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IPAP > IDz Block 3 > Flashcards

IDz Block 3 Flashcards

1
Q

How do Cestodes eat?

What are the body parts?

A

Absorb through integument

Scolex (attachment)
Neck
Segmented body- proglottids

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2
Q

Cestodes are AKA ? and what are the 4 types

A

Tapeworms
Hymenolepiasis- Nana, Diminuta
T solium Saginata
D Latum

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3
Q

H Nana are AKA and grow to be ? big

These are the MC cause of ?

How is the infection started and where does it reside?

A

Dwarf Tapeworm, 15-40mm

Cestode infections worldwide

F-o ingestion of eggs
In ileum, attach to villus

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4
Q

S/Sx of Hymenolepiasis infections

What S/Sxs are rarely seen?

Since PE is rarely useful, what is seen on lab results and how is this Tx

A

Restless Abd pain Irritable Diarrhea Nasal/Anal pruritus

HA Extremity pain Hive Anorexia Dizzy Bloody diarrhea Inc appetite Behavior N/V

Eosinophilia
Eggs in stool
Tx w/ Praziquantel

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5
Q

Life cycle of Taeniasis

A

Human SmInt- eggs in feces
Cattle/pig ingest eggs
Embyos penetrate gut lumen, encyst muscular tissue= infection 2-3mon
Cysticercus attaches in SmInt

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6
Q

Taeniasis adults can develop ? many eggs and live for ?

Since most of these infections are ASx until large worm burden, what are the S/Sx?

A

50K eggs/day
25yrs

Hunger Epigastric Anorexia Diarrhea Malaise Abd pain Weight loss Nausea

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7
Q

What is the most striking/main feature of the other form?

What can happen w/ migrating proglottids during a Taeniasis infection

A

T Saginata- passing proglottis

Appendicitis
Cholangitis

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8
Q

What PE finding of Taeniasis is less/more common in kids and more in adults?

What form can present with an odd presentation?

A

Adults: Subcutaneous nodules
Peds: weight loss

Cysticercosis- Neuro abnormalities

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9
Q

What labs are drawn during a Taeniasis infection

How is this Tx

A

Stool sample
Ab detection- early/invasive
Cellophane swab
CBC

Praziquantel
Surgery if obstruction present

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10
Q

Define Cysticercosis

Where is this seen in the US

What is the definitive host and how does it get infected??

A

Systemic dissemination d/t larval form of T Solium

SoCal

Humans, F/o route

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11
Q

What tissues can Cysticercosis infect?

This parasite is also the MC ?

A

Muscle Eye CNS Heart Skin

Parasitic infection of CNS

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12
Q

What are the S/Sxs of Neurocysticercosis

S/Sxs of Cysticercosis

A

Seizure HA AMS Vision change N/V

Papilledema Hyperreflex Afebrile Nystagmus SubQ nodules

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13
Q

What Labs/Rads are ordered for Cysticercosis

A

CT* MRI

Biopsy nodule
ELISA 
CBC
CSF 
Stool for Taeniasis
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14
Q

How is Cysticercosis Tx

A

Main focus= Sx care
CCS Osmotic Diuretic
O2
Anticonvulsant

Not for NeuroCystic:
Albendzaole/Praziquantel + Dexamethasone
Maybe Etanercept (anti-TNF)

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15
Q

Where are Diphyllobothriasis infection acquired from

Where does it reside in and for how long

A

Embryo from crustacean eaten by fish consumed raw by human

Small Intestine x 10yrs

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16
Q

MC presentation of Diphyllobothriasis infestation

What other S/Sx may be seen

A

ASx

Hunger Dizzy
Fatigue Weak*(rare) Numb Diarrhea

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17
Q

Diphyllobothriasis has unusual affinity for ?

This may cause PTs to present w/ issues resembling ? issue

A

Vit B12

Megaloblastic anemia

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18
Q

What would be seen on lab results in Diphyllobothriasis infections

How are these infections T

A

Stool ova/parasites
CBC- dec Hgb/Hct
Inc MCV, Eosinophils
Low B12/Folate

Praziquantel w/ vitamins

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19
Q

Trematodes have ? body parts and are AKA

What is seen on lab results in suspected Trematode infections?

A

Flat body w/ cuticle and sucker, Flukes

Eosinophilia= migrating, none during intestinal phase

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20
Q

What are the types of Trematodes?

