IDz Block 2 Flashcards
1
Q
Coccidio causes ? fevers
Where is Coccidio endemic to and in ? PTs
A
San Joaquin/Valley Fever
C Immitis/C Posadasii
AZ CA NM West TX
Lab
Filipino Pregnant
2
Q
What are the S/Sxs of a Coccidio infection
How does the chronic version present
A
Pulm: 60% ASx
Acute pneumoina- hilar/mediastinal adenopathy
E-multiform/nodosum
Chronic Pneumonia:
TB-like w/ thin wall cavities/nodules
3
Q
What is the more common for of Coccidio infections
What parts of the body can it infect?
A
Secondary/disseminated
Fulminant- MC in Filipino AfAm Pregnant ImmComp
Skin
Bones- vertebrae
Meninges
4
Q
How is Coccidio in Pulm, Disseminated and Meningeal forms Tx
A
Pulmonary: Sx care
Disseminated, severe: Amphotericin B
Other: Flu/Itraconazole
Meningeal:
Fluconazole x life
IV Amphotericin B
New: PO VT 1598
5
Q
Histo is the MC cause of ? pulm/cardiac issue
What are the S/Sxs of Histo infection
A
Fibrosing mediastinitus
Flu-like, hilar/mediastinal lymphadenopathy
6
Q
Who/how does chronic pulmonary HIsto present
Who/how does disseminated cases present
If PT is being worked up for Addison’s Dz, ? infection needs to be r/o
A
Male smokers w/ TB like Dz: Bullae Cavitation Granuloma
AIDS/ImmComp: Fever Anemia Weight loss Skin/PO lesions
Histoplasmosis
7
Q
When Dx Histo, what Dx needs to be r/o
How is Histo Tx
What forms Tx is controversial
A
TB w/ PPD TST
Acute Pulm: only Tx if hypoxemia/ lasts >1mon
Sev: Amphotericin B
Mild/Mod: Itraconazole
AIDS PTs: Itraconazole x life
Fibrosing Mediastinitis- consider if inc ESR or Complement titers >1:32
8
Q
What forms of Histo is Tx not indicated
Who does Crypto present more commonly in?
A
Self-limited/flu like
Acute pericarditis
Rheumatoid manifestation
ASx
M>W
AIDS when CD4 <200 w/ CNS (MC Meningitis)
9
Q
What Sx is less common w/ Crypto meningitis and what is frequent
How can the pulmonary version present
How does the cutaneous version present
A
Rare: Fever/stiff neck
Common: N/V
Subacute to ARDS
Papule Pustule Ulcer Nodule
10
Q
What are two random sites of infection that can indicate Crypto
Why is Crypto hard to Tx
How is it Tx
A
Prostate
Medullary cavity of bones
Encapsulated
ImmComp-
Pulm w/ Fluconazole
CNS w/ Amphotericin B
11
Q
Who does Zygomycosis infect
What is Paracoccidomycosis similar to
A
Ca
Acidotic DM
Malnourished kids
Severely burned PTs
South American blstomycosis
12
Q
What are the 5 types of non-albicans yeasts and what are they associated w/
A
Tropicalis- malignancy Krusei- resistant to fluconazole Parapsilosis- TPN Lusitaniae- Amphotericin resistant Glabrata- urinary tract, fluconazole resistant
13
Q
What are the 5 types of superficial Candidiasis infections
What are the two systemic ones?
A
Intertrigo Vaginitis Onychomycosis Thrush Esophagitis
Funguria
Candidemia
14
Q
What PTs get thrush
Esophageal Dz form is seen in who/how?
A
Neonates
DM on ABX
ImmSupp
PTs incorrect inhaled steroids
Odynophagia Dysphagia ImmComp- often w/ thrush
15
Q
Most systemic/deep Candidiasis infections are Tx by ?
Diarrhea means an abnormal increase in ? criteria
How long is it present for it to be acute or chronic
A
IV Amphotericin B
IV Voriconazole
Weight: 250gm/day
Liquid: 80% water
Frequency: 3/day 2/wk
<3wks
>3wks
16
Q
How does Acute GE present
What are the different causes of food poisoning and incubation times
A
1-5 days: watery diarrhea, N/V
Ultrashort: 1-2hrs, chemical
Short: 1-6hrs, preformed toxin
Long: 8-16hrs, toxin produce post-consumption
17
Q
What is the most expensive food borne illness causing microbe
What are two medical conditions that predispose individuals to diarrhea
A
Salmonella
C Diff- PPIs, ABX
Plesiomonas species- liver Dz/malignancy
18
Q
Salmonella species are more likely to infect ? PTs
Rotavirus is more likely to infect ?
