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PLE Review > IM-Infectious > Flashcards

IM-Infectious Flashcards

1
Q

Painful, grouped vesicles on penis

Diagnosis?
Initial test?
Accurate test?
Drug of choice?

A

GENITAL HERPES (HSV 2)

Initial test: Tzank smear

Accurate test: PCR of DNA scrapings

Drug of choice: Acyclovir (IV in neonatal herpes and HSV enceph), Valacyclovir

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2
Q

Nontender ulcerated nodule with indurated border

Diagnosis?
Etiologic agent?
Initial test?
Accurate test?
Drug of choice?
A

PRIMARY SYPHILIS

Etiologic agent: Treponema pallidum

Initial test: RPR VDRL?

Accurate test: Dark-field microscopy in primary

Drug of choice: Single dose Penicillin

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3
Q

Differentiate stages of Syphilis

Most infectious stage?

A

1 Chancre

2 Macular rash on palms and soles, Condyloma lata
-most infectious

3 Tabes dorsaljs, Neurosyphilis, Gummas, Argyll-Robertson pupil

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4
Q

Yellowish mucopurulent vaginal discharge, dysuria, unprotected sex

Diagnosis?
Etiologic agent?
Initial test?
Accurate test?
Drug of choice?
A

MUCOPURULENT CERVICITIS

Etiologic agent? N. gonorrhea or C. Trachomatis

Initial test? Swab for gram stain

Accurate test? NAAT or culture (Thayer-Martin Agar)

Drug of choice? Ceftri/cefix single dose + Azith/Doxy single dose

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5
Q

Hypogastric pain, fever, cervical motion tenderness

Etiologic agent?
Next best step?
Initial test?
Accurate test?
Drug of choice?
A

PID

Etiologic agent:

Next best step? Preg test, Bhcg

Initial test? NAAT or culture

Accurate test? For salpingitis, laparoscopy

Drug of choice? Ceftri single dose + Doxy x 14 days + Metro

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6
Q

Vulvar itching, white clumped discharge

A

VULVOVAGINAL CANDIDIASIS

C. Albicans
Fluconazole single dose

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7
Q

Vulvar itching, profuse whitish-yellowish HOMOGENOUS discharge, strawberry cervix

A

TRICHOMONAL VAGINITIS
T. Vaginalis, trophozoite

Wet mount

Metronidazole single dose
Treat asymptomatic partner

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8
Q 
Fishy odor with 10% KOH
Clue cells (coccobacillary)
A

BACTERIAL VAGINOSIS
G. vaginalis

Metronidazole x 7 days

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9
Q

Loose blood stools
Potato, egg salad
Nausea, vomiting, cramping abdominal pain

Diagnosis?
Etiologic agent?
Initial test?
Accurate test?
Drug of choice?
A

BACTERIAL FOOD POISONING

Etiologic agent: S. aureus

Best next step: Hydration

Cornerstone of dx: Stool analysis

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10
Q

Duration

Acute diarrhea
Persistent
Chronic

A

<2wks
2-4wks
>4wks

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11
Q

Fried rice

A

Bacillus cereus

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12
Q

Loose blood stools, burgers fries spag, low grade fever

Anemia, thrombocytopenia

A

E. Coli (EHEC)
O157:H7 toxin
Shiga toxin

Hemorrhagic colitis - grossly bloody diarrhea

Hemolytic uremic syndrome
-ARF, thrombocytopenia, microangiopathic Hemolytic anemia

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13
Q

Sudden onset nausea, vomiting, rice water diarrhea

A

CHOLERA
V. Chilerae

Most important: water, electrolyte
May give: oral tetra or doxy

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14
Q

Watery, greasy, foul smelling diarrhea, from camping/hiking

A

GIARDIASIS

G. Lamblia

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15
Q

AIDS

Chronic diarrhea and malabsorption

A

Cryptosporidium

CD4 <100

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16
Q

Fever, right upper quadrant abdominal pain

Anchovy paste on aspiration

A

AMEBIC LIVER ABSCESS
Etiology: E. Histolytica
Usually in right lobe of liver
Tx: metro + iodoquinol