A

Blood: Schistosomiasis- Haematobium Japonicum Masoni

Liver- F Hepatica

Lung- P Westermani

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21
Q

Eosinophilia is not present during ? infections?

Where do the different types of Blood flukes like to invade?

A

Protozoa

Haematobium- veicals
Japonicum- SM Vein
Masoni- IM Vein

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22
Q

Trematodes are hermaphrodites except for ?

What are the 3 types of Schistosoma species that invade humans and in ? countries

A

Schitosoma spp.

Haematobium- Africa ME
Japonicum- Far East
Masoni- SAmerica Caribbean Africa ME

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23
Q

What Schistosomiasis’ are excreted from feces or urine?

Which ones are indicted in bladder cancer

Where do Schistosomiasis mature prior to invading human hosts?

A

Japon/Masoni- feces
Haematobium- urine

Haematobium- due to vescile plexus invasion

Snails (snail fever)

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24
Q

What is acute Schistosomiasis AKA?

These S/Sxs are due to ? etiology

A

Katayama fever d/t Mansoni/Japonicum

Serum Sickness reaction

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25
Q

How is Schostosomiasis Dx?

When are samples needed when Dx Haematobium?

How are Schistosomiasis infections Tx?

A

Eggs in stool/urine
Ab detection

Urine samples Noon-3pm

Praziquantel

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26
Q

F Hepatica is AKA and found in ?

How are these infections acquired and where do they mature w/in the host?

A

Sheep liver fluke
Larvae in fish

Raw water cress
Bile ducts

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27
Q

What are the two phases of a Fascioliasis infection and Sxs seen in each

These infections are also suspected of causing ? in Vietnam vets

A

Acute- V/D/F x months
Chronic- tumor/obstruction Sxs

Cholangiocarcinoma

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28
Q

How are Fascioliasis infections Dx?

How are they Tx?

A

Egg identification
Ab detection ELISA

Triclabendazole

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29
Q

What is the MC form of Paragonimiasis infections in humans?

How long can these infections last for in humans?

A

Westermani in Far East

20yrs

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30
Q

How are Paragonimiasis infections acquired?

A

Unembryonated egg leaves human via stool/sputum

Reconsumed in crab/crayfish

Duodenum to diaphragm

Eggs in sputum swallowed and passed

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31
Q

How are Paragonimiasis Dx

How is it Tx

A

Eggs in stool/sputum
Confirmed w/ biopsy
Complement fixation

Praziquantel

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32
Q

Define Nematode

Since these are AKA Helminthes, these are the MC of what 2?

A

Unsegmented worm w/ round body, mouth gut anus

MC world: Ascariasis
MC US: pinworm

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33
Q

What are the 4 types of intestinal nematodes?

What are the two cutaneous nematodes?

A

Strongyloidiasis
Hookworm
Ascariasis
Enterobiasis

Toxocariasis
Trichinellosis

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34
Q

How are Strongyloidiaisis infections acquired

A

Larvae in soil penetrate feet
Travels via blood to lungs
Swallowed, attaches to intestines

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35
Q

What are the S/Sxs of Strongyloidiasis infections

When is eosinophilia seen/absent?

A

Loefflers Synd. (pulm migration)
Urticaria
GI

Seen- acute/chronic
Absent- dissemination

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36
Q

How are Strongyloidiasis infections Dx

How is this Tx

A

Larvae in stool/duodenal fluid
EIA recommended

Ivermectin
Albendazole

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37
Q

What is the 2nd MC infection worldwide and what are the types

How are infections acquired

How long do these infections last?

A

Hookworm:
A Duodenal
N Americanus

Larvae in dirt penetrate feet
Travel via blood to lungs, swallowed
Attaches in small intestine

5yrs, makes 7K eggs/day

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38
Q

What are the S/Sx of Hookworm infections?

How is this Dx?

How is it Tx

A

Pica/Protein malnutrition
IDA- MC Sx
Ground itch- penetration site

Eggs in stool
Larvae needed to differentiate

Albendazole
Mebendazole

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39
Q

What is the largest intestinal nematode?

This one is also the MC ?

A

Ascariasis lumbricoides

MC helminthe worldwide

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40
Q

How are Ascariasis infections acquired?