A
Malaria Achlorhydria Sickle Cell Hemolytic anemia Dysmotility ImmSupp Malnutrition
Hospitalized
19
Q
Giardia species are more likely to infect ? PTs
When is viral AGE suspected?
A
Chronic pancreatitis
Achlorhdria
Cystic fibrosis
Agammaglobulinemia
No bacterial/epidemiology clues
Prominent vomit
Over <3 days
14hrs incubation
20
Q
Adenovirus
Calcivirus
A
Fecal/Oral transmission
Serotypes 40-41
Diarrhea Adeno>Rota x 1-2wks
Tx: supportive
Fecal/Oral transmission
Oysters
Lasts 3 days, Tx: supportive
21
Q
Rotavirus
Unique fact
A
MC cause diarrhea in infants
MC cause of death from diarrhea in developing country
Fecal/Oral spread
Tx: support
Vaccine avail, not used
22
Q
Cytomegalovirus
What adverse outcomes can occur w/ this infection
A
Usually ImmComp/Crohn’s PTs
Can be invasive/colitis
Watery/melena stools
Tx: support, antivirals
Toxic Mega Sepsis Peritonitis Death
23
Q
Yersinia Entericolitica
Staph A
A
Raw pork causing Sxs in 1wk
Pseudo-appendicitis/sepsis
polyarticular arthritis
Tx: Cipro, Trimeth/Sulfa
Sudden N/V/D, 30m-8hrs
Tx: supportive
24
Q
Bacillus Cereus
Clostridium
A
Multiplies in foods at room temps
Spores heat resistant
Rice/pastas- Fried Rice Syndrome
Tx: Cipro, Trimeth/Sulfa
Gas gangrene, mild GI Sxs
Foods high in protein/starches
Not contagious
Tx: supportive
25
Campylobacter jejuni
Community acquired inflammatory enteritis
Fecal/oral, chicken, puppies
or unpasteurized food transmission
```
Pseudoappendicitis
Abd pain (no pain w/ salmon/shigella)
Fever +104
HA Myalgia +10 BM/day
Dx: stool culture
Tx: Azithromycin
```
26
Salmonellosis
Nontyphoid
Birds Amphibs Reptiles Fruit/Veg
Eggs/Dairy
Cholera-like diarrhea
Dx: culture MacConkey agar
Tx: Cipro
27
Typhoid is AKA ? Fever
What are the two types of Typhoid
Enteric
S Typhi= typhoid fever, more common/severe
S paratyphi= more mild
28
How is Typhoid transmitted
What is the hallmark of the infection
Fecal/urine contaminated foods
Mononuclear phagocytic cells in Liver Nodes Spleen Peyer patches of ileum
29
What are the different timing of phases and Sxs of typhoid
Incubation: ASx or diarrhea/constipation
Wk 1: HA Malaise Fever
Wk2: Rose spots on chest/abdomen, fade w/ pressure
Bradycardia w/ dicrotic pulse
Wk 3: pea soup diarrhea, AMS, toxic/death
Wk 4: fever, AMS and distension resolve
30
How is Dx of typhoid definitive
How is it Tx
Isolated from marrow sample
Cipro
Ceftriax/Azith in Asia
31
What are the two microbes that cause 90% of Shigella infections
What does it cause and how
Sonnei
Flexneri
Bacillary dystenery via invasion of colonic epitherlium and enterotoxin production
32
How is Shigellosis transmitted
This infection doesn't cause but increases viruence of ?
