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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
How is HPV Tx surgically How is HPV Tx w/ meds?
``` CO2 laser Electrosurgery LN2 cryotherapy Excision (laser therapy for inner lesions on females) ``` Podofilox Imiquimod Trichloroacetic acid
26
Gonorrhea is AKA ? What type of microbe is it
Clap Gram - intracellular aerobic diplococcus
27
S/Sxs of Gonorrhea
F: D/c CMT Dysuria/pareunia M: D/c Epididymis pain Dysuria Both: fever, infection of membrane tissue
28
What is the fear with gonorrhea in women that goes unTx What is the form of disseminated gonorrhea infection?
PID: acute salpingitis leading to ectopic pregnancy ``` Arthritis Dermatitis Syndrome: Polyarthralgia Septic arthritis Tenosynovitis Endocarditis Meningitis ```
29
How is Gonorrhea Dx What is the CDC's recommendation for Dx
GT PUC Gram stain TMA PCR US/CT Culture isolation* Culture and Susceptibility testing
30
What types of gonorrhea strains are more likely to exhibit antimicrobial resistance? How is Gonorrhea Tx
MSM strains Ceftriaxone and Azithromyin Alt: Azithromycin 2g PO Tx fail: Ceftriaxone + Azith + test for cure 7days
31
What is the MC reported IDz in the US How is this infection Dx
Chlamydia, especially in PTs <25y/o TMA
32
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/ ?
Azithromycin, Ceftriaxone Alt: Doxy C Trachomatis- Chlamydia family Genital ulcer Dz
33
What are the three stages of an LGV infection
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
34
How is LGV Dx How are they Tx
Complement fixation 1:64 Therapeutic: aspiration Tx: Doxy x 3wks
35
What organisms can cause Nongonococcal urethritis:
``` Non-G Urethritis: Mycoplasma genital: MSM, PID, labor Trichomonas Chlamydia* Ureaplasma Mycoplasma hominis ``` Rarely: LGV HSV Syphillis
36
How is NG and G urethritis Tx How does syphilis present?
NGU: Azith, Doxy GU: Azith, Ceftriax Round, demarcated borders, painless w/ regional adenopathy
37
What form of syphilis is considered non-infectious What are the S/Sxs of congenital syphilis
Tertiary- Gummatous syphilis Multiple organ involvement either early (first 2yrs) or late (older than 2yrs)
38
2* syphilis may present w/ ? derm finding What parts of the body are commonly affected by gummas syphilis?
Alopecia Liver Skeleton Testis
39
Cardiovascular syphilis can arise ? yrs later and usually affects ? What may be found on PE?
10yrs after primary infection Ascending aorta Aortic valve insufficiency
40
When can neurosphylis develop? How can they present
Any stage of syphilis CN8 palsy Argyle Robertson pupils Tabes dorsalis Stroke/meningitis Sxs
41
Syphilis can infect a fetus how long after an infection? Why is this infection not caught during prenatal work ups?
4yrs prior Late/limited prenatal care Failure to adhere to screening
42
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?
20wks Depressed facial bones Hutchinson incisors Mulberry molars- too many cusps
43
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?
VDRL titers ``` Infection, viral/bacterial Lupus Immunizations Marijuana use (biological false pos) Pregnancy ```
44
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?
CDT: Ceftriax Doxy Tetra Probenicid Aqueous Pen G
45
How is BV Tx Chancroid infections are usually found in ? 2 countries and co-infect w/ ? How does it present?
Clindamycin PO/cream Tinidazole Metronidazole* Africa, Caribbean HSV 2, Syphilis HA Anorexia Painful ulcer Bubo
46
How are chancroids definitively Dx How are they Tx
Gram stain-unreliable Culture- definitive Ceftriaxone Azithromycin
47
Granuloma inguinale is AKA ? How does this present?
Donovanosis Beefy red bump that is painLESS Spreads w/ erosion, depigmentation
48
Which IDz has to be Dx w/ punch biopsy? What is seen when viewed under microscope?
