIV Dx and fever x 4wks (out) / 3 days (in) w/ 2 day incubation

Organ transplant

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3
Q

What labs are drawn when investigating FOUO

What images are ordered?

A

Culture prior to ABX, grown x 2wks
Titers
CBC
CRP/ESR

All PTs get CXR (TB risk)

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4
Q

What areas of the body can be biopsied when investigating FOUO?

Empiric ABX are used if DDx includes ?

What Tx is controversial and avoided

A

LP Lymph Marrow Skin

Infectious dz

Steroids

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5
Q

What biological warfare agents are classified as Category C

What agents are classified as “other important zoonotic” ?

A

Nipah
Hantavirus

West Nile
Hendra
Rift Valley
Spongiform encephalopathy

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6
Q

Anthrax

A

Gram + rod shaped Bacillus Anthracis

Contact w/ hides
Ingestion of meat
Inhalation of spores

NOT transmitted person to person

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7
Q

Cutaneous anthrax can be AKA ?

How does this present

A

Malignant pustule

PEV UB
Pustule Erythematous papul
Vesicle Ulcer Brawny edema

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8
Q

What are the S/Sxs of inhalation anthrax?

What are the two phases?

A

Malaise, Lymphdenopathy

Initial: viral URI, rhinorrhea, pharyngitis
Later: dyspnea, hemoptysis

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9
Q

S/Sxs of intestinal anthrax

How is anthrax Dx?

A

GASH
GE Ascites Sepsis Hematemesis/chezia

CXR- wide mediastinum
Rapid ELISA
Culture everything

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10
Q

Anthrax Dx

What is given for postexposure PO prophylaxis

A

Cipro + LInezolid or Clindamycin

Vaccine +
Cipro or Doxy x 60 days

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11
Q

How are PTs exposed to aerosolized anthrax managed?

How are non-complicated, naturally acquired cutaneous cases of anthrax Tx?

A

Regardless of vaccination Hx: 60 days of antimicrobial drugs

Cipro x 7-10 days

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12
Q

What are the names of the injection meds for anthrax post-exposure prophylaxis?

These two meds are also approved for use in ? scenarios

A

Obiltoxaximab, Biothrax

Prevent inhalation anthrax when alternative therapies are unavail/inappropriate

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13
Q

What are the complications that can occur after anthrax?

What are the three types of the ‘zoonotic dz of rodents’?

A

Scarring
Airway occlusion
Death

Plague:
Bubonic- fleas
Pneumonic- aerosol
Septicemic

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14
Q

S/Sxs of Pneumonic Plague

S/Sxs of Bubonic Plague

S/Sxs of Septicemia Plague

A

CHAFT Hemoptysis
Chills HA Fever Toxic

BMF
Buboe (inguinal) Malase Fever

CNS, lungs (no buboes)

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15
Q

What would be seen on lab results if plague is present

How is it Tx

What two meds are used for post-exposure prophylaxis

A

WBC 20K w/ inc bands
Inc split fibrin split (Low DIC)
Inc LFTs

Strepto/Gentamycin

Doxy/Cipro

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16
Q

What are the complications of plague

What are the initial and later rash locations of smallpox?

A

DIC ARDS Shock Superinfection

Initial: oropharynx, face, forearms
Later: trunk and legs

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17
Q

What is the sequence of a smallpox lesion

A 
Synchronous: MVPSS
Maculopapular
Vesicle
Pustule/pocks
Scabs/scars w/ sebaceous destruction
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18
Q

Characteristics of Hemorrhagic Smallpox

Characteristics of Malignant Smallpox

A

Dusky erythema
Petechia
Hemorrhage of skin/membranes

Lesions
Velvet vesicles
Red fine grained skin
No formation of pustules/scabs

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19
Q

Tx for smallpox?

Tx for small and monkeypox?

How often are new vaccines needed?

A

Tecovirimat

Cidofovir

10-15yrs

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20
Q

How is post-smallpox exposure prophylaxis managed?

What is the natural reservoir of cow pox?

A

Vaccinate if within 4 days and no vaccine Hx
CDC guidance for eligibility of Vaccina Immune Globulin within 3 days (best within first 24hrs)

Small wild rodents

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21
Q

What form of variola is more deadly?