Where do the infect in the body

A

F/o route

Eggs hatch to larvae, penetrate intestine wall

Travel via blood to lungs, swallowed

Matures, NOT in Jejunum/Ileum releasing 200K eggs/day

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41
Q

What are the S/Sxs of an Ascariasis infection

How is this Dx

How is this Tx

A

Migrating= biliary occlusion,
PO expulsion
Lung migration= Loefflers Hemoptysis

Eggs in stool

Albendazole
Mebendazole

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42
Q

Human pinworms are AKA ?

What is the only host of this parasite and makes it the MC ?

A

Enterbius Vermicularis

Human, preschool/kids
MC helminthe in US

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43
Q

Where do Enterobiasis infections mature?

What are two rare outcomes possibly seen, especially in female PTs?

A

Larve reside in cecum
Females travel to anus, lay 11K eggs/night= pruritus

Appendicitis
Salpingitis

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44
Q

How are Enterbiasis infections Dx

How is this Tx

A

Scotch tape test for eggs

Mebendazole

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45
Q

Cutaneous Larva Migrans is caused by ?

What is different about this infection and host

This is the MC ?

A

Ancylostoma Caninum

Humans accidental hosts, penetrate skin from walking barefoot on beach

Tropically acquired dermatosis

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46
Q

What are the S/Sxs of a Ancylostoma Caninum infection

How is it Dx

How is it Tx

A

Intense pruritus
Erythematous linear lesions

Lesion appearance

Albendazole Ivermectin

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47
Q

Toxocariasis is AKA ?

This can cause ?

How is an infection acquired

A

T Canis/Cati- dog/cat roundworm

Visceral larva migrans
Ocular larva migrans

Fecal/oral

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48
Q

Toxocariasis ocular larva migrans can be mis-Dx as ?

How is it Dx

How is it Tx

A

Leukokoria/retinoblastoma

Clinical Dx

Albendazole, Mebendazole

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49
Q

How are Trichinellosis infections acquired

What are the different types and from eating ?

A

Eating carnivore meat
Not killed by smoke/salting

T psudospirilis- mammal/bird
T nativa- arctic bears
T nelsoni- African meats
T britovi- Europe/Asian carnivores

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50
Q

What are the S/Sxs of Trichinellosis

What life threatening issues can develop from infection?

A

Larval migration= invasive phase:
Facial edema
Conjunctivitis
Splinter hemorrhage

Pneumonia
CNS- encephal/meningitis
Myocarditis

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51
Q

How is Trichinellosis Dx

How is it Tx

A

Eosinophilia during migration
CT/MRI
Muscle biopsy

Steroids
Albendazole
Mebendazole

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52
Q

Define Protozoa

What infectious microbes fall in this class?

A

Unicellular motile eukaryotes

Giardiasis
Crypto
Leishmaniaisis
Amebiasis
Malaria
Babesiosis
Toxoplasmosis
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53
Q

Amebiasis is caused by ?

What does this cause

A

E Hystolytica

Amebic liver abscess, M>F in 10% of world population

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54
Q

Where does Amebiasis infect the body

What are the S/Sx

What past Hx may indicate PT has Amebiasis

A

Tophozite colonizes colon, invades mucus, spreads in circulation

Fulminant/necrotizing colitis
Rectovaginal fistula

Dysentery

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55
Q

Who does fulminant/necrotizing colitis present in?

What do amebic liver abscesses present with that is different from colitis form?

A

Malnutrition
Younger PTs
Pregnancy
CCS use

Fever, RUQ pain
Single abscess= weight loss w/out fever/pain

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56
Q

PE findings of Amebic Colitis and Amebic Liver Abscess

A 
Colitis: 
Fever 
Weight loss 
Diffuse abdominal tenderness
Heme pos stool
Abscess: more severe
Fever
Weight loss
RUQ tenderness
Hepatomegaly
Jaundcie
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57
Q

What is the DxToC for Amebiasis

What would be seen on US of Amebiasis

What would be seen on CT?

A

Enteric Parasite Panel PCR-
Stool exam for trophozoites/cysts
OnP- Hystolytica and Dispar look identical

Homogenous Hypoechoic round lesion

Round low attenuation w/ enhanced rim
Low attenuation= started calcification

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58
Q

How is Amebiasis Tx

A 
Metronidazole 
Tinidazole
Iodoquinol luminal agent
Paromomycin luminal agent
Fulminant colitis- surgery
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59
Q

What is the MC parasite ID’d in stool specimens w/ ? type of syndrome

How is this infection acquired

What are the two MC infections in the summer, especially in kids

A

G Lamblia
Malabsorption

F/o ingestion of contaminated water

Giardiasis Pinworms

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60
Q

What does Giardiasis do to the body

What can it release in the body?

