IFNX III Flashcards
What is the most common cause of cestode infx worldwide
H. Nana
What is the TxOC for Hymenolepiasis
Praziquantel (biltricide) and Supportive Care
What are the two types of Taneia
T. Solium (pork) and T. Saginata (cow)
What is the most common feature of Taeniasis (Solium and Sagintata)
Passage of proglottids in the stool (passive and active BM)
Assoc with. Appendicitis and Cholangitis
What is the TxOC for T. Solium and T. Saginata
Praziquantel
And surgical removal for clogged areas. (Appendicitis, Cholangitis, ect)
What causes cysticercosis
T. Solium (pig)
Common from areas in asia, rising in SoCal (10% of all SZR in SoCal)
What is the most common parasitic infection of the CNS
Cystiercosis from T. Solium
A pt from SoCal recently traveled to asia presents with a SZR, think of what parasite
T. Solium, ( Cysticersosis )
A pt presents with calcified intramusular nodules, think what parasite
T. Solium
What shows up on stool sample for cystercercosis
The Taenia not the cystercosi
What is the Tx approach to cystericosis
1st priorty is SZR treatment and possibel surgery
Albendazole and Praziquantel
+dexamathasone
A pt presents from Russia after eating fresh water fish, what is the possible parasite
Diphyllobothriasis (fish worm/eggs)
A pt presents with fatigue, diarrhea, dizzyness, low h/h, low b12 and folate (megoblastic anemia) , numbness of the extremities, all from eating fresh water fish
Think..
Diphyllobothrium
What is the TxOC for diphyllobothrium
B12 and Folate supplementation + praziquantel
Is eosinophilia presnt in protazoan infections?
NO!
What are the three blood flukes
S. Haematobium (africa/ ME)
S. Japonicum (Far east)
S. Mansoni ( Africa, South/ Central America)
S. Haematobium is a common cause of what cancer
Long term infx inplicated in bladder cancer, possible bue to anatomica relationship to vesicle plexus
What is the TxOC for schistomiasis
Praziquantel
What is the TxOC for fascioliasis
Triclabendazole
A pt presents from eating crawfinsh, with uticaria, N/V/D, abdominal pain
Think
P. Westermani
What is the TxOC for paragonimiasis (crawfish trematode)
Praziquantel
A parent presents with thier child from running around barefoot down in the south, father found a worm in the childs diaper after two days of diarhhea
Think of what parasite
Strongloidiasis
What is loefflers syndrome
A minifestation of strongyloidiasis
Pulm infections from the worms migration
What is the TxOC for strogyloidisasis
Ivermectin and/or Abendendazole
What are the two hookworms
Ancylostoma duodenal
Necator americanus
A pt presents with iron deficiency, has a ground itch at site or parasite bite, Pt is a young child that was running around barefoot
Think
Hook worms
What is the TxOC for hookworms
Abendazole
Mebendazole
What is the largest nematode and is the most common helmith worldwide
A. Lumbricoides
A pt presents coughing up a worm, think of what round worm
Ascariasis
What is the TxOC for a pt coughing up a worm
Aka ascariasis
Tx with abendazole or mebednazole
What is the only host for enterobius vermicularis
Humans
A pt presesnt with nocturnal anal puritis,
Think of what nematode
E. Vermicularis
What is the TxOC for Human Pin worms
Mebendazole
A pt presents with small tunneling on the feet and inbetween the toes…
Think what round worm
Ancylostoma caninum
Cutaneous larva migrans
What is the TxOC for Cutaneous Larva Migrans
Albendazole
Ivermectin
And wear shoes!