A

Hemorrhagic- uniformly fatal by day 6 of rash
Malignant- frequent fatal
Major- 30%

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22
Q

How long for HSV initial and recurrence Sxs/viral shedding to stop?

How is HSV described in words

A

Initial: 2wks, 3wks
Rec: 10 days, 5 days

Erythematous papule to vesicle to pustule to ulcer

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23
Q

How is HSV Dx

How is it Tx

A

Punch biopsy- ImmComp
Tzanck smears- MNG cells
PCR
Culture- CSF, serum

FAV-clovir
Topicals: PA-clovir, Doconasal

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24
Q

How is HPV Dx

A

Biopsy- ImmComp

PCR- 9 high risk types, 5 low risk types

Cervical Pap

STD panel: Hep HIV Syphillis G/C

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25
Q

How is HPV Tx surgically

How is HPV Tx w/ meds?

A 
CO2 laser
Electrosurgery
LN2 cryotherapy
Excision
(laser therapy for inner lesions on females)

Podofilox
Imiquimod
Trichloroacetic acid

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26
Q

Gonorrhea is AKA ?

What type of microbe is it

A

Clap

Gram - intracellular aerobic diplococcus

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27
Q

S/Sxs of Gonorrhea

A

F: D/c CMT Dysuria/pareunia

M: D/c Epididymis pain Dysuria

Both: fever, infection of membrane tissue

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28
Q

What is the fear with gonorrhea in women that goes unTx

What is the form of disseminated gonorrhea infection?

A

PID: acute salpingitis leading to ectopic pregnancy

Arthritis Dermatitis Syndrome: Polyarthralgia 
Septic arthritis
Tenosynovitis
Endocarditis
Meningitis
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29
Q

How is Gonorrhea Dx

What is the CDC’s recommendation for Dx

A

GT PUC
Gram stain TMA PCR US/CT
Culture isolation*

Culture and Susceptibility testing

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30
Q

What types of gonorrhea strains are more likely to exhibit antimicrobial resistance?

How is Gonorrhea Tx

A

MSM strains

Ceftriaxone and Azithromyin
Alt: Azithromycin 2g PO
Tx fail: Ceftriaxone + Azith + test for cure 7days

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31
Q

What is the MC reported IDz in the US

How is this infection Dx

A

Chlamydia, especially in PTs <25y/o

TMA

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32
Q

How is chlamydia Tx

What microbe is the cause of LGV and what family of microbe does it belong to

LGV occurs in 10% of PTs w/ ?

A

Azithromycin, Ceftriaxone
Alt: Doxy

C Trachomatis- Chlamydia family

Genital ulcer Dz

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33
Q

What are the three stages of an LGV infection

A

Primary: <30 days after infection w/ small/painless papule that rapidly heals

Secondary: 2-6wks after initial, painful unilateral bubo, systematic spread
M: Dx w/ groove sign: inguinal ligament raised over buboe
F: rarely dx, lack of adenopathy

Tertiary: genitoanorectal syndrome, usually in F PTs

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34
Q

How is LGV Dx

How are they Tx

A

Complement fixation 1:64

Therapeutic: aspiration
Tx: Doxy x 3wks

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35
Q

What organisms can cause Nongonococcal urethritis:

A 
Non-G Urethritis: 
Mycoplasma genital: MSM, PID, labor
Trichomonas
Chlamydia*
Ureaplasma
Mycoplasma hominis

Rarely:
LGV HSV Syphillis

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36
Q

How is NG and G urethritis Tx

How does syphilis present?

A

NGU: Azith, Doxy
GU: Azith, Ceftriax

Round, demarcated borders, painless w/ regional adenopathy

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37
Q

What form of syphilis is considered non-infectious

What are the S/Sxs of congenital syphilis

A

Tertiary- Gummatous syphilis

Multiple organ involvement either early (first 2yrs) or late (older than 2yrs)

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38
Q

2* syphilis may present w/ ? derm finding

What parts of the body are commonly affected by gummas syphilis?

A

Alopecia

Liver Skeleton Testis

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39
Q

Cardiovascular syphilis can arise ? yrs later and usually affects ?

What may be found on PE?