A

Alters epithelial function
Vilous atrophy

Cytopathic substances= damaged intestinal epithelium

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61
Q

S/Sxs of Giardiasis

Since PE is usually benign, what may be seen

A 
Urticaria
Frothy/greasy stool that float*
Anorexia
Nausea
Sleep d/o

Abdominal tenderness

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62
Q

How is Giardiasis Dx

How is it Tx

A

EPP PCR- DxTOC
Alt- duodenal biopsy

Tinidazole
Metronidazole

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63
Q

Most of Leishmaniasis infections are ? and AKA ?

What are the different types

A

Visceral- Kala-azar
AKA Black Fever

Skin- PKADL, Recidivans
Mucocutaneous
Viscerotropic

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64
Q

How is Leishmaniasis transmitted

What type of microbe is it

A

Zoonosis- Sand flies (Lutzomyia Longipalpis)

Obligate intracellular protozoa

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65
Q

How does cutaneous Leishmaniasis present

If this turns into a systemic infection, where does it reside and w/ ? Sxs

A

Raise edge, central crater
Regional lymphadenopathy

Marrow Spleen Liver
Fever
Weight loss
Spleen>liver megaly

66
Q

Leishmaniasis ‘Wet Pizza’

Leishmaniasis Dried

This can be an opportunistic infection along w/ ?

A

L Major

El Tropica

HIV

67
Q

What is a common lab finding w/ Visceral Leishmaniasis

What is the characteristic PE finding of this infection

A

Pancytopenia

Skin darkening

68
Q

How is Leishmaniasis Dx

Criteria for Mild Dz

A

Tissue isolate- Giemsa stain
Cutaneous lesion

<4 lesions
None >5cm
No cosmetic sensitive areas
No joint involvement

69
Q

How is Mild Leishmaniasis Tx

How are other cases Tx

A

Paromomycin
Liquid N2 w/ IDz consult

Sodium Stibogluconate
Liposomal amphotericin
Impavido- Tx all forms
Meglumine Antimoniate
Fluconazole- cutaneous
Thermo Radio frequency
70
Q

What populations have the highest Crypto infection rates

Where does it infect in the body?

What are the two types of Crypto

A

Kids 1-5yo
MSM
HIV/AIDS CD4<200

Jejunum if healthy
ImmComp- whole GI tract if CD4 <200

Parvum, Hominis

71
Q

What are two rare S/Sxs of Crypto

How is it Dx

How is it Tx

A

Icterus, Ascites

EPP PCR

Healthy: Nitazoxanide
ImmComp: HAART therapy

72
Q

What causes Babesiosis in US and Europe

What is the vector and host for this microbe

A

US: B Microti
Europe: B Divergens, more severe

Tick vector
Vertebrate host

73
Q

How does Babesiosis present

Sxs are due to ?

A

Fever
Malaria-like paroxysm
Fatigue

Parasitism of RBCs

74
Q

PTs w/ ? SurgHx have a poor prognosis if infected w/ Babesiosis

How is this transmitted

A

Splenectomy

In Utero
Blood transfusions

75
Q

How is Babesiosis Dx

A

Wright/Giemsa stain:
Thin blood smears
Ring forms
Maltese cross- pathognomonic

Serology: IgM IFA 1:64= Dx

CBC: anemia, thrombocytopenia

Inc LFTs/ESR

76
Q

How is Babesiosis Tx

A

Atovaquone + Azith
Clinda + quinine
Transfusion exchange

77
Q

Malaria infections are characterized by ?

What microbe causes this?

What is the carrier?

A

Cyclic F/C/Sweat

Protozoan of genus Plasmodium

Anopheles

78
Q

Define Archaic

Majority of malarial cases and deaths are due to ? subtype

A

Malaria term
Archaic, bad/foul air, miasma

P Falciparum in sub-saharan peds <5y/o

79
Q

What are the 4 types of malarias

What is the new type that was found in SE Asia?

A

P Falciparum- tropics
P Vivax- most wide spread
P Ovale- tropical west Africa
P Malariee- tropic

P Knowlesi- simian malaria

80
Q

What temp is needed for malaria?