Amebic colitis

  • definitive: trophoizoite with rbc in stool
  • flask shaped ulcer
  • metro + iodoquinol

Asymptomatic carrier: iodoquinol

17
Q

Salmon-colored, maculopapular rash on trunk (rose spots)

Bradycardia at peak of fever

Muttering deliriun, coma vigil at the height of fever

HALLMARK: fever + abdominal pain

A

TYPHOID FEVER
S. typhi

Accurate test: blood culture (BUS)
Antibx: Ciprofloxacin
Most common manifestation: enterocolitis

18
Q

Waded on flood waters, fever, body aches, conjunctival suffusio , abdominal pain, jaundice, no urine output

Diagnosis?
Etiologic agent?
Initial test?
Accurate test?
Drug of choice?
A

LEPTOSPIROSIS

Next best step: hydrate with PNSS

Gold standard: Culture and isolation

Drug of choice?

  • mild: Doxy
  • severe:m (Weil’s): Pen G

Pulmo hemorrhage: methylpred w/in 12h
Predict AKI ahead of Crea: Urine NGAL

19
Q

Chills, fever spikes, sweating stages

Travel to endemic area

Diagnosis?
Etiologic agent?
Initial test?
Accurate test?
Drug of choice?
A

MALARIA
Plasmodium

Accurate: Thick and thin blood smears
Infective stage: Sporozoites
Relapse: Hypnozoites

Severe falciparum: Artesunate then ACT
Nonfalciparum: ACT or chloroquine + primaquine
Pregnant: Quinine + Clindamycin
Prophy: 2wks before travel up to 4 weeks after travel

20
Q

From Samar
Weight loss, abdominal enlargement, coffee ground vomiting

Hepatosplenomegaly, lymphadenopathy

A

SCHISTOSOMIASIS
hooklike spine: S. Japonicum
Terminal spine: s. Hematobium
Lateral spine: s. Mansoni

Infective: cercaria
Tx: praziquantel

Skin: swimmers itch, cercarial dermatitis
Skin, Liver: Katayama syndrome/Acute (high degree eosinophilia)
GI: chronic

21
Q

Fever
Eosinophilia
Freshwater

A

Schistosomiasis

22
Q

Fever
Eosinophilia
Raw pork

A

Trichinella

High vasculature:
Skeletal muscles, EOM (periorbital edema), cardiac (tachyarrhyrhmia)

23
Q

Fever
Eosinophilia
Larvae currens

A

Strongyloides

24
Q

Punctured wound
Trismus
Difficulty talking

A

TETANUS

Etiologic agent: C. tetani
Toxin: tetanospasmin, blocks gaba and glycine
Most common site: superficial abrasion, limbs
Affected first: face, jaw
Tx: Metro, HTIG

25
Q

HIV titers highest in? (Body fluid)

Most common neurologic sydrome in AIDS

Measures risk of getting opportunistic infection:

Long term prognosis:

Antiretroviral effectiveness:

A

Semen, blood

AIDS dementia complex

CD4

Viral load

Viral load

26
Q

CD4<200
Dry cough
Dyspnea
Hypoxia

A

PCP

Cotri (+steroids if with hypoxemia) x 21 days

27
Q

CD4 <200
Headache
Nausea, Vomiting
Focal neurologic deficit

A

TOXOPLASMOSIS

Pyrethamine

28
Q

CD4 < 50
Blurring of vision (retinitis)
Diarrhea (colitis)

A

CMV

Gancyclovir

29
Q

CD4<50
Fever
Headacve
Neck stiffness

A

Cryptococcus

Amphotericin B + Fluocytocin

30
Q

CD4 < 50
Fever
Weight loss
Fatigue

A

MAC

Clarith + Ethambutol
Prophy: Azith

31
Q

Preferred imaging in fever of unknown origin

Most common etiology

Most implicated etiology

Most common diagnosis among neoplasms

A

Abdominal utz over CT scan

Infection

TB

Malignant lymphoma

PLE Review (9 decks)

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