A

10yrs after primary infection
Ascending aorta

Aortic valve insufficiency

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40
Q

When can neurosphylis develop?

How can they present

A

Any stage of syphilis

CN8 palsy
Argyle Robertson pupils
Tabes dorsalis
Stroke/meningitis Sxs

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41
Q

Syphilis can infect a fetus how long after an infection?

Why is this infection not caught during prenatal work ups?

A

4yrs prior

Late/limited prenatal care
Failure to adhere to screening

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42
Q

CDC recommends that all females delivering stillborn babies prior to ?wks are tested for syphilis?

What are the PE findings of a PT w/ late congenital syphilis?

A

20wks

Depressed facial bones
Hutchinson incisors
Mulberry molars- too many cusps

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43
Q

What lab result is used to monitor the efficacy of care for PTs Tx for syphilis

What other systemic Dzs/issus can trigger a false-pos for syphilis on a RPR test?

A

VDRL titers

Infection, viral/bacterial
Lupus
Immunizations
Marijuana use (biological false pos)
Pregnancy
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44
Q

What are the alternative meds for Tx syphilis?

What med is added to Pen G when Tx neurosyphilis

How is congenital syphilis under 30 days Tx?

A

CDT: Ceftriax Doxy Tetra

Probenicid

Aqueous Pen G

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45
Q

How is BV Tx

Chancroid infections are usually found in ? 2 countries and co-infect w/ ?

How does it present?

A

Clindamycin PO/cream
Tinidazole
Metronidazole*

Africa, Caribbean
HSV 2, Syphilis

HA Anorexia Painful ulcer
Bubo

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46
Q

How are chancroids definitively Dx

How are they Tx

A

Gram stain-unreliable
Culture- definitive

Ceftriaxone
Azithromycin

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47
Q

Granuloma inguinale is AKA ?

How does this present?

A

Donovanosis

Beefy red bump that is painLESS
Spreads w/ erosion, depigmentation

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48
Q

Which IDz has to be Dx w/ punch biopsy?

What is seen when viewed under microscope?

A

Donovanosis

Speckled round eggs

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49
Q

How is Granuloma Inguinale/Donovanosis Tx

Bed bugs belong to ? species

A

Azithromycin x 3wks
If ulcers don’t respond within few days, add Gentamicin (aminoglycoside)

Cimex

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50
Q

? term encompasses lice and what is the concern w/ these infestations

Where are the different types usually seen?

A

Pediculosis- secondary skin infections

Capitis- occipital, post-auricular
Distance of nits from scalp= duration of infestation (closer to scalp= newer infection)

Corpus: bites found anywhere but no nits in hair

Phithrius pubis: pubes, perienium, eyebrows and eyelashes

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51
Q

Pedicuosis infestations can quickly be visually Dx by ?

How are these Tx

A

Woods lamp

Permethirn 1%
Ivermectin 0.5% for resistance and PTs over 6mon old
Malathion 0.5% (8-12hrs)
REPEAT Tx in 7 days to kill nits

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52
Q

What type of pediculosis infestation is indicative of child abuse?

What are scabies eggs called?

A

Pediculosis pubis

Scybala

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53
Q

What was the first human Dz proven to be caused by a specific pathogen?

What PT populations is this infestation highest in?

A

Scabies

<15y/o
Sexually active
ImmComp
Debilitated

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54
Q

How do scabies present?

What PT population is this type of infestation rare in?

A

Crescendo pruritis, worse at night

Neonates

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55
Q

How do scabies appear on PE?

Where are they usually seen?

If PT that is ImmComp acquires scabies infestations, how do they present?

A

Serpinginous
Burrow- pathognomonic for scabies infestation

Webs of fingers
Flexors of wrist
AC space
Axilla

Bullous lesions

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56
Q

How is a scabies infestation Dx?

How are they Tx?

A

Skin scrapings for mite/eggs

Permethrin 5%- neck down
Ivermectin PO

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57
Q

Bed bugs are a vector for ? and ? adverse reaction is well described with their infestation

How do bed bug infestations present in clinic

A

Hep B
Anaphylactoid

Papule Bullae Wheal
Hemorrhagic puncta

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58
Q

How are bed bugs Tx

Which forms of hepatitis are transmitted through fecal/oral or through serum?