Donovanosis Speckled round eggs
49
How is Granuloma Inguinale/Donovanosis Tx Bed bugs belong to ? species
Azithromycin x 3wks If ulcers don't respond within few days, add Gentamicin (aminoglycoside) Cimex
50
? term encompasses lice and what is the concern w/ these infestations Where are the different types usually seen?
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
51
Pedicuosis infestations can quickly be visually Dx by ? How are these Tx
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
52
What type of pediculosis infestation is indicative of child abuse? What are scabies eggs called?
Pediculosis pubis Scybala
53
What was the first human Dz proven to be caused by a specific pathogen? What PT populations is this infestation highest in?
Scabies <15y/o Sexually active ImmComp Debilitated
54
How do scabies present? What PT population is this type of infestation rare in?
Crescendo pruritis, worse at night Neonates
55
How do scabies appear on PE? Where are they usually seen? If PT that is ImmComp acquires scabies infestations, how do they present?
Serpinginous Burrow- pathognomonic for scabies infestation Webs of fingers Flexors of wrist AC space Axilla Bullous lesions
56
How is a scabies infestation Dx? How are they Tx?
Skin scrapings for mite/eggs Permethrin 5%- neck down Ivermectin PO
57
Bed bugs are a vector for ? and ? adverse reaction is well described with their infestation How do bed bug infestations present in clinic
Hep B Anaphylactoid Papule Bullae Wheal Hemorrhagic puncta
58
How are bed bugs Tx Which forms of hepatitis are transmitted through fecal/oral or through serum?
Creams w/ CCS PO antihistamine F/o: A E (acute only) Serum: B C D G (acute and chronic)
59
Chronic hepatitis can lead to ? or ? and is caused by ? form What labs are ordered and what will be seen on results for hepatitis?
Ca Cirrhosis B and C Urine/serum bilirubin Elevated serum bilirubin= infectious hepatitis +30mg= severe hepatitis Prothrombin time
60
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 ?
Shellfish Blood Sexual contact Age
61
What lab results is Dx of acute Hep A When can Twinrix be given?
IgM anti-HAV Arrives 5 days before Sxs, gone by 6mon 0 1mon 6mon if PT is >18y/o >12mon= Havrix
62
Vaccines offer ? type of immunity What is used for post exposure Tx of Hep A exposure
Active Immune serum globulin within 2wks of exposure
63
Hep E is usually a benign course infection except in ? How is it Dx
Pregnant PTs IgM and IgG anti-HEV HEV RNA in serum/stool
64
? type of virus is Hep B This form is more infective than ?
DNA virus 100x more than HIV through blood/sex contact
65
What is the odd relation between contracting Hep B and age Chronic HEB is usually ?
Younger PTs- chronic Older PTs- acute cases ASx
66
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 ?
HBsAg IgM and anti-HBc IgG anti-HBc
67
What lab result is indicative of successful immunity from Hep B? What results are indicative PT has chronic hepatitis and is a carrier?
Anti-HBs (HBsAb) HBsAg and/or anti-HBc
68
Hep B immunoglobulin and Hep B vaccine can be given for post-exposure within ? days What is the goal when treating chronic Hep B?
7 days for Tx and prevention Inhibiting viral replication
69
What meds are used for chronic Hep B What meds are used as 2 or 3rd line options?
PEG-IFN Entecavir Tenofovir Adefovir Lamivudine
70
What lab result is used to plan and monitor Hep B Tx? Hep C infections usually also come with ?
HBV DNA HIV
71
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?
IVDA Sexual contact 30yrs
72
What are 4 factors that can accelerate the progression of Hep C into cirrhosis? What PTs are tested for Hep C
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
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?
+ HCV PT w/ + needle stick HCV + mother Opioid IVDA
74
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
Screen: Anti-HCV Confirmed: PCR- RNA If neg, repeat in 1mon 2 and 3 1- more common 4
75
What are the s/e of using IFN for Hep C Tx Hep D infects PTs that are carriers of ? How does it present?
