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IDz Block 2 Cram Flashcards

1
Q

MCV is the MC cause of ?

How is CMV Dx

A

Post-implant infections (kidney)

Virus isolation from:
Newborn- urine
Adult- Ag/DNA detection

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2
Q

CMV is an early manifestation of ?

How is it transmitted

PTs can have CMV and be ASx but still have ?

A

HIV/AIDS

Semen Cervical secretion Urine Milk Saliva

Viremia

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3
Q

Since Peds secrete CMV longer than adults, what antivirals can be used?

A

V/G-clovir

Foscarnet

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4
Q

Mumps may also have an unproven association w/ ? systemic Dz

If PT doesn’t have parotitis, what two issues can be involved

A

DM

Neuro Orchitis

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5
Q

What are 6 rare but possible Sxs of Mumps

How can it be Dx

A 
Pericarditis
Arthritis
Neuritis
Throiditis
Mastitis
Nephritis

ELISA IgM

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6
Q

? PTs w/ Mumps are typically subclinical

How is Mumps transmitted

A

<2y/o

Droplet/contact w/ saliva

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7
Q

How long is Mumps isolated w/in saliva

CDC recommends isolating these PTs for how long

When are these PTs max infectious but what can be post for longer

A

7 days before parotitis

5 days after onset

48hrs prior to onset
Urine x 14 days after onset

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8
Q

1% of Polio Pts will present w/

Commonly a minor illness is recognized in acute polio w/ ? Sxs

A

Aseptic meningitis

HA Fever Malaise N/V

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9
Q

When polio results in paralysis, how is the paralysis define and what additional Sx is present

What are the 3 categories of Polio

A

Asymmetric flaccid paralysis of LE w/ retained senses
+ Fever

Abortive- mild
Non-paralytic- meningeal irritation, spasms
Paralytic- Spinal/Bulbar
B: CN- respiratory/vasomotor

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10
Q

What type of gait is acquired in Polio PTs

What is the sequale that can develop that affects the opposite limb

A

Equinus foot- muscles pull toes down, not up. Can extend, not flex

Post-Polio Syndrome

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11
Q

How is Polio different from GBarre

Non-paralytic polio DDxs include

A

GBS- symmetric paralysis w/ high protein in CSF
No F/Ha/N/V

Brain abscess- NeuroSyph
Leptospirosis- Encephalitis
Mono

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12
Q

How is Polio Dx

How is a presumptive Dx made

A

Virus isolation from:
Pharyngeal CSF Stool

4x inc/rise of Ab levels

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13
Q

What is the vaccine for virus strains of Polio

What is the risk of receiving the inactivated form of vaccine

A

cVDPV1 (OPV, live)

Higher levels of GI viral excretion
Harder to transport/conduct ShotEx

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14
Q

Progression of Vericella lesions

How are the vesicles described

The vesicles are more likely to occur where?

A

Maculopapular x hrs
Vesicular x 4 days
Granular scabs

Monocular that collapse on puncture

Areas of irritation:
Diaper Axilla

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15
Q

What are the primary causes of Varicella related death in adults or kids

Varicella is linked to ? Syndrome

A

Adult: viral pneumonia
Peds: sepsis/encephalitis

Reyes

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16
Q

Alot of PTs w/ Zoster will have ? issue

What microbe is Varicella/Zoster

A

Post-herpetic neuralgia

Human Alpha Herpesvirus 3
HAH-3

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17
Q

How is Varicella transmitted

How long are they contagious

A

Person-person/direct contact
Respiratory secretion
Droplet/airborne

Varicella:5 days before/after rash
Zoster: 7 days after appearance

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18
Q

What is used for post-exposure prophylaxis for Varicella

What is the shingles vaccine and for who?

A

VZIG w/in 96hrs
Varicella vaccine
Acyclovir

Shingrix >50y/o

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19
Q

Erythema Infectiosum is AKA

If infects ? ages

What is the microbe

A

5th Dz
Erythrovirus

5-15y/o

Parvovirus B19

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20
Q

What seasons is Erythema Infectiosum common?

How long is the incubation

How does it present

A

Winter/Spring

4-14 days prior to Sx onset

Lacy rash
Arthritis of hands feet or knees
Slapped cheek

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21
Q

Why is a definitive Dx of Erythema Infect needed?

What are some complications that can arise?