What is the cause of Visceral and Ocular larva migrans
Toxocariasis from the larva of T. Canis and T. Gati
A pt presetns with fever, visceral larva migrans, anorexia, wt loss, heptaosplnomegaly, with ophtamlic lesions, and visual disturbances, and cataract appearnace
Think of what round worm
Toxocariasis
What is the TxOC from toxocariasis (visceral and ocular larva mirgans)
Albendazole and/or Mebendazole
A pt states he is an avid hunter, and loves to eat bear, pigs, and deer, he hunts mainly in the US
Presents with signifigant pain, perirobital and facial edema, and a very HIGH fever, conjunctivitis, and SPLINTER hemorrhages
Think what parasite
Trichinellosis
What is the Tx of Choice for Trichnellosis
Albendazole and/or mebendazole
What is the test of choice to find amebias
EPP PCR ( enteric parasite panel)
What is the TxOC for amebiasis
Metronidazole
Tinidazole
Iodoquinol Luminal Agent
Paromomycin Luminal agent
For fulminant- SRGRY
A pt presents with fever, wt loss, diffuse abd tenderness, may be in the RUQ
Hem pos stools
+/- jaundince
Think
Amediasis
Or liver abscess amebiasis
What is the most common parasite ID’d in stool specimins
Giardia Lamblia
A pt presents after camping in the western US ( can also be in day cares)
Mode of transmission often fecal oral from contaminated water ingestion
S/s: diarrhea, abd distention , cramps, Nausea, with foul greasy, frothy stools, flactulence,
Think giardiasis
What is the DxOC for Giardias
EPP PCR
Finding trophozites or cysts
What is the TxOF
Tinidazole
Or metronidazole
There are no surgical options as it may resolve spont.
What are the two types of leishmaniasis
Cutaneous and visceral
Where are the promiment regions for visceral leishmaniasis
India, bangladesh, Napal, Sudan, Brazil
What is the zector for leishmaniasis
Sand flys (L. longipalpis)
A pt presents with lesions exposed skin, with a raised edge and a central crater
Current deployed to the M/E
Think
Lieshaniasis from a sand fly bite
What are the S/s of Black fever
Aka visceral lieshmaniasis
Recurrent high fever, Wt loss, signifigiant splenomegaly / hepatomegaly , post kala-azar dermal lesions
Can coexist with HIV
A pt presents with recurrent fevers, darkening of the skin, with hepatosplenomegaly, on CBC has pancytopenia
Think
Visceral leishmaniasis
A pt presents (may be a child or HIV comp)
With watery diarrhia, with wt loss, low grade fever, and pancreatic involvment , RUQ/epigastric pain, with hyperactive bowl sounds
From swimming in contaminated or recreational water like water parks (not common in the south)
Think
Cryptosporidiosis
Cryptospordosis likes to infect HIV at what CD4 count
200
Esp. Less than 50
What is the TxOC for Immuncomp vs Comp Cryptosporidiosis
Immunocomp is HAART Tx
COmp: No tx ind, may use nitazoxanide , S/s care
A pt presesnts after hiking in the appalachians, says they were bitten by a tick
Has fever, chills, diaphoresis, and then prostration, malaria like illness
Think
Babesiosis from B. Microti (Tick)
What is the progression of S/s of babesiosis
Looks almost exactly like malaria
But didnt travel
Starts as chills to fever, to diaphoresis, to prostration
What is the TxOC for Babesiosis
Clindamycin +quinine
Where is malaria most common
90 percent of cases are from africa
What is the vector for malaria
Anopheles mosquito
What is the most widespread malaria type
P. Vivax
What is the pathophys of malaria
Sporozoites migrate into hepatocytes (liver phase) within minutes emerge into the bloodstream after a few weeks
Rupture of infected erythrocytes lead to fever and merozoite release
What is the time frame for fever for P. Knowlesi
24 hrs
What is the time frame of fever for P. Faliparum, Vivax and Ovale
48 hrs, can be sporadic
What is the time frame for fever for P. Malariae
72 hrs
What is the most severe type of malaria
P. falciparum
A pt presents with fever, HA< mild anemia
May be immune/partially immune/non-sterile/innate immunity
Recently travelled from africa
Think
Malaria
Why is P. falciparum so bad
Targets all RBCs causing severe anemia
A pt presents with splenic rupture, may ben in a coman, with severe anemia and renal failure
Malaria
Chronic P. malariae leads to
Nephrotic syndrome
On labs, a pt presents with no eosinophilia, with acute renal fialure, elevated bilirubin, and hypo glycemia
Think
Malaria
What is the Dx OC for malaria
Thick and thin smears
Three smears apart seperated by 12-24 hours
When should prevention for malaria be started
1-2 weeks before
Doxy every day
Atovaquone/proguanil every day (only 7 days post)
Primaquine everyday (14 days post)
Chloroquine every week (has resistance)
Mefloquine every week ( causes sleep d/o)
What is the TxOC for severe malaria (P. falciparum 14 day incubation)
IV artesunate
Should steroids be used for malaria
No, can make cerebral s/s worse
What is the infx rate of animal bites
80%
What is the DOC for dog bites
Augmentin ( Amoxicillin with clauvanate acid)
What is the most common pathogen of cat bits
Pastruella multocida
What is the most common pathogen in dog bites
Capnocytophaga canimorsus
But 2nd is P. Multocida
How are dog/ cat bites treated on the face vs hands
Facial wounds rarely become infected and can be closed right away
Wound on the hands should be left open, as well as hands older than 6 hours (primary closure)
What is the agent of cat scratches
Bartonella henselae
What is the most common S/s of cat scrathes
Adenopathy in children
How does cat scratch fever present
Hx of contact with a cat
Rash (along lymph path)
Lymhpadenitis
FUO
Parinaud oculoglandular syndrome in 2-3% of pts
What is the TxOC for Cat strach dz/ Fever
Immunocompenten with class s/s
Azithromycin
Who is the risk to (mother or fetus) with toxoplasmosis
Fetus!