Neuropsychiatric Marrow suppression Flu-like HBsAg Severe acute presentation similar to Hep B, low risk for chronic infection
76
Hep D super infections have higher risk for ? and rapid progression to ? How is Hep D transmitted
Chronic liver dz Cirrhosis IVDA, Sexual contact
77
How is Hep G transmitted This form can co-infect w/ ? 2
Blood transfusion Co-infect w/ Hep B B and C
78
HIV replicates on the surface receptors of ? cells This includes ? cells
CD4 surface receptor ``` Microglial cells Dendritic cells Monocytes Alveolar macrophages Macrophages ```
79
Initial HIV Sxs present ? wks after infection and resemble a ? infection Abs would be almost 100% detectable by ?mon
2-4wks Infetious mononucleosis 3mon post-exposure
80
? lab test is used for screening and ? is used for confirmation of HIV What would be seen on a CBC result
Screen w/ ELISA Confirm w/ Western blot Thrombocytopenia Anemia Neutropenia
81
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 ?
CD4 lymphocyte % <200/14%
82
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
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
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?
AIDS dementia Aspergillosis Cytomegalovirus Crypto Toxoplasmosis M avium complex Every month after initiating/changing Tx Q3mon
84
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 ?
HSV- acyclovir Toxo: pyrimethamine M Avium: Clarythromycin PJ- TMP/SMX Viral load is undetectable 200-400 copies
85
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 ?
CD4 count Viral loads Clinical status- thrush Viral load Gloves Eye-pro Gown Booties
86
What fluids are NOT considered infectious w/ HIV as long as no blood is visible in them
Feces Urine Nasal secretions Tears Vomit Saliva Sputum Sweat
87
What is a less/more severe type of HIV exposure? HIV infection status of source are classified into ? 2
Less: solid needle, superficial More: large, deep, bloody Class 1: ASx, low viral load (<1,500 copies) Class 2: Sxs, high viral load
88
What are the recommended HAART combos ? PT education has to happen and they achieve viral suppression within ?mon of starting
Recommend: Lami Aba Dolut Bic/Ten Ala/Emtri Alt: Ten Emtri Cobi Elvit Efan/Ten/Emtri Taken same time every day 6mon
89
What are the post-HIV/AIDS exposure meds
Basic: Zido + Lami Emi + Teno Stav + Lami Expanded: Basic + Lopin or Atazan x 28days, best started w/in 72hrs
90
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?
6 and 12wks 6mon Extend to 12mon if infected w/ Hep C <300 or can't perform job Emtri TDF
91
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
Emtri TDF Emtri Teno Afen Vaginal intercourse
92
# Define Antigenic Shift Define Antigenic Drift
Major genetic change resulting in pandemics (1918 Spanish flu) Minor mutation leading to epidemics
93
What is the difference between Influenza A, B and C
A: outbreaks due to antigenetic shifts=pandemic B: antigenetic drifts, less variation than A; school/barracks outbreaks= epidemic C: mild illness
94
What PT populations have the highest attack and complication rates w/ influenza When are these PTs infective?
Kids: highest attack Elderly: highest mortality and complication, lowest attack 1 day before Sx onset
95
What would be seen on CBC in PTs w/ influenza Where can the virus be isolated from for ? Dx studies
Leukopenia Mild leukocytosis Nasopharyngeal, throat, sputum Immunoassay
96
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?
Tylenol Neuroaminidase inhibitors- Zana/Oseltamivir Baloxavir Marboxil
97
Why do we avoid giving aslicylates to PTs < 16y/o w/ influenza FluMist vaccines are given to PTs how old?
Reyes syndrome 2-49y/o
98
What are the indications to give the influenza vaccine? What are the c/i to giving the vaccine
``` +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
What complications can arise from influenza infections
1* influenza pneumonia 2* bacterial pneumonia Myositis/Rhabdo Renal failure Myocarditis Tracheobronchitis Neuro- Reyes/GBS
100
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?
HSV or CMV M avian complex P jiroveci Varicella pneumonia
101
Varicella pneumonia is more common/severe in adults and ImmComp, how does it present? How does CMV pneumonia in an ImmComp PT present
Pneumonia w/ rash Couth and Tachy Interstitial pulmonary infiltrates
102
What type of viral pneumonia is exclusive to ImmSupp PTs? How are they Tx?
