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Infectious Flashcards

1
Q

“Valley Fever”

A

aka Coccidiomycosis

grows in soil
Transmission: inhaling spores

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2
Q

Sx of Cocci/”Valley fever”

A

Can be:

  • Pulmonary
  • “Valley fever” mixture
  • Disseminated or persistent
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3
Q

Primarily pulmonary sx of Valley fever/Cocci

A

Mild flu like illness

Fever, chills, runny nose, HA, cough, pleuritic CP

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4
Q

“Valley fever” classic sx

A 
Fever
Joint pain (ankles and knees)
Skin rash- Erythema nodosum, Erythema multiform, or maculopap
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5
Q

Disseminated/ persistent Cocci sx

A

CNS (meningitis)

Can affect any organ esp the lungs, skin, soft tissue, lymph nodes, and joints

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6
Q

Diagnosing Cocci

A

Order serology (igG, igM) or Culture

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7
Q

What is seen in tissues if someone has Cocci?

A

Spherules- thick walled spheres containing endospores

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8
Q

If someone has meningitis from Cocci

A

CSF: fungal pattern- lymphocytosis (inc) and decreased