How is it Tx

A

Associated w/ myocarditis

Hemolytic anemia
TTP
Post-infection glomerulonephritis
Hepatitis

NSAIDS, not ASA

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22
Q

Roseola is AKA

What ages does it infect

What is the microbe

A

6th Dz

1-5y/o

HHV-6

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23
Q

How does Roseola present

What can be used for Tx of complicated cases

A

Fever
Preiorbital edema
Cervical/occipital adenopathy
Rose rash on trunk/extremities

G/C-clovir
Foscarnet

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24
Q

When are Rubeola PTs contagious

Vaccine be given at ? age

A

Prior to prodrome
4 days after rash

15mon

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25
Q

PTs that are not vaccined for Rubeola but are exposed receive ?

Rubella is AKA ?

This can resemble/mimic ?

A

Immune Globulin- 3-6 days
Vit A

German Measles

Scarlet fever
Coxsackie
Mono Rash

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26
Q

What is the most characteristic feature of a Rubella infection

What is the name of this feature

A

Post-auricular/cervical, occipital adenopathy that precedes rash x 5-10 days

Forsheimer Spots

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27
Q

? Sx of Rubella is common in adults but rare in children

What are two common lab results

A

Encephalitis

Leuko*/Thrombocytopenia

28
Q

What part of pregnancy is at the highest risk for acquiring CRS

What is the MC underlying condition that causes PTs to progress to Necrotizing Fasciitis

A

First 16wks

DM

29
Q

Necrotizing Fasciitis is usually initiated by ? microbes

What anaerobic/polymicrobic microbes can cause it?

A

Vibrio Aeromonas GAS Staph A

Bacteriodes Clostridium Peptostrepto

30
Q

PT w/ Necrotizing Fasciitis will present w/ cellulitis like Sxs, but what is different?

What ABX are started while awaiting for lab confirmation?

What therapy adjunct may be utilized for these PTs?

A

PoP on exam

Vancomycin
Imipenem
Pen G and Clindamycin

Hyperbaric chamber

31
Q

What images are ordered for suspected Necrotizing Fasciitis and which one is preferred?

What microbe causes Strep Throat

A

X-rays: gas bubbles
MRI: preferred for exam of soft tissue and edema

Strep Pyogenes- GAS

32
Q

Strep throat usually infects ? PTs during what part of the year

It is rarely seen in kids under ? age

How is it transmitted

A

5-12y/o late fall-early spring

<3y/o

Person to person

33
Q

How is Strep throat Tx

Rheumatic fever is a sequelae of ?

This can progress to deteriorate ? heart valves

A

IM Benzathine PCN
Pen VK or Amoxicillin
PCN Allergy- Clindamycin

GAS
Mitral Aorta T/P
Rarely aorta alone

34
Q

What are the Major criteria for Rheumatic Fever

What are the Minor

A

Polyarthritis
Erythema marginatum
Carditis
Syndenham chorea

Polyarthralgia
ESR/CRP inc
Reversible PR prolongation
Fever

Dx= 2 major or 1 major, 2 minor

35
Q

Rheumatic fever PTs are placed on bed rest for Tx until ?

What meds can be used

A

Afebrile
Normal ESR EKG and Pulse

PCN
CCS
Salicylates

36
Q

Scarlet fever is due to ? toxin

Where does the rash begin?

How is this Tx

A

Erythrogenic

Neck Axilla Groin

Pen V
Erythromycin

37
Q

SSS is similar to ? and is a ? mediated response

SSS is AKA ?

What are the most common sites for it to occur?

A

Scarlet
Exotoxin

Ritter Dz

Oral/nasal cavity
Umbilicus
Throat

38
Q

What is seen on PE of PTs w/ SSS

How is this Tx

A

Nikolsky’s Sign

Support w/ fluids
IV Nafcillin

39
Q

TSS is usually caused by ? but can be caused by ?

What will be seen on PE

A

Staph A
GAS

Desquamination on palms/soles 7-14d later
HOTN

40
Q

TSS should be considered w/ ? PT presentation

How is it Tx

A

Sudden fever
Rash
HOTN
Systemic toxicity

Staph origin (MC)- Nafcillin
Strep origin- Pen G + Clinda
41
Q

Name of GBS

This is a major cause of ? in neonates

What does it cause in adults

A

Strep Agalactiae

Sepsis/meningitis

Peripartum fever

42
Q

How are GBS infections Tx

What are complications of this infection?