HSV pneumonia MC cause of post transplant pneumonia High dose IV Acyclovir
103
How do viral pneumonias look on x-ray according to their cause?
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
Hanta virus is found in ? but cant be transmitted by ? What are the MC S/Sxs of Hantavirus What are the MC PE findings
Deer mice feces Person to person Fever CHills Myalgias in back/legs Tachy Fever Tachy
105
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 ?
No petechiae even w/ thrombocytopenia inc Hct Acidosis Dec albumin
106
What is the definitive Dx method for Hantavirus How does this infection progress on CXRs How is Hantavirus Tx
Serology Mild pulmonary edema to base/perihilar pattern Ribavirin
107
Bacterial pneumonia is AKA Its MC caused by ? It can be caused by ? atypicals
CAP MC Streptococcus/ pneumococcal pneumonia Atypicals: Legion Mycoplasma Chlamydia Klebsiella Gram negs Anaerobes
108
What type of cough w/ Strep Pneumo pneumonia How does this appear on CXR but what caution is needed
Rusty blood sputum Alveolar pattern* Resolution lags behind clinical recovery
109
What will be seen on lab results in PTs w/ Strep/Pneumo pneumonia What is the DOC for Tx for PTs w/ comorbid conditions
Leukocytosis w/ L shift Inc ESR/CRP Amoxicillin and Clavulanate
110
What drugs are used for PCN susceptible CAP? What drugs are used for PCN resistant strains? How long are the PTs Tx for?
Ampicillin Amoxicillin Pen G Genifloxacin levofloxacin Moxifloxacin Afebrile x 5 days
111
Prevention of Strep/Pneumo pneumonia is best w/ pneumococcal vaccine given when ? Atypical pneumo can be caused by ? 3 microbes
+65y/o High risk Dxs 2wks prior splenectomy ImmComp Mycoplasma Pnemo* Legionella Pneumo Chlamydia psittaci
112
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
Mycoplasms pneumo in PTs 5-35y/o Acute ottitis media- (Bullous myringitis) Fluffy infiltrates w/ diffuse lobular involvement Doxy/Azithromycin
113
How is MAC Tx or prevented How is Chlamydia Psittaci Dx How is it Tx
Tx: Clarithromycin Prev: Azithromyvin CXR LFTs Serlogic testing w/ PCR Azith Doxy
114
What are the S/Sxs of Chlamydia Psittaci that are unique What type of microbe is legionella and where is it harbored
Hematuria Photophobia Horder spots Splenomegaly Gram neg bacteria in cooling water systems
115
Who's more likely to get Legionella How is this different
Men Smoker Alcoholic ImmSupp DM Confusion/neuro Sxs GI Sxs Liver/renal Dz
116
How is Legionella Dx How is it Tx
Multi-lobar CXR w/ rapid deterioration Urine Ag test for Serogroup 1 Sputum culture Levofloxacin Azithromycin
117
When can Staph A cause pneumonia in kids What Sx will be absent in kids but is present in adults How is this Dx
First 8wks of life preceding viral infection Pneumatoceles CXR Blood culture Sputum Gram stain
118
How is Staph A pneumonia Tx Staph A is morel likely if ? pre-existing Dz is present
MSSA- nafcillin MRSA- vancomycin Abscess present= ventilator Empyema= chest tube Influenza
119
Adults w/ Staph A pneumonia needs to have what other Dx considered simultaneously What other bacteria can cause CAP/
Influenza Morazella Cat Hemophilus influenza
120
What other bacteria can cause bacterial pneumaoni in hospitals or neutropenic acquired How is Kelbsiella pneumonia Tx
Proteus Psuedomonas Providencia Gram-neg rod microbes Piperacillin/tazobactam
121
Bronchitis is the result of ? What two atypicals can cause this
Respiratory Virus Mycoplasma Pertussis
122
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
Strep pneumo H influenza Amoxicillin
123
How does pertussis present in infants What is PE finding/sign is Dx for pertussis
Apneic spells Frenal ulcer
124
How is pertussis Dx How is it Tx What microbe causes ARDS
DFA or culture Azithromycin Corona virus- 6 types
125
What is the biggest risk factor for acquiring ARDS if PT is <50y/o Herpes genitalis is characterized by ?