Fecal/oral w/ contaminated food/water
Colitis
33
How do Shigellosis infections present
How is it Dx and what is rarely seen
How is it Tx and what is avoided
Bloody/mucus diarrhea w/ lower abdomen tenderness but norm/hyper sounds
Stool culture w/ R/WBCs
Rarely leukocytosis
Cipro
NO narcotic anti-diarrheals
34
How is ETEC Tx
How does O157:H7 present
Loperamide w/ one of:
Azith or Cipro
Aemcolo
Shiga toxin causes watery shifting to bloody diarrhea
35
How does Cholera present
How is it Tx
Painless rice water stool w/ fishy odor
No fevers
Fluid/E+
Doxy/Azith can shorten course
36
What is the vaccine for cholera and when does it have to be taken
Listeria is dangerous in ? PT populations
Vaxchora for 18-64y/os 10 days before travel
Pregnancy- Hispanic
Neonate
Elder
ImmComp
37
How is Listeria transmitted and how does it present
What are possible but rare presentations
Foodborne illness presnting w/ diarrhea
```
PAMAE
Pneumonia
Abscess
Meningitis/Encephalitis
Arthritis/osteromyelitis
Endocarditis
```
38
How do adults present w/ Listeria
How can neonates present w/ this infection?
FM BAH
Fever Myalgia Back pain Arthralgia HA
CNS Abscess Granuloma (AMS common, brain stem infection= encephalitis)
39
How is Listeria Dx
How is it Tx
CSF best
Blood culture
Wet mounts can show motile microbes
Ampicillin or TMP/Sulf
40
Empiric antimicrobial therapy is given to PTs for Listeria if ?
Where can Botulism infections come from
Exposed, Fever >100.6
Canned foods/honey
Wounds- IVDU
Smoked meats
41
Hemorrhagic fever viruses are all ? types
They all damage ? structures in the body
RNA- enveloped in fatty coat
Microvasculature= inc vascular permeability
42
What form of Dengue is more virulent
What is it's carrier
DEN-2
Aedes aegypti/albopictus- 35N/35S day time feeder prefers human
43
PTs w/ low WBCs and fever indicates ? etiology
How does Dengue present
Viral
High fever +105
Retro orbital pain- common
Trunk scarlatinaform or maculopapular rash
44
Why is it dangerous when a Dengue fever stops
This period when it stops causes PT to be at increased risk for ?
Returns in 24hrs worse- Saddleback fever
DHF or DSS
45
What is the hemorrhagic presenting manifestation of Dengue
1/3 of PTs w/ DHF form of Dengue will have ? Sx
Almost all PTs w/ DHF will have?
Petechiae/purpura
Conjunctival injection
Pharyngeal injections
46
What is the MC PE finding for Dengue
What is the name of the Dx test
Petechiae/bleeding at venipuncture
Tourniquet test: inflate BP x 5min, + if 20 petechiae per sq inch
47
What will be seen on lab results in PTs w/ Dengue
Leukopenia at end of febrile phase
Heme/Lymph increase before defervescence/shock
HypoNa- MC metabolic change
LFT- low albumin
48
Hct below 20% will be seen as ? and if it falls below 10% ? is seen
What lab results can be usd for Dx Dengue
20- seeping plasma
10- real bleeding
IgG/IgM inc x4
IgM shows at day 5
DENV R-PCR or NSI- first week
IgM anti-Den ELISA- day 5 of illness
49
How are the different forms of Dengue Tx
What is the name of the vaccine and who can get it
DF: acetaminophen
DHF/DSS: IV fluids, blood transfusion w/ FWB
Dengavaxia- 9-16 w/ previous Dengue Dx
50
What are the complications from Dengue fever
Neuro: encephalopathy, GBarre, Transverse myelitis
DHF/DSS can lead to liver failure
Over hydration
51
What mosquito carries Yellow Fever
How are yellow fever infections established in the body
Aedes aegypti
Mosquito pukes virus
Replicates in reticuloendothelial cells, overwhelm ImmSystem
52
Yellow fever can present w/ ? Sxs
What are the phases
Jaundice
Black water vomit
Saddle back pattern
Acute, 3 days: fever/HA/N/bilious vomit Conjunctival injections
24hr remission
Toxic Phase
53
What will be seen on lab results in Yellow Fever
How are they Tx
Leuko/Thrombocytopenia
Inc convalescent titer
IgM inc 7-10 days post infection
Central venous access (FFP) Mosquito netting
54
What is the natural reservoir of Ebola
What is the single subtype
Bats
Marburg
55
What type of virus is Ebola
What is the name of the vaccine
Filo= thread
VSV-ZEBOV for >18y/o
56
What will be seen on PE late in an Ebola infection
What two findings are indicative of a fatal or poor prognosis
Hippocratic face
Bleeding
Tachypnea
Hiccups
Tachypnea
57
What will be seen on lab results in Ebola PTs
How is it Dx
-penias
Metabolic acidosis
Inc BUN/SrCr
IgM/IgG ELISA
PCR
58
How is Ebola Tx
Virus bodies have been isolated from what two locations in the body after recovery
Re-hydrate Isolate Nutrition
Human convalescent plasma
ZMAPP
Anterior chamber
Semen
59
What is the carrier of Lassa
What is the MC sequela of this infection
Mastomy rodents in W Africa
Deafness
60
Lassa is AKA ? Syndrome that is a major cause of Peds admissions in WAfrica
What would be seen on lab results
Swollen Baby- anasarca/bleeding/edema
ASTs higher than LFTs
Lymph/Cytopenia
61
How is Lassa Dx
How is it Tx
Ag ELISA
PCR
Ribavirin- best if started in 6 days
62
Hantavirus is better known as ?