Usually these infections don’t occur above ? elevation

A

> 77*F

6,000 ft

81
Q

What form of malaria starts infectious process

A

Sporozites migrate to hepatocytes= Liver Phase

Erythrocytic phase after few wks= invade/rupture RBCs
Fever/Merozoite release

82
Q

Vivax/Ovale are ? form and linger in ? organ for months

How long are the incubation and fevers for the different forms

A

Hypnozoite
Liver

Falci 12d, 48hrs
Viviax 14d, 48hrs
Ovale 17d, 48hrs
Malariae 28d 72hrs

83
Q

Which forms of malaria can relapse?

Which one doesn’t have hypnozoite stage but is unique because ?

A

Vivax Ovale

Malariae, prolonged erythrocyte infection or ASx

84
Q

What are the 3 phases and lengths of malaria infections

What is Falciparum so bad

A

Cold 15-60m
Hot 2-6hrs
Sweat 2-4hrs

Microvascular sequestration
Hyperparasitemia >250K/>5%
Targets RBCs, dec Hct 8-10% in 48hrs

85
Q

? form of malaria causes anemia

? form causes nephrotic syndrome

? types can cause splenic rupture

A

P Falciparum

Chronic P Malariae

Vivax Ovale 2-3mon later

86
Q

What lab result is absent in malaria

What non-Dx lab features indicate poor prognosis

A

Eosinophilia

Cr > 3mg
Acidosis Jaundice
Hyperlactatemia
Hypoglycemia
Elecated ATLs
87
Q

How is malaria Dx

Define Parasitemia

A

Thick/thin smears, 12-24hrs apart
Highest yield, soon after fever spikes

Thick 20x more sensitive
Thin better for speciation

Parasites per 1000 RBCs

88
Q

What are the alternate Dx tests for malaria

A

Rapid dipstick for LDH
Facliparum from others

BinaxNOW Falciparum Vivax

89
Q

Malaria prevention/prophylaxis

What meds are used, s/e or length of use

A

DEET
Permethrin clothes

Doxy qd- sunburn, vaginitis
Atovaquone- 7d after return
Primaquine- 14d after return and terminal prophylaxis
Chloroquine- CNS s/e
Tafenoquine- neurotoxic s/e
90
Q

What drug is used for preventing P Vivax relapses

What drug is used for eradicating persistent hypnozoites

A

PART w/ Primaquine

Primaquine phosphate
Tafenoquine for Vivax

91
Q

What drug is used for malarial Tx in PTs w/ Chloroquine sensitivity

What if they’re Chloroquine resistant

What is Falciparum Tx with

A

Chloroquine Phosphate

Artethemer and Lumefantrine
Atovaquone and Proguanil
Quinine Sulfate and Doxy

Artesunate

92
Q

What serial lab tests are done during malarial Tx

A

Smears q6-12hrs for decline parasite loads

Decline of 75% in 48hrs or parasites not cleared of blood in 7days= Tx regimen needs to be changed

93
Q

What needs to be avoided when treating cerebral malaria

Which forms are likely to relapse

Which one has recrudescence

A

Steroids

Vivax Ovale

Flaciparum and reinfection

94
Q

What form of malaria has low levels of infection

Dogs are more likely to bite ?

Cats are more likely to bit ?

A

P Malariae

Hand Thigh/Head

Hand Arm

95
Q

Why would CT be ordered for dog bite

How are these Tx

A

Penetrating head injury

200mL NaCl flush
Staph/Anaerobe coverage
Tetanus/Rabies

Amox Clavu- TxOC

96
Q

What is the MC pathogen from cat bites

What is the MC pathogen from dog bites

A

Paturella multocida

Capnocytophaga Canimorsus

97
Q

Animal bites on the ? rarely become infected

Wounds on ? are left open to heal

A

Face

Hands/LE
Older than 6hrs

98
Q

What microbe causes Cat Scratch Fever

This causes the MC cause of ?

Overall, this is the MC cause of ?

A

Bartonella Henselae

Chronic adenopathy in Peds

Regional adenopathy

99
Q

What nodes are affected by Cat Scratch

If PT has prolonged fever x 1-2wks w/out source, suspect ?