Obesity- inc inflammation Ulcerative/Necrotic cervical mucosa
126
Blood cultures for FOUO work up are grown x ?wks What type of microbe is plague
2wks Plague- Gram - coccobacillus bipolar safety pin
127
What does JORRP stand for PT presents w/ hemorrhagic mediastinitis, what is the next step
Juvenile Onset Recurrent Respiratory Papillomatosis Vertical transmission HPV 6/11 CXR for wide mediastinum from anthrax
128
What is used for anthrax exposure prevention This is also used for ?
DOD Avip vaccine/PrEP Post exposure for unvaccinated PTs
129
What is recommended for immediate protection from anthrax? Smallpox vaccine is ? type
Vaccine + 60 days antimicrobials Intradermal inoculation w/ bifurcated needle
130
PTs that import pets into US from overseas may need ? vaccine Drew drop on rose petal= ?
Cidofovir- small/monkey pox vaccine Varicella
131
? STD has the largest reported numbers to the CDC for any reason What are the constitutional Sxs seen w/ 2* Syphilis
Chlamydia HA Malaise Sore throat Fever
132
? STD can present w/ a necrotic rash? What part of this STD is contagious
2* syphilis Mucous patches
133
What are the microbes causing BV and the color of d/c
Gardnerella: gray d/c Trichomoniasis: green d/c Candidiasis: white d/c
134
Clue cells may be AKA ? PT education piece when using -azoles for BV
Epithelial clumping Metallic taste No ETOH consumption
135
? bug infestation may present as ASx in kids ? ectoparasite infestation is an epidemic in the US?
Pediculosis Scabies
136
When do bed bug prevalence activity increase? Use extreme caution or avoid cryofreezing HPV warts off of ? Don't freeze warts off of ?
Before dawn Penile meatus Urethra meatus
137
PT is "peeing fire" has ? 3 Dzs w/ buboes in DDx
Gonorrhea Plague Chancroid LGV
138
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
Mycoplasma genitalium FAM AND Fever Anorexia Malaise Aversion N/V Diarrhea Coca cola urine Jaundice Tender hepatomegaly
139
# Define Fulminant Hepatic Failure What other body system will have decreased function w/ this form of hepatitis
LF w/ hepatic encephalopathy Hep A/B- 1% E in Asia C if super infected w/ A Renal function is decreased
140
What are the incubation time from shortest to longest of the hepatitis viruses? ? form of Hepatitis can be acquired from perinatal exposure?
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
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
Uninsured Veterans IVDU Prisoners Liver Dz/failure/related death Clotting factors
142
HIV replicates in/on ? cells? This type of cell includes ? 5 types
CD4 surface receptor ``` Monocyte Macrophage Microglial Alveolar macrophage Dendritic ```
143
# Define HIV eclipse phase At ? level does HIV become detectable? What is being measured for detection?
Infection establishes within lymphoid tissues, not at detectable levels 10K HIV RNA
144
What physiological process indicated HIV infection has taken and is in the PT
Acute Retroviral Syndrome: | inflammatory response of cytokine storm
145
? 9 OIs are indicative of a definitive AIDS Dx w/ or w/out HIV dx/evidence
Candida Crypto Cytomegalo HSV Kaposi: HHV-8 Lymphoma, brain Mycobacterium Pneumocystis Toxoplasmosis
146
? 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
Toxoplasmosis Cytomegalovirus Jiroveci pneumonia
147
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
Clarythromycin Azithromycin HSV: Ag detection IF/PCR CMV: Ag detection IF/PCR Measles: hemaglutination, culture Varicella: Ag detection, IF
148
PTs w/ bowel resection in MedHx may contract ? type of respiratory issue ImmunohistoHx
Bacterial pneumonia Cell/tissue ID through Ag/Ab interactions

IPAP (212 decks)

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