What are the high risk settings for acquiring MRSA

A

Pen G

Neuro Hearing Blind

Prison
Competitive sports
Military training

43
Q

How is MRSA Tx

A

OutPT or <5cm:
TMP/Sulfa
Doxy
Clinda

InPT: Vancomycin

MRSA Carriers Tx:
Bactroban
Chlorhexidine

44
Q

What does tetanus release that causes MSK issues

What are the 4 types of tetanus infections

A

Tetanospasmin

Generalized- MC/most severe
Local
Cephalic- facial muscles only
Neonatal

45
Q

MC presenting Sx of tetanus

Where do tetanus seizures occur

A

Trismus

Flex/abd of arms
LE extension
Opisthotonos
Clench fists on thorax

46
Q

What is used to Tx tetanus

What infection is re-named to sepsis once organ damage sets in

A

Diazepam
Immglobulin
Metronidazole

SIRS

47
Q

What is the criteria for SIRS

Most deaths from SIRS are associated w/ ?

A

Fever >100/4
HR +90
RR +20/PaCO2 <32mm/
WBCs >12K or <4K

Malignancy

48
Q

What are the stages of SIRS

Extrapulmonary TB is common in ? PTs

A

I: Rubor Dolor Calor Tumor
II: cytokine release
III: humoral cascade

Co-existing HIV

49
Q

Cornerstone of Dx L-TBI is?

What is the only way to Dx

A

PPD

Culture
NAA

50
Q

AST>ALT in ?

Reactivated TB is AKA and has ?

A

Lassa

Old Dz
Calcified peripheral and nodular nodes

51
Q

TB tx

A

Rifampin INH Pyrazinamide Ethambutol

D/c E first
2mon- stop P
R and I x 4mon

52
Q

How is INH resistant TB Tx

Ribivarin Tx for

A

RPE x 6mon

Congo Hanta Lassa

53
Q

Define Two Step Testing

How is LTB Tx

A

Negative
Rpt 1-3wks
Pos= previous infection

54
Q

What are the prodrome Sxs of Rubeola

Dormant form of tetanus is ? and the active form is ?

A

FC3
Fever Conjunctivitis Coryza Cough

Spore- dormant
Vegetative- active

55
Q

Rubeola

A

Measles

Droplet spread to prodrome of FC3/Koplik

Red-blotchy rash from Face Trunk Extremeties

Vit A deficient

Complications: COPED

Death: ecephalitis/pneumonia
Imm at 15mon

Exposure Tx: ImmGlobulin, Vit A

56
Q

Rubella

A

Blueberry muffin

DPM rash

Similar to Scarlet Coxasck Mono

Adenopathy/Forscheimer

Encephalitis adult>ped

CRS <16wks: MCDG

Syndrome: PCM

DM1- manifestation of mild case

Dx w/ neonate CSF

57
Q

CMV

A

CNS/LIver

MC cause transplant infection

Transmission: SCUMS

ASx PT- viremia

Tx: F/G/V

58
Q

Mono

A

HHV4

Sx: FATS

Burkitt/Nasopharyngeal Ca

Dx w/ Monospot

59
Q

Mumps

A

Linked to DM

No parotitis- Neuro/Orchitis

Atypical Sxs: PANTMN

Dx ELISA

60
Q

Polio

A

Infects GI, moves to Neuro

90% sub-acute infxn

3 categories:
Abortive: mild
Non-para: spasms
Para: spinal/bulbar- CN, resp, vasomotor

Vaccine cVDPV-1

61
Q

Varicella

A

Maculopapular Vesicle Granular scab

Vesivle-monocular, collapsable

Death: adult- pneumonia ped- encephalitis

Reyes Syndrome

62
Q

Herpes Zoster/Shingles microbe

A

HAH-3

63
Q

Erythema Infectum

A

5th Dz ParvoB19 Erythemavirus

Lacy rash
Arthritis hand foot knee
Slapped cheek

Linked w/ myocarditis

Tx: NSAIDs

64
Q

Roseola

A

6th Dz HHV 6

Rash at defervescence
Seizure Hx w/ fever

Rose rash Adenopathy
Periorbital edema

Tx: F/C/G

65
Q

Zika

A

Flavivirus

Microvephaly Eye Barre

No ASA/NSAIDs

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