A

Creams w/ CCS
PO antihistamine

F/o: A E (acute only)
Serum: B C D G (acute and chronic)

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59
Q

Chronic hepatitis can lead to ? or ? and is caused by ? form

What labs are ordered and what will be seen on results for hepatitis?

A

Ca Cirrhosis
B and C

Urine/serum bilirubin
Elevated serum bilirubin= infectious hepatitis
+30mg= severe hepatitis
Prothrombin time

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60
Q

What weird food can carry Hep A?

What are the two more rare but possible transmission methods for this version?

Severity of the Dz increases due to ?

A

Shellfish

Blood
Sexual contact

Age

61
Q

What lab results is Dx of acute Hep A

When can Twinrix be given?

A

IgM anti-HAV
Arrives 5 days before Sxs, gone by 6mon

0 1mon 6mon if PT is >18y/o
>12mon= Havrix

62
Q

Vaccines offer ? type of immunity

What is used for post exposure Tx of Hep A exposure

A

Active

Immune serum globulin within 2wks of exposure

63
Q

Hep E is usually a benign course infection except in ?

How is it Dx

A

Pregnant PTs

IgM and IgG anti-HEV
HEV RNA in serum/stool

64
Q

? type of virus is Hep B

This form is more infective than ?

A

DNA virus

100x more than HIV through blood/sex contact

65
Q

What is the odd relation between contracting Hep B and age

Chronic HEB is usually ?

A

Younger PTs- chronic
Older PTs- acute cases

ASx

66
Q

What lab result would be the first indication of a Hep B infection

What would be the first Ab seen?

This first Ab is eventually replaced by ?

A

HBsAg

IgM and anti-HBc

IgG anti-HBc

67
Q

What lab result is indicative of successful immunity from Hep B?

What results are indicative PT has chronic hepatitis and is a carrier?

A

Anti-HBs (HBsAb)

HBsAg and/or
anti-HBc

68
Q

Hep B immunoglobulin and Hep B vaccine can be given for post-exposure within ? days

What is the goal when treating chronic Hep B?

A

7 days for Tx and prevention

Inhibiting viral replication

69
Q

What meds are used for chronic Hep B

What meds are used as 2 or 3rd line options?

A

PEG-IFN Entecavir Tenofovir

Adefovir Lamivudine

70
Q

What lab result is used to plan and monitor Hep B Tx?

Hep C infections usually also come with ?

A

HBV DNA

HIV

71
Q

What is the MC cause of Hep C

This form has less transmission likelihood through ?

What is the median time for this form to lead to cirrhosis?

A

IVDA

Sexual contact

30yrs

72
Q

What are 4 factors that can accelerate the progression of Hep C into cirrhosis?

What PTs are tested for Hep C

A

Inc alcohol
>40 when infected
Chronic Hep B/HIV infected
Male

Clotting Liver Injected Transplant Dialysis 
Injected illegal drugs
Received clotting factors
Blood/organ transplant
Hemodialysis
Liver dz
73
Q

When do medical workers need to be screened for Hep C

When are babies tested?

? causes the greatest increase of HCV cases between ages 18-39?

A

+ HCV PT w/ + needle stick

HCV + mother

Opioid IVDA

74
Q

How is Hep C Dx

Since there are more than 50 genotypes of Hep C, what two have favorable prognosis and which one has a poor prognosis?

What genotype is rare and harder to Tx

A

Screen: Anti-HCV
Confirmed: PCR- RNA
If neg, repeat in 1mon

2 and 3
1- more common

4

75
Q

What are the s/e of using IFN for Hep C Tx

Hep D infects PTs that are carriers of ?

How does it present?

A

Neuropsychiatric
Marrow suppression
Flu-like

HBsAg

Severe acute presentation similar to Hep B, low risk for chronic infection

76
Q

Hep D super infections have higher risk for ? and rapid progression to ?