What Sx can remain for months

A

Cervical Submandibular Preauricular

Cat Scratch

Fatigue

100
Q

What syndrome may present w/ Cat Scratch

How is it Dx and confirmed

How is it Tx

A

Parinaud Oculoglandular

Node biopsy
Serology confirms

Azith

101
Q

What type of microbe is Toxoplasmosis

How is it transported and disseminated in the body

A

Obligate intracellular parasite

Trans: lymphatics
Diss: hematogenously

102
Q

How does Toxo kill AIDS PTs

In ImmComp PTs how does it present

A

Encephalitis, MC manifestation

Mono-like w/ visual changes

103
Q

What is the MC presenting Sx of Toxoplasmosis

How is Toxo Tx

A

Chorioretinitis- 4yr later w/ blurred vision/blindness

None necessary except,
Peds <5y/o

104
Q

How are AIDS PTs w/ cerebral toxoplasmosis Tx

What med is used as primary prophylaxis for these PTs

A

Pyrimethamine Sulfadiazine Leucovorin

Trimeth/Sulfameth

105
Q

What 4 microbes can cause atypical

Which one causes fish tank granuloma

A

Chelonae Leprae Ulcerans Marinum

Marinum as granuloma or sporotrichotic lymphangitis

106
Q

How is M Marinum Dx

How can this infection mislead a PHA?

How is it Tx

A

Culture grown 77-89.6*
Photochromogenic:
Dark- White
Light- yellow

False Pos PPD

Clarith Ethambutol
Rifampin Ethambutol

107
Q

M Uclerans infection is AKA ?

This is the ? MC mycobacteriosis of humans

A

Buruli Ulcer in Africa Australia

3rd after TB and Leprosy

108
Q

How is M Ulcerans Tx

M Leprae is AKA ? Dx

A

Rifampin and Clarith/Moxiflox
Debrisment/grafts

Hansen Dz

109
Q

How does M Leprae present

How is it Dx

How is it Tx

A

Dec sensation
Peripheral neuropathy
Bilateral ulnar neuropathy

Skin biopsy
Nasal scrapings

Rifampin Dapsone and Clofazimine

110
Q

M Chelonae is associated w/ ? animals

Also associated w/ ? hobby

How is it Tx

A

Frog/turtles

Tattoos

Tobramycin/Clarith x 4-6mon

111
Q

What causes Leptospirosis

This is the MC ?

How is it contracted?

A

Pathogenic spirochetes

Zoonosis in world

Body fluid contact
Urine contaminated water/soil

112
Q

What are the two syndromes of a Leptospirosis infection

What is the gold standard to Dx

A

Anicteric- mild flu-like
Incteric- Wells Dz, can lead to organ failure

Isolation from tissue/urine
Extent determined w/ CBC Liver panel Coag studies

113
Q

What are the classic PE findings of a Leptospirosis infection?

How is Leptospirosis Tx

A

Lumbar/calf muscle pain

Severe: IV PCN G
OutPT: PO Doxy

114
Q

What bacteria can cause encephalitis

What viruses can cause it

A

Cerebritis

HSV
Varicella
MMR
Arbovirus
Rabies
N Fowleri
Toxoplasmosis
115
Q

What are the MC presenting Sxs of Encephalitis

How is this Dx

A

AMS
Personality change

CT w/ and w/out contrast
MRI
CSF- essential

116
Q

If HSV causes encephalitis, where was it laying dormant

How does HSV travel to the CNS?

A

Trigeminal ganglia

Olfactory bulbs

117
Q

What subacute form of encephalitis does HSV 1 cause

What subacute form does HSV 2 cause

A

Brainstem encephalitis

Myelitis

118
Q

Anterior opercular syndrome is AKA ?

How is HSV induced encephalitis Dx

How is it Tx

A

Benign recurrent meningitis

PCR for DNA
CT scan- low density lesions in temporal lobes

Acyclovir

119
Q

What carries Arbovirus

What is the cornerstone to Tx

A

Mosquito, get infected from birds
Ticks

Prevention

120
Q

How is arbovirus encephalitis different than encephalitis?

Most of Arbovirus Encephalitis are due to ? microbe

A

Dys/pyuria
Movement d/o

West Nile- Flavivirus

121
Q

How does West Nile encephalitis present?