What is the difference between Hanta's AKA and HFRS
Hemorrhagic Fever w/ Renal Failure Syndrome
HFRS occurs in Far East
63
What is the Triad of Hanta
What PTs are more likely to have a mild infection
Fever
Hemorrhage
Renal Insufficiency
PTs <15y/o
64
# Define HOTN stage of Hanta and what it means
How many phases are there w/ this infection
Tachy- indicates impending shock
Acute abdomen- paralytic ielus
Convulsion
Purposeless movements
```
Febrile
HOTN
Oliguric
Diuretic
Convalescent
```
65
What is a lasting consequence of Hanta infection that can last for years
How is it Dx
Proteinuria
```
Leukocytosis
Inc Hct
Thrombocytopenia
Abnormal LFTs
HypoNa/HyperK
```
Elisa
66
How is Hanta Tx
What are two possible complications that can occur
Fluid/E=
Ribivirin
Pulmonary edema
HyperCa
67
Crimean Congo fever is AKA ?
What carries this dz
How is it contracted
Central Asian fever
Ticks
Livestock
68
How does Crimean Congo Fever present
How is it Dx
How is it Tx
Flu-like, 3-5d later bleeding
Massive ecchymosis*/epistaxis
Hepatomegaly
ELISA/PCR
Ribavirin
69
What is a rare but possible complication from Crimean Congo fever?
What is the second leading cause of death from infection?
Encephalitis
TB
70
What type of microbe is TB
Where do they establish infections in the body?
Acid fast
Non-motile/spore/encapsulated
Terminal airspaces, macrophages ingest and transport to regional nodes
71
Who are the two types of non-respiratory TB infect and how do they present?
What would be heard on PE for pulmonary TB
ImmComp/Elderly
Meningitis: HA AMS Low Fever
Skeletal- MC in spine (Potts dz)
Absent sounds in upper lobes
72
How is TB Dx
What may be the first mycobacterial indication a PT has TB
How is this indication confirmed for definitive Dx
PPD/TST/Mantoux- cornerstone for LATENT
Early morning sputum culture x 3 days
Blood culture- QTF-G
Detection of Acid Fast Bacilli in smear
Culture or Nucleic Acid Amplification
73
Prior to initiating TB Tx, screening must be done due to ? organ affected
What would be seen on CXR of Primary Progressive TB
Liver
Central apical/LL lobe infiltrate
Pleural effusion
74
What would be seen on Reactivated TB CXR
Define Old Dz
Cavity w/ non-calcified round infiltrates
Ranke complex: Calcified peripheral/hilar nodes
(Peripheral= Ghon complex)
Homogenous Calcified nodule
75
How is TB Tx
Isolate in neg-press room
N-95 mask for PT care
Universal precautions
RIPE regime
D/c E once isolate proven to be susceptible
D/c P after 2mon
If INH resistant- RPE x 6mon
76
How is TST done
What can cause a false-pos TST
5 units intradermally, measure response in 2-3 days
All += CXR
MMR/live virus vaccines
77
What are the criteria for a Pos-TST 5mm or larger
```
Close contact
HIV Pos
Organ transplant
Long term steroids
Fibrotic lesion on CXR, not granulomas
```
78
What is the criteria for a Pos-TST 10mm or larger
What is the criteria for a recent converter
DM Renal Dz Ca
IVDU w/ Neg HIV
Kids <4y/o w/ exposure
Resident/employee of high risk facility
10mm inc x 2yrs
Recent immigrant
79
Define Two Step Testing
Hypersensitivity to TB, initial PPD causes boost reaction
Retest in 1-3wks
+= previous infection
If avail, use QTF-G over two step
80
How is LTBI Tx
INH 300mg PO x 9mon
Pyridoxine 25-50mg PO qd
INH resistant/PT can't tolerate:
Alternate: Rifampin
81
LTBI direct observation Tx option
How long are all of the TB Tx regimes
INH and Rifapentine
Isoniazid: 9 or 6mon
Rifapentine: 4mon
Isoniazid/Rifapentine: 3mon
82
What f/u monitoring is needed during TB Txs
If PTs are taking INH, what do they need to avoid?