How is Hep D transmitted

A

Chronic liver dz
Cirrhosis

IVDA, Sexual contact

77
Q

How is Hep G transmitted

This form can co-infect w/ ? 2

A

Blood transfusion
Co-infect w/ Hep B

B and C

78
Q

HIV replicates on the surface receptors of ? cells

This includes ? cells

A

CD4 surface receptor

Microglial cells
Dendritic cells
Monocytes
Alveolar macrophages
Macrophages
79
Q

Initial HIV Sxs present ? wks after infection and resemble a ? infection

Abs would be almost 100% detectable by ?mon

A

2-4wks
Infetious mononucleosis

3mon post-exposure

80
Q

? lab test is used for screening and ? is used for confirmation of HIV

What would be seen on a CBC result

A

Screen w/ ELISA
Confirm w/ Western blot

Thrombocytopenia
Anemia
Neutropenia

81
Q

What lab result is used as the counter-predictor of progression of HIV?

Opportunistic pathogen and Cas are more likely when CD4 count drops below ?

A

CD4 lymphocyte %

<200/14%

82
Q

What are the top 3 MC signs of HIVs Acute Retroviral Syndrome?

These Sxs indicate ? physiological process has occurred?

What opportunistic infections can occur when CD4 levels are below 200

A

Cytokine storm causing: Fever Fatigue Pharyngitis

Abs have just become detectable and becomes infectious

P jiroveci pneumonia- MC OI associated w/ AIDS
Kaposi sarcoma
Candidiasis

83
Q

What opportunistic infections can occur when CD4 levels are below 100

What opportunistic infections can occur when CD4 levels are below 50

How often are CD4 counts measured in HIV PTs?

A

AIDS dementia
Aspergillosis
Cytomegalovirus

Crypto
Toxoplasmosis
M avium complex

Every month after initiating/changing Tx
Q3mon

84
Q

How are AIDS PTs w/ HSV, Toxoplasmosis, M Avium or P jiroveci Tx

When is the likelihood of HIV transmission lowest?

Viral suppression is defined as less than ?

A

HSV- acyclovir
Toxo: pyrimethamine
M Avium: Clarythromycin
PJ- TMP/SMX

Viral load is undetectable

200-400 copies

85
Q

What tools are used to measure AIDS treatment therapy?

Which tool is used to indicate when to start/change therpy?

Occupational exposure for HIV includes universal precautions that include ?

A

CD4 count
Viral loads
Clinical status- thrush

Viral load

Gloves Eye-pro Gown Booties

86
Q

What fluids are NOT considered infectious w/ HIV as long as no blood is visible in them

A

Feces
Urine
Nasal secretions

Tears
Vomit

Saliva
Sputum
Sweat

87
Q

What is a less/more severe type of HIV exposure?

HIV infection status of source are classified into ? 2

A

Less: solid needle, superficial
More: large, deep, bloody

Class 1: ASx, low viral load (<1,500 copies)

Class 2: Sxs, high viral load

88
Q

What are the recommended HAART combos

? PT education has to happen and they achieve viral suppression within ?mon of starting

A

Recommend:
Lami Aba Dolut
Bic/Ten Ala/Emtri

Alt:
Ten Emtri Cobi Elvit
Efan/Ten/Emtri

Taken same time every day
6mon

89
Q

What are the post-HIV/AIDS exposure meds

A

Basic:
Zido + Lami
Emi + Teno
Stav + Lami

Expanded:
Basic + Lopin or Atazan

x 28days, best started w/in 72hrs

90
Q

Healthcare persons are f/u w EIA how often after an HIV/AIDS exposure

AD members w/ HIV/AIDS are medically retired when CD4 count reaches ?

What medication is recommended for pre-exposure prophylaxis against HIV?

A

6 and 12wks
6mon
Extend to 12mon if infected w/ Hep C

<300 or can’t perform job

Emtri TDF

91
Q

What HIV pre-exposure med is used primarily?

What pre-exposure med is used for receptive anal intercourse safety against HIV?

Receptive form is not for use in ? population

A

Emtri TDF

Emtri Teno Afen

Vaginal intercourse

92
Q

Define Antigenic Shift

Define Antigenic Drift

A

Major genetic change resulting in pandemics (1918 Spanish flu)

Minor mutation leading to epidemics

93
Q

What is the difference between Influenza A, B and C

A

A: outbreaks due to antigenetic shifts=pandemic

B: antigenetic drifts, less variation than A; school/barracks outbreaks= epidemic

C: mild illness

94
Q

What PT populations have the highest attack and complication rates w/ influenza

When are these PTs infective?