How is it Dx

A

Extreme lethargy
Flacid paryalysis

Leukopenia
Serology testing

122
Q

What are the 3 pathways for microbes to cause meningitis

What microbe causes Meningitis in adults and kids

A

Invasion of bloodstream
Retrograde neuronal pathway
Direct spread- sinusitis/OM

Strep Pneumo

123
Q

What is the presenting triad of meningitis

What Sx do elderly PTs present without

A

Fever
AMS
Nuchal rigidity

  • Meningeal Sxs
    + lethargy
124
Q

How is meningitis Dx

What 3 bacteria can cause meningitis

What 3 are more common in neonates

A

CSF

Strep pneumo
N meningitidis
H influenzae

Listeria monocytogenes
E Coli
Groupd B Beta strep

125
Q

How is Strep Pneumo meningitis Tx

What will be seen on lab results

What vaccine can be used to prevent this strain?

A

Cefotaxime/Ceftriaxone and Vanc and Dexameth

PMNs >1000, low glucose

PCV13

126
Q

What type of microbe is Meisseria meningitidis

How many serogroups are there

How is this Tx

A

Gram-neg diplococcus

A B C W X Y
B more common in US

Cefotaxime/Ceftriaxone and Vanc and Dexameth

127
Q

What are the two vaccines that can prevent N Meningitidis in college dorms/military barracks?

Slide 32 Deck Encephalitis

A

MenACWY
MenB

Questions off of chart

128
Q

Where are Listeria Mono infections common

How is it Tx

A

Cellmediated immne deficiencies

Amp + Gentamicin

129
Q

What drugs are used for post-exposure prophylaxis after N Meningitidis exposures

A

Ceftriax
Rifampin
Cipro

130
Q

What microbes cause viral meningitis

What cause parasitic meningitis

What causes fungal meningitis

What special microbes can cause meningitis

A

Enterovirus HSV Arthropod HIV

Amebic meningitis

C Neoformans
C Immitis
B Dermatidis
Candidiasis
H Capsulatum

TB Syphilis

131
Q

What microbe that causes meningitis has been found in vials of Methylpredisolone acetate

How is TB meningitis Tx

How is Syphilis meningitis Tx

A

Exserohilum
Aspergillis

INH + Pyrazinamide

Aqueous crystaline PCN G
Benzathing PCN G

132
Q

What microbes are associated w/ Prion Related Dzs

Why are these Dxs so bad

A

Kuru
Creutzfeldt Jakob Dz
Bovine spongiform encephalopathy

All prion dzs= fatal

133
Q

How are Prion Dzs Dx

What joints are most likely to become infected

What will be seen on lab results

A

MRI- inc intensity
CSF- inc proteins

Knees

Inc ESR
Synovial WBCs >50K
90% PMLs
Low Glucose

134
Q

What microbe is most likely to cause joint infections?

What microbe is most likely to infect prosthetic joints

What microbe is most likely in PTs under 30y/o

A

Staph A

MRSA
Strep pyogenes

N Gonorrhea

135
Q

What would an initial x-ray of an infected joint show?

When would an x-ray be more useful and not as useful?

A

Negative

Less useful in osteomyelitis

136
Q

What drugs are used for joint infections?

What part of the body is more likely to contract septic/infectious bursitis

A

MSSA- Nafcillin/Oxacillin
MRSA- Vanc + Rifampin
P Aeruginosa- Ceftazidime
N Gonorrhoeae- Ceftriaxone

Patellar/Olecranon of older adults

137
Q

S/Sxs of septic bursitis

What two presenting Sxs require immediate aspiration

What is the MC microbe of septic bursitis and where does it infect

A

Fever Cellulitis Boggy swelling
Dec motion

Fever + Cellulitis

Staph A in Olecrannon/Prepatellar

138
Q

What are the 4 stages of osteomyelitis pressure injuries

Define Suspected Depp Tissue Injury

A

1: intact injury
2: partial thickness loss of dermis
3: full thickness tissue loss
4: full thickness w/ exposed bone

Purplish area due to damage of tissue, thin blister over dark wound bed

139
Q

What must be done during osteomyelitis Tx prior ABX

What part of the bone does osteomyelitis MC infect

A

Bone biopsy

Metaphases

140
Q

Osteomyelitis microbes that is MC, diabetic foot infection, joint or Sickle Cell

What is the best way to Dx

What lab is used to track Tx progression

A

MC- Staph A
Diabetic- anaerobe
Joint- MRSA
Sickle- Salmonella

Bone scan + in 2days
MRI*/CT + in 2days
Bone biopsy

ESR

141
Q

PT stepped on nail, penetrated skin and causes osteomyelitis, how is it Tx?

What does prosthetic joint infections of Periostitis look like?