AST/ALT monthly
Acetaminophen
Alcohol
-azoles
83
What are the drug side effects of Rifampin
Isoniazid
Pyrazinamide
Ethambutol
Thrombocytopenia
Accelerated clearance
Dec OCP effectiveness
Liver Dz
Interact w/ Phenytoin
Peripheral neuropathy
Hyperuricemia
Visual acuity changes
84
What are the necrotizing microbes
What are the anaerobic/polys?
Group A hemolytic strep
Staph A
Vibrio
Aeromonas
Bacteroides
Clostridium
Peptostreptococcus
85
What is the difference in presenation between necrotizing fasciitis and cellulitis
What are two ABX to start in PTs w/ suspected necrotizing fasciitis while labs are pending
PoP to appearance of erythemic areas
Pen G and Clindamycin
Imipenem
Vancomycin
86
Who is MC infected by Strep Pyogenes
How is it Dx
How is it Tx
5-12y/o, Rare <3y/o from person to person
Rapid , Culture
Benzathine PCN
Pen VK/Amox x 10 days
PCN Allergy: Clindamycin
87
Rheumatic fever is a sequela of ?
This can progress to deteriorate heart valves, particularly ? in order
G Group A beta-hemolytic strep
MItral, Aortic, P/T
88
What are the major criteria for Rheumatic fever
What are the minor criteria?
Polyarthritis
Erythema marginatum
Carditis
Syndenham chorea
Fever
Polyarthralgia
Reversible PR prolongation
Inc ESR/CRP
2 major or
1 major and 2 minor
89
How is Rheumatic Fever Tx
Scarlet fever is AKA ?
Bed rest until afebrile/ESR normal
CCS PCN Salicylates
Erythrogenic Toxin
90
What are two unique PE findings of scarlet fever
What does the rash look like
Tongue dorsum w/ white exudate
Projecting edematous papillae
Starts in axillae, gron and neck
Circumolar pallor rash, rough like sand paper
91
How is scarlet fever Tx
Define SSS
Pen V
Erythromycin
Exotoxin response w/ exfoliation= Nikolsky's Sign
92
What are the MC sites for SSS
What is it AKA?
PO cavity
Umbilicus
Nasal cavity
Throat
Ritter Dz
93
How is SSS Tx
What microbes can cause Toxic Shock Syndrome
Who does it usually affect?
Fluids
IV Nafcillin until culture results
Staph A
Rarely- Group A Strep
Women
94
How does TSS present
How is it Dx
Bullae
Scarlet fever like rash
Desquamation 7-14 days later on palms/soles
HOTN
3 system involvement
95
How is TSS Tx
What is the name of the BGS microbe and what does it cause in females?
Staph origin: Nafcillin
Strep origin: Pen G, Clinda
Strep Agalactiae- peripartum fever MC manifestation
96
What are the two types of GBS infections in neonates
How is it Dx
How is it Tx
Early: <20hrs post-birth
Late: 1wk-3mon later
Cultures
PCN G
97
What are the risks of GBS infection survivors
How is MRSA Tx
Neuro: seizure, deaf, blind
<5cm: TMP/Sulfa Doxy Clinda
Larger lesion: Vancomycin
98
What are the two forms of Tetanus
Of the 3 toxins released, which one causes issues
Spore: dormant in soil/dirt
Vegetative cell- active
Tetanospasmin- neuromuscular d/o
99
What are the 4 presentations of tetanus
General: skeletal muscles, MC/Most severe
Local
Cephalic: facial muscles only
Neonate
100
What is the MC Sx of tetanus
What are seizures due to teatnus like?