A

Kids: highest attack
Elderly: highest mortality and complication, lowest attack

1 day before Sx onset

95
Q

What would be seen on CBC in PTs w/ influenza

Where can the virus be isolated from for ? Dx studies

A

Leukopenia
Mild leukocytosis

Nasopharyngeal, throat, sputum
Immunoassay

96
Q

What meds are used for Sx Tx of influenza?

What meds can be given for influenza A or B if Sxs are present for <48hrs?

What med is given for A and B resistant strains?

A

Tylenol

Neuroaminidase inhibitors- Zana/Oseltamivir

Baloxavir Marboxil

97
Q

Why do we avoid giving aslicylates to PTs < 16y/o w/ influenza

FluMist vaccines are given to PTs how old?

A

Reyes syndrome

2-49y/o

98
Q

What are the indications to give the influenza vaccine?

What are the c/i to giving the vaccine

A 
\+65y/o
Chronic Dz
Health workers
Aspirin use under 18y/o
Resident of nursing home

GBarre Syndrome
Acute febrile illnesses
Thimerosal allergy- contact solution
Egg allergy

99
Q

What complications can arise from influenza infections

A

1* influenza pneumonia
2* bacterial pneumonia

Myositis/Rhabdo
Renal failure

Myocarditis
Tracheobronchitis
Neuro- Reyes/GBS

100
Q

What are two specific viral causes of pneumonia in ImmComp PTs

What are the two respiratory infections seen in HIV/AIDS PTs

What type of pneumonia is rarely seen in kids?

A

HSV or CMV

M avian complex
P jiroveci

Varicella pneumonia

101
Q

Varicella pneumonia is more common/severe in adults and ImmComp, how does it present?

How does CMV pneumonia in an ImmComp PT present

A

Pneumonia w/ rash
Couth and Tachy

Interstitial pulmonary infiltrates

102
Q

What type of viral pneumonia is exclusive to ImmSupp PTs?

How are they Tx?

A

HSV pneumonia
MC cause of post transplant pneumonia

High dose IV Acyclovir

103
Q

How do viral pneumonias look on x-ray according to their cause?

A

HSV: peripheral nodules, coalesce to infiltrates

CMV: lower lobes, possible interstitial involvement after organ transplant

RSV: bilateral interstitial/patchy infiltrate w/ consolidation/effusions

Varicella: fluffy/nodular infiltrates w/ possible calcification

104
Q

Hanta virus is found in ? but cant be transmitted by ?

What are the MC S/Sxs of Hantavirus

What are the MC PE findings

A

Deer mice feces
Person to person

Fever CHills Myalgias in back/legs

Tachy Fever Tachy

105
Q

What finding would NOT be seen on blood work of Hanta

What lab results may be seen in Hantavirus

The virus can cause a lot of lab results to be elevated except for ?

A

No petechiae even w/ thrombocytopenia

inc Hct
Acidosis

Dec albumin

106
Q

What is the definitive Dx method for Hantavirus

How does this infection progress on CXRs

How is Hantavirus Tx

A

Serology

Mild pulmonary edema to base/perihilar pattern

Ribavirin

107
Q

Bacterial pneumonia is AKA

Its MC caused by ?

It can be caused by ? atypicals

A

CAP

MC Streptococcus/ pneumococcal pneumonia

Atypicals: Legion Mycoplasma Chlamydia Klebsiella
Gram negs
Anaerobes

108
Q

What type of cough w/ Strep Pneumo pneumonia

How does this appear on CXR but what caution is needed

A

Rusty blood sputum

Alveolar pattern*
Resolution lags behind clinical recovery

109
Q

What will be seen on lab results in PTs w/ Strep/Pneumo pneumonia

What is the DOC for Tx for PTs w/ comorbid conditions

A

Leukocytosis w/ L shift
Inc ESR/CRP

Amoxicillin and Clavulanate

110
Q

What drugs are used for PCN susceptible CAP?

What drugs are used for PCN resistant strains?

How long are the PTs Tx for?

