IDz Block 2 Cram Flashcards
MCV is the MC cause of ?
How is CMV Dx
Post-implant infections (kidney)
Virus isolation from:
Newborn- urine
Adult- Ag/DNA detection
CMV is an early manifestation of ?
How is it transmitted
PTs can have CMV and be ASx but still have ?
HIV/AIDS
Semen Cervical secretion Urine Milk Saliva
Viremia
Since Peds secrete CMV longer than adults, what antivirals can be used?
V/G-clovir
Foscarnet
Mumps may also have an unproven association w/ ? systemic Dz
If PT doesn’t have parotitis, what two issues can be involved
DM
Neuro Orchitis
What are 6 rare but possible Sxs of Mumps
How can it be Dx
Pericarditis Arthritis Neuritis Throiditis Mastitis Nephritis
ELISA IgM
? PTs w/ Mumps are typically subclinical
How is Mumps transmitted
<2y/o
Droplet/contact w/ saliva
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
7 days before parotitis
5 days after onset
48hrs prior to onset
Urine x 14 days after onset
1% of Polio Pts will present w/
Commonly a minor illness is recognized in acute polio w/ ? Sxs
Aseptic meningitis
HA Fever Malaise N/V
When polio results in paralysis, how is the paralysis define and what additional Sx is present
What are the 3 categories of Polio
Asymmetric flaccid paralysis of LE w/ retained senses
+ Fever
Abortive- mild
Non-paralytic- meningeal irritation, spasms
Paralytic- Spinal/Bulbar
B: CN- respiratory/vasomotor
What type of gait is acquired in Polio PTs
What is the sequale that can develop that affects the opposite limb
Equinus foot- muscles pull toes down, not up. Can extend, not flex
Post-Polio Syndrome
How is Polio different from GBarre
Non-paralytic polio DDxs include
GBS- symmetric paralysis w/ high protein in CSF
No F/Ha/N/V
Brain abscess- NeuroSyph
Leptospirosis- Encephalitis
Mono
How is Polio Dx
How is a presumptive Dx made
Virus isolation from:
Pharyngeal CSF Stool
4x inc/rise of Ab levels
What is the vaccine for virus strains of Polio
What is the risk of receiving the inactivated form of vaccine
cVDPV1 (OPV, live)
Higher levels of GI viral excretion
Harder to transport/conduct ShotEx
Progression of Vericella lesions
How are the vesicles described
The vesicles are more likely to occur where?
Maculopapular x hrs
Vesicular x 4 days
Granular scabs
Monocular that collapse on puncture
Areas of irritation:
Diaper Axilla
What are the primary causes of Varicella related death in adults or kids
Varicella is linked to ? Syndrome
Adult: viral pneumonia
Peds: sepsis/encephalitis
Reyes
Alot of PTs w/ Zoster will have ? issue
What microbe is Varicella/Zoster
Post-herpetic neuralgia
Human Alpha Herpesvirus 3
HAH-3
How is Varicella transmitted
How long are they contagious
Person-person/direct contact
Respiratory secretion
Droplet/airborne
Varicella:5 days before/after rash
Zoster: 7 days after appearance
What is used for post-exposure prophylaxis for Varicella
What is the shingles vaccine and for who?
VZIG w/in 96hrs
Varicella vaccine
Acyclovir
Shingrix >50y/o
Erythema Infectiosum is AKA
If infects ? ages
What is the microbe
5th Dz
Erythrovirus
5-15y/o
Parvovirus B19
What seasons is Erythema Infectiosum common?
How long is the incubation
How does it present
Winter/Spring
4-14 days prior to Sx onset
Lacy rash
Arthritis of hands feet or knees
Slapped cheek
Why is a definitive Dx of Erythema Infect needed?
What are some complications that can arise?
How is it Tx
Associated w/ myocarditis
Hemolytic anemia
TTP
Post-infection glomerulonephritis
Hepatitis
NSAIDS, not ASA
Roseola is AKA
What ages does it infect
What is the microbe
6th Dz
1-5y/o
HHV-6
How does Roseola present
What can be used for Tx of complicated cases
Fever
Preiorbital edema
Cervical/occipital adenopathy
Rose rash on trunk/extremities
G/C-clovir
Foscarnet
When are Rubeola PTs contagious
Vaccine be given at ? age
Prior to prodrome
4 days after rash
15mon
PTs that are not vaccined for Rubeola but are exposed receive ?
Rubella is AKA ?
This can resemble/mimic ?
Immune Globulin- 3-6 days
Vit A
German Measles
Scarlet fever
Coxsackie
Mono Rash
What is the most characteristic feature of a Rubella infection
What is the name of this feature
Post-auricular/cervical, occipital adenopathy that precedes rash x 5-10 days
Forsheimer Spots
? Sx of Rubella is common in adults but rare in children
What are two common lab results
Encephalitis
Leuko*/Thrombocytopenia
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
First 16wks
DM
Necrotizing Fasciitis is usually initiated by ? microbes
What anaerobic/polymicrobic microbes can cause it?
Vibrio Aeromonas GAS Staph A
Bacteriodes Clostridium Peptostrepto
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?
PoP on exam
Vancomycin
Imipenem
Pen G and Clindamycin
Hyperbaric chamber
What images are ordered for suspected Necrotizing Fasciitis and which one is preferred?