Trismus/Lock jaw
```
No Loc, sever pain
Opisthotonis
Flexion/abduction of arms
Clench fists on thorax
Extension of LEs
```
101
How is Tetanus Dx
How is it Tx
Clinical
Peripheral leukocytosis
Diazepam for seizures
Metronidazole
Tetanus immune globulins
102
When is SIRS classified as septic
What are the criteria needed for Dx
One acute organ dysfunction/failure
```
Two of:
Temp over 100.4/under 98.6
HR +90 (absent if on BB/CCB)
RR +20 (most serious marker)
PaCO2 <32mmHg
WBC >12K or <4K
```
103
What are the different stages
1: Rubor Tumor Calor Dolor Functio laesa
2: body attempt to correct homeostasis, low fever
3: cytokine release turns destructive, humoral cascade leads to dilation/inc permeability- end organ damage
104
Most deaths due to SIRS is due to ?
How is measles spread
What is the presenting Sxs of the prodrome
Underlying Ca
Rubeola- droplet
FC3
Fever Conjunctivitis Coryza Cough
105
What is pathognomoinc for Rubeola
What does the rash look like
What is seen on lab results
Koplik spots
Day 3-7, red blotchy rash
Face to trunk to extremeties
Leukopenia
106
Measles is more likely to infect PTs w/ deficiency of ?
What are the complications that can come out of a measles infection?
Vit A
COPED
Croup Ottitis media Pneumonia Encephalitis Diarrhea
107
Why do PTs die from measles
How is this Dx
When are they contagious
<5y/o due to pneumonia or encephalitis
Background
Measles IgM= confirmation
Before prodrome
4 days after rash appears
108
When can Peds get measles vaccine
How is post-exposures Tx
15mon
Vit A
ImmGlobulin if:
Not immunized
72hrs after exposure but w/in 6 days
109
What is the most characteristic feature of Rubella
This finding precedes ? by how long
Post-auricular Occipital Cervial adenopathy
Rash by 5-10days
110
What are the names of the Rubella spots
What female PTs w/ Rubella are more likely to have ? Sx
What Sx is more likely in adults than in kids?
Forscheimer spots
Arthralgia/Arthritis
Encephalitis
111
What are common lab results in Rubella
Why is early identification of Rubella needed in pregnant PTs
if this is not caught early, what can develop
Leuko/Thrombocytopenia
Avoid CRS- congenital rubella syndrome in first 16wks of pregnancy
Deaf Cataract Microphthalmia Glaucoma
112
What is the Trifecta of Rubella Syndrome
What is a late manifestation of pregnancy and CRS
Microcephaly
PDA
Cataracts
DM-1
113
How is Rubella Dx in mothers?
How is it Dx in newborns
ELISA IgM
CSF
114
How does Rubella transmit
Where does the virus leave the body
Winter/spring transmitted through naso secretions
Secretions
Urine
115
When are PTs w/ Rubella infectious
CMV is a strain of HHV ?
1wk before onset
4 days after rash
#5
116
How are the most severe form of CMV infections acquired by infants?
CMV infects what two parts of the body
If they survive, what are the consequences?
Perinatal infection
Intrauterine infection
Blood transfusion to seronegative infants
CNS
Liver
Dear Retardation Motor disability
117
CMV is the MC cause of
How are these infections Dx
Post-transplant infections (kidney)
Newborn: virus isolate from urine
Adult: Ag/DNA detection
118
CMV is an early manifestation of ?
How is CMV excreted out of the host body
HIV/AIDS
Saliva Cervical secretions Urine Milk Semen
119
What does CMV cause in ASx PTs
Who secretes CMV longer, adults or babies?
What antivirals are effective?
Viremia
Babies
V/G-clovir
Foscarnet
120
What is the MC of infectious mono?
What Sxs characterize this infection
EBV- HHV 4
Fever
Sore throat, exudative
Cervical adenopathy
Splenomegaly
121
EBV/Mono may present with jaundice but will have ? normal lab result?
These infections are more severe in ? PTs and are linked w/ ? Cas
Norm LFTs
Older
Burkitt lymphoma
Nasopharyngeal Ca
122
EBV/Mono is AKA ?
Mumps usually infects ? gland but can also infect ?