A

Ampicillin
Amoxicillin
Pen G

Genifloxacin
levofloxacin
Moxifloxacin

Afebrile x 5 days

111
Q

Prevention of Strep/Pneumo pneumonia is best w/ pneumococcal vaccine given when ?

Atypical pneumo can be caused by ? 3 microbes

A

+65y/o
High risk Dxs
2wks prior splenectomy
ImmComp

Mycoplasma Pnemo*
Legionella Pneumo
Chlamydia psittaci

112
Q

What is the MC cause of CAP?

What unique Sx does it present with?

Since CAP is Dx w/ clinical presentation, what may be seen on CXR?

How is it Tx

A

Mycoplasms pneumo in PTs 5-35y/o

Acute ottitis media- (Bullous myringitis)

Fluffy infiltrates w/ diffuse lobular involvement

Doxy/Azithromycin

113
Q

How is MAC Tx or prevented

How is Chlamydia Psittaci Dx

How is it Tx

A

Tx: Clarithromycin
Prev: Azithromyvin

CXR
LFTs
Serlogic testing w/ PCR

Azith
Doxy

114
Q

What are the S/Sxs of Chlamydia Psittaci that are unique

What type of microbe is legionella and where is it harbored

A

Hematuria
Photophobia
Horder spots
Splenomegaly

Gram neg bacteria in cooling water systems

115
Q

Who’s more likely to get Legionella

How is this different

A

Men Smoker Alcoholic ImmSupp DM

Confusion/neuro Sxs
GI Sxs
Liver/renal Dz

116
Q

How is Legionella Dx

How is it Tx

A

Multi-lobar CXR w/ rapid deterioration
Urine Ag test for Serogroup 1
Sputum culture

Levofloxacin
Azithromycin

117
Q

When can Staph A cause pneumonia in kids

What Sx will be absent in kids but is present in adults

How is this Dx

A

First 8wks of life preceding viral infection

Pneumatoceles

CXR
Blood culture
Sputum Gram stain

118
Q

How is Staph A pneumonia Tx

Staph A is morel likely if ? pre-existing Dz is present

A

MSSA- nafcillin
MRSA- vancomycin
Abscess present= ventilator
Empyema= chest tube

Influenza

119
Q

Adults w/ Staph A pneumonia needs to have what other Dx considered simultaneously

What other bacteria can cause CAP/

A

Influenza

Morazella Cat
Hemophilus influenza

120
Q

What other bacteria can cause bacterial pneumaoni in hospitals or neutropenic acquired

How is Kelbsiella pneumonia Tx

A

Proteus
Psuedomonas
Providencia
Gram-neg rod microbes

Piperacillin/tazobactam

121
Q

Bronchitis is the result of ?

What two atypicals can cause this

A

Respiratory Virus

Mycoplasma
Pertussis

122
Q

What two microbes can be isolated from brnchitis sputum even if PT is ASx

Usually no ABX are given for bronchitis, but what two can be given it PT has mild/mod case and is smoker

A

Strep pneumo
H influenza

Amoxicillin

123
Q

How does pertussis present in infants

What is PE finding/sign is Dx for pertussis

A

Apneic spells

Frenal ulcer

124
Q

How is pertussis Dx

How is it Tx

What microbe causes ARDS

A

DFA or culture

Azithromycin

Corona virus- 6 types

125
Q

What is the biggest risk factor for acquiring ARDS if PT is <50y/o

Herpes genitalis is characterized by ?

A

Obesity- inc inflammation

Ulcerative/Necrotic cervical mucosa

126
Q

Blood cultures for FOUO work up are grown x ?wks

What type of microbe is plague

A

2wks

Plague- Gram - coccobacillus bipolar safety pin

127
Q

What does JORRP stand for

PT presents w/ hemorrhagic mediastinitis, what is the next step

A

Juvenile Onset Recurrent Respiratory Papillomatosis
Vertical transmission HPV 6/11

CXR for wide mediastinum from anthrax

128
Q

What is used for anthrax exposure prevention

This is also used for ?

A

DOD Avip vaccine/PrEP

Post exposure for unvaccinated PTs

129
Q

What is recommended for immediate protection from anthrax?

Smallpox vaccine is ? type

A

Vaccine + 60 days antimicrobials

Intradermal inoculation w/ bifurcated needle

130
Q

PTs that import pets into US from overseas may need ? vaccine

Drew drop on rose petal= ?