What microbe causes Strep Throat
X-rays: gas bubbles
MRI: preferred for exam of soft tissue and edema
Strep Pyogenes- GAS
Strep throat usually infects ? PTs during what part of the year
It is rarely seen in kids under ? age
How is it transmitted
5-12y/o late fall-early spring
<3y/o
Person to person
How is Strep throat Tx
Rheumatic fever is a sequelae of ?
This can progress to deteriorate ? heart valves
IM Benzathine PCN
Pen VK or Amoxicillin
PCN Allergy- Clindamycin
GAS
Mitral Aorta T/P
Rarely aorta alone
What are the Major criteria for Rheumatic Fever
What are the Minor
Polyarthritis
Erythema marginatum
Carditis
Syndenham chorea
Polyarthralgia
ESR/CRP inc
Reversible PR prolongation
Fever
Dx= 2 major or 1 major, 2 minor
Rheumatic fever PTs are placed on bed rest for Tx until ?
What meds can be used
Afebrile
Normal ESR EKG and Pulse
PCN
CCS
Salicylates
Scarlet fever is due to ? toxin
Where does the rash begin?
How is this Tx
Erythrogenic
Neck Axilla Groin
Pen V
Erythromycin
SSS is similar to ? and is a ? mediated response
SSS is AKA ?
What are the most common sites for it to occur?
Scarlet
Exotoxin
Ritter Dz
Oral/nasal cavity
Umbilicus
Throat
What is seen on PE of PTs w/ SSS
How is this Tx
Nikolsky’s Sign
Support w/ fluids
IV Nafcillin
TSS is usually caused by ? but can be caused by ?
What will be seen on PE
Staph A
GAS
Desquamination on palms/soles 7-14d later
HOTN
TSS should be considered w/ ? PT presentation
How is it Tx
Sudden fever
Rash
HOTN
Systemic toxicity
Staph origin (MC)- Nafcillin Strep origin- Pen G + Clinda
Name of GBS
This is a major cause of ? in neonates
What does it cause in adults
Strep Agalactiae
Sepsis/meningitis
Peripartum fever
How are GBS infections Tx
What are complications of this infection?
What are the high risk settings for acquiring MRSA
Pen G
Neuro Hearing Blind
Prison
Competitive sports
Military training
How is MRSA Tx
OutPT or <5cm:
TMP/Sulfa
Doxy
Clinda
InPT: Vancomycin
MRSA Carriers Tx:
Bactroban
Chlorhexidine
What does tetanus release that causes MSK issues
What are the 4 types of tetanus infections
Tetanospasmin
Generalized- MC/most severe
Local
Cephalic- facial muscles only
Neonatal
MC presenting Sx of tetanus
Where do tetanus seizures occur
Trismus
Flex/abd of arms
LE extension
Opisthotonos
Clench fists on thorax
What is used to Tx tetanus
What infection is re-named to sepsis once organ damage sets in
Diazepam
Immglobulin
Metronidazole
SIRS
What is the criteria for SIRS
Most deaths from SIRS are associated w/ ?
Fever >100/4
HR +90
RR +20/PaCO2 <32mm/
WBCs >12K or <4K
Malignancy
What are the stages of SIRS
Extrapulmonary TB is common in ? PTs
I: Rubor Dolor Calor Tumor
II: cytokine release
III: humoral cascade
Co-existing HIV
Cornerstone of Dx L-TBI is?
What is the only way to Dx
PPD
Culture
NAA
AST>ALT in ?
Reactivated TB is AKA and has ?
Lassa
Old Dz
Calcified peripheral and nodular nodes
TB tx
Rifampin INH Pyrazinamide Ethambutol
D/c E first
2mon- stop P
R and I x 4mon
How is INH resistant TB Tx
Ribivarin Tx for
RPE x 6mon
Congo Hanta Lassa
Define Two Step Testing
How is LTB Tx
Negative
Rpt 1-3wks
Pos= previous infection
What are the prodrome Sxs of Rubeola
Dormant form of tetanus is ? and the active form is ?
FC3
Fever Conjunctivitis Coryza Cough
Spore- dormant
Vegetative- active
Rubeola
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
Rubella
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
CMV
CNS/LIver
MC cause transplant infection
Transmission: SCUMS
ASx PT- viremia
Tx: F/G/V
Mono
HHV4
Sx: FATS
Burkitt/Nasopharyngeal Ca
Dx w/ Monospot
Mumps
Linked to DM
No parotitis- Neuro/Orchitis
Atypical Sxs: PANTMN
Dx ELISA
Polio
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
Varicella
Maculopapular Vesicle Granular scab
Vesivle-monocular, collapsable
Death: adult- pneumonia ped- encephalitis
Reyes Syndrome
Herpes Zoster/Shingles microbe
HAH-3
Erythema Infectum
5th Dz ParvoB19 Erythemavirus
Lacy rash
Arthritis hand foot knee
Slapped cheek
Linked w/ myocarditis
Tx: NSAIDs
Roseola
6th Dz HHV 6
Rash at defervescence
Seizure Hx w/ fever
Rose rash Adenopathy
Periorbital edema
Tx: F/C/G
Zika
Flavivirus
Microvephaly Eye Barre
No ASA/NSAIDs