The Kissing Dz
Parotid
Sublingual/maxillary
123
What are 3 rare but possible outcomes of Mumps
How is it transmitted
Sterility
Unilateral deafness
Encephalitis
Droplet spread from saliva
124
What are the characteristic findings of Polio paralysis
What are the 3 categories of polio infections
Asymmetric
Fever w/ onset
Flaccid paralysis w/out sensory loss
Abortive- mild
Non-paralytic- meningeal irritation/muscle spasms
Paralytic- spinal or bulbar- CN respiratory or vasomotor centers
125
PTs w/ polio in LE walk w/ ? gait
Polio is more likely to affect ? part of the body
Equinus foot, can extend but not flex (muscles can pull toes down, but not up)
Legs>arms
126
How is Polio differentiated from GBarre Syndrome
How is this infection Dx
GBS- symmetric w/ high proteins in CSF
F/Ha/N/V are absent
Isolation from stool, CSF or PO secretions
Dx= 4x/rising inc of Abs
127
Where are Varicella lesions more abundant
How does Varicella lead to death in adults and kids
Areas of irritation-
Diaper Axilla
Adults: viral pneumonia
Kids: septic/encephalopathy complications
128
Varicella and Herpes Zoster are both linked to ? Syndrome
What is the complication occurring from Zoster
Reyes
Post-herpetic neuralgia
129
What microbe is the infecting agent for Varicella or Zoster
What vaccine can be given for post-exposure protection
HAH- 3
VZIG
130
What Zoster vaccine is given to PTs over ? age
What antiviral can be used
RZV >50
Acyclovir
131
Erythema is AKA ?
What microbe causes this
Fifth Dz
Erythrovirus
Slapped cheek
Parvovirus B19
132
How is Erythema Infectiosum Dx and why is getting a Dx important
What are complications that can occur
How is it Tx
Anti-B19 IgM
Associated w/ myocarditis
Hemolytic anemia
TTP
Post-infect glomerulonephritis
Hepatitis
NSAIDs, not ASA
133
Roseola is AKA and infects ? ages
What microbe is responsible
6th dz
1-5y/o (5th Dx 5-15y/o)
HHV 6
134
Although normally Tx Sx, what can be used during Roseola Tx
Zika virus is AKA ? virus
G/C-clovir
Foscarnet
Flavi
135
Metro is used in the Tx of ?
What trimester is affected by Lassa or Mumps
Wound botulism
Tetanus
Lassa 3rd
Mumps 1st
136
All mycotic Dzs are __ at 77* and are __ at 98.6
What is the exception
Molds
Yeast
Coccidio- spherules in tissue
137
Blastomycosis affects ? PTs and what are the two types of primary
Cutaneous form affects ? areas in precedence
Males, ASx 50%
Primary- self resolving
Acute: bacterial pneumonia
Chronic- TB
Face Extremity Neck Scalp
138
Blastomycosis affects ? parts of the body
Which PTs are Tx
How is it Tx
CNS Osteo GU
ALL PTs
Severe/CNS: amphotericin
Mild/Mod: Itra/Fluconazole
139
What is Doxy used to Tx
What is Ritter Dz
Bats carry ?
Cholera w/ Azith
MRSA w/ TMP/Clinda
Staph SSS
Histo
140
? presents w/ bloody stool
? causes pancreatitis
Death from SIRS is higher if ? is associated
Jejuni O157 CMV Shigellosis
TB Giardia Mumps
Malignancy
141
? microbes cause saddle fever
What viral hemorrhagic fever causes has a triad w/ renal failure?
Dengue
Yellow
Hanta: Hemorrhage Fever Renal failure
142
What is a Ranke Complex
What microbes can lead to deafness
Reactivated TB w/ calcification complexes
Lassa CRS Mumps CMV GBS
143
What two have sandpaper rashes
What two cause anasacara
Scarlet
Scalded
Yellow Lassa
144
Coccidio includes two microbes that cause different forms of ? fever
This microbe is a hazard in ? setting
```
San Joaquin (Immitis)
Valley (Posadasii)
```
Laboratory
145
How does acute or chronic Coccidio present
What is the more common form
This can invade ? 3 tissues in the body
Acute pneumonia: adenopathy, erythema multiform
Chronic- TB0like
Fulminant
Skin Bone Meninges
146
How is Coccidio Tx
```
Acute Pulm= no therapy, Sx only
Severe: amphotericin
Other: Itra/Fluconazole
Meningeal: fluconazole x life
Amphotericin
```