A

Cidofovir- small/monkey pox vaccine

Varicella

131
Q

? STD has the largest reported numbers to the CDC for any reason

What are the constitutional Sxs seen w/ 2* Syphilis

A

Chlamydia

HA Malaise Sore throat Fever

132
Q

? STD can present w/ a necrotic rash?

What part of this STD is contagious

A

2* syphilis

Mucous patches

133
Q

What are the microbes causing BV and the color of d/c

A

Gardnerella: gray d/c

Trichomoniasis: green d/c

Candidiasis: white d/c

134
Q

Clue cells may be AKA ?

PT education piece when using -azoles for BV

A

Epithelial clumping

Metallic taste
No ETOH consumption

135
Q

? bug infestation may present as ASx in kids

? ectoparasite infestation is an epidemic in the US?

A

Pediculosis

Scabies

136
Q

When do bed bug prevalence activity increase?

Use extreme caution or avoid cryofreezing HPV warts off of ?

Don’t freeze warts off of ?

A

Before dawn

Penile meatus

Urethra meatus

137
Q

PT is “peeing fire” has ?

3 Dzs w/ buboes in DDx

A

Gonorrhea

Plague Chancroid LGV

138
Q

PT w/ NG urethritis that either had MSM, has PID or experienced premature labor contracted ? microbe

Acute S/Sxs of viral hepatitis

3 S/Sxs of advanced Dz

A

Mycoplasma genitalium

FAM AND
Fever Anorexia Malaise
Aversion N/V Diarrhea

Coca cola urine
Jaundice
Tender hepatomegaly

139
Q

Define Fulminant Hepatic Failure

What other body system will have decreased function w/ this form of hepatitis

A

LF w/ hepatic encephalopathy
Hep A/B- 1%
E in Asia
C if super infected w/ A

Renal function is decreased

140
Q

What are the incubation time from shortest to longest of the hepatitis viruses?

? form of Hepatitis can be acquired from perinatal exposure?

A

A: 15-50, Avg- 28 days
E: 15-60, Avg- 40 days
B: 45-180, Avg 60-90 days
C: 49-56 days

Hep B

141
Q

50% of Hep C PTs belong to what 4 PT populations

HIV co-infection w/ Hep C triples ? three risks

Hepatitis C Tx is controversial due to hepatotoxic meds + inflamed liver may dec ? production

A

Uninsured Veterans IVDU Prisoners

Liver Dz/failure/related death

Clotting factors

142
Q

HIV replicates in/on ? cells?

This type of cell includes ? 5 types

A

CD4 surface receptor

Monocyte
Macrophage
Microglial
Alveolar macrophage
Dendritic
143
Q

Define HIV eclipse phase

At ? level does HIV become detectable?

What is being measured for detection?

A

Infection establishes within lymphoid tissues, not at detectable levels

10K

HIV RNA

144
Q

What physiological process indicated HIV infection has taken and is in the PT

A

Acute Retroviral Syndrome:

inflammatory response of cytokine storm

145
Q

? 9 OIs are indicative of a definitive AIDS Dx w/ or w/out HIV dx/evidence

A

Candida
Crypto
Cytomegalo

HSV
Kaposi: HHV-8
Lymphoma, brain

Mycobacterium
Pneumocystis
Toxoplasmosis

146
Q

? is the MC space occupying lesion in an AIDS infected PT

? is a common infection in ImmunoCOMPETENT PTs

What is the MC IO in AIDS PTs

A

Toxoplasmosis

Cytomegalovirus

Jiroveci pneumonia

147
Q

What are AIDS Pts w/ CD-4 count below 50 given for protection against M. Avium infections

How are HSV, CMV, measles and varicella pneumonias Dx

A

Clarythromycin
Azithromycin

HSV: Ag detection IF/PCR
CMV: Ag detection IF/PCR
Measles: hemaglutination, culture
Varicella: Ag detection, IF

148
Q

PTs w/ bowel resection in MedHx may contract ? type of respiratory issue

ImmunohistoHx

A

Bacterial pneumonia

Cell/tissue ID through Ag/Ab interactions

IPAP (212 decks)

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