A pt presents with cervical lymphadenopthay
Fever, malasie, night sweats, HA, myalgias, pharyngitis
Has either been around cats or hunters who ate uncooked deer meat
Think
Toxoplasmosis
A pt with aids that has toxoplasmosis will present how
Toxoplasmosis encephalitis
What is the Tx for Tocoplasmosis in aids pts
(LOOK UP ANSWER, Pet assoc dz)
A pt presents with skin truama around an aquarium/ or coral Salt water,
Has a papulue that has ulcerated, with localized pain and induration, may have tendon or septic arthritis
Think
M. Marinum
What is the Tx for M. Marinum
Clarithromycin
Ethambutol
+ rifamipin
X 1 moth
A pt presents from a trip to africa, was playing with horses, possumsm and dogs,
Has a scratch on the leg, that has become infected and has large ulcers and plaques,
( look up the MYCOBAT that fits this, after M. Miranum)
Leprosy is common from contact with what animal>?
Armadillos
Skin lesions with deminished sensations with peripheral neuropathy suggestive of
Bilateral ulnar neuropathy is suggestive of
Leprosy
What are the DOC for leprosy
Rifampin, dapsone and clor(something?)
M. Chelonae is associted with what animals
soil, frogs
A pt just got a new tattoo, what mycobacterium could they have gotten
M. Chelonae
A pt presents from a tropcal area, swimming in the water, is possible infected with the most common zoonosis in the world
S/s: Icterus (severe),
leptospirosis ( look up other s/s)
What are the classic S/s of leptospirosis
( look at pet associated Dz, lecture 3)
What is the Tx for severe vs outpt leptospirosis
Severe: IV Pen G
( Look Up outpt) lectue before encephalitis
A pt presents with exterme lethargy, flaccid paralysis, leukopenia from being bit by a mosquito
Think
West nile/ Encephalitis
A pt presents with fever, nuchal rigidity, and AMS
Think
Meningitis
Look at meningitis Diffferential slide and know it
Lecture 3 slides (meningitis)
What is the #1 cuase of bacterial menigits
N. Meningitidis
What is the most common meningitis in neonates
Group B
Look up others and add
What is the tx for strep pneumo
Cefotaxaine or Ceftriaxone + ( one other drug, look up to add in meningitis lecture )
Know the listeria monocytogens slide
A pt presents wtih parasethisa/ pain at a bite with tingling, or itchy feeling at a site of a bite even after healing…
Think
Rabies
What is the most reliable test of infection during the first week of rabies
Nuchal skin biopsy with Negri Bodies ( eosinophilic cytoplasmic inclusions)
What is the tyopical test for clinical Dx of rabies
Serum rapid fluorescent focus inhibition test (RFFIT)
What is the Tx approach to rabies
Optimal results require the following:
1. Immediate vigorous wound cleansing
—Solution of 1 part soap and 4 parts water
- Passive and active immunizations
Prevent progression to full-blown rabies - Vaccines commonly available
—Human diploid cell vaccine (HDCV)
—Purified Chick Embryo vaccine (PCEC)
What is the pre exposure immunization for rabies
Primary IMM on days 0, 7, 21, 28
And A booster in the deltoid
What is post exposure IMM for rabies
Vax on days 0, 3, 7, and 14 if no prior IM
Or On days 0 and 3 if prior IM