A

Cipro

Endosteal scalloping focal/diffuse osteolysis

142
Q

What type of organism is Ricketts

What color do these microbes stain during lab work?

A

Obligate intracellular gram-neg coccobacilli

Red w/ Giemsa stain

143
Q

Rickets are usually transmitted to humans by arthropods except for ?

What part of the body does Rickettsial Dz infect

A

Q-fever

Skin and Adrenals

144
Q

How is Rickettsial Dz Tx

This Dz is caused by ? microbe

What vector carries the microbe?

A

Doxy

Rickettsia Prowazekii

Pediculus humanus

145
Q

Since Rickettsial Dz is becoming Doxy resistant, what drug is used for Tx

How does Rieckettsial Dz rashes spread

A

Azithromycin

Trunk to extremities, spares face palms and soles

146
Q

What causes Murine Typhus

What causes RMSF

A

Rickettsia typhi carried by rat flea

Rickettsia rickettsii carried by Wood/Dog tick

147
Q

How does Rickettsial Dz progress in presentation

A

Day 1-2: abrupt onset fever/Ha
Day 2-4: rash on wrist/ankle spreads centrally
Day 5-7: fever 104*F, rash spreads to palm/sole
Day 7-9: rash necrosis, most fatalities

148
Q

How is Rickettsial Dz Tx

What microbe causes Q Fever and what does this cause

A

Doxy- TxDoC, best if started w/in 5 days of Sxs

Coxiella burnetii- macrophages in lungs, vegetated heart valves

149
Q

How does Q-fever present

What is the mainstay for Dx

A

Intractible HA
NO Rash

Serology cross reactivity

150
Q

What microbe causes Lyme Dz

What is the carrier?

A

Borrelia burgdorferi

Ixodes ticks- AKA Deer Tick

151
Q

What are the two stages of initiating a Lyme Dz infection by time of year

How long does the tick have to be attached for an infection to take root?

A

Nymph stage, spring-summer
Adult stage, fall

24hrs

152
Q

What are the three stages of Lyme Dz

What is the characteristic sign of an infection?

A

Localized Disseminated Persistant
Local/Dissem part of early infections
Persistent- late infection, w/in 1yr

Erythema migrans

153
Q

Lyme Dz usually infects ? CN

If PT presents w/ this manifestation, what Tx adjustment is made

A

7 and Bells Palsy

Add 10 day taper of steroids

154
Q

What is the cardiac manifestation of Lyme Dz

What is the hallmark of a late Lyme infection

A

Carditis/Lyme Carditis- 1 2 or 3rd degree blocks

Arthritis, usually knee/large joints

155
Q

What joints are more likely to be involved in monoarticular Lyme Dz

How long can it take for this to occur

A

Knee Ankle Wrist

Within 6mon of erythemous migrans

156
Q

How are Lyme infections identified

What would be seen on lab results

A

Ab detection proves exposure, not active infection
Confirm w/ Western Blot

AB blocks
Inc CBC ESR
WBCs in joint fluid

157
Q

How is each of the Lyme infections Tx

Tick bite, endemic
Tick bite, non endemic
EM
Carditis
Facial nerve paralysis
Meningitis
Arthritis
A

Doxy

None

Doxy/Amox

IV Ceftriaxone/PO Doxy

Doxy

IV Ceftriaxone

Doxy

158
Q

What is the MC rabies carrier

Rabies is not a Dz of rodents w/ ? exception

How can human to human infections occur

A

Cats-1
Bats- 3rd most reported
Dogs- MC worldwide, NHPs second

Groundhogs

Organ/Corneal transplant

159
Q

What Genus is Rabies

What part of the NS does it infect

Bites on ? part of the body are bad

A

Lyssavirus

Gray matter, limbic, midbrain and hypothalamus

Head/neck

160
Q

What findings are pathognemonic for rabies

What is the acute neuro period called

A

Paresthesia/pain at site
Hydro/aerophobia
Negri bodies

Parayltic/Dumb/Apathetic rabies

161
Q

How is rabies Tx

A

Wound cleansing w/ 1 part soap/4 parts water
Human diploid cell vaccine
Purified chick embryo vaccine

Pre-exposure: immunization on day 0 7 21 28 then booster
No vaccHx- HDCV/PCEC on day 0 3 7 14
Prior Vacc- re-vacc on day 0 and 3

IPAP (212 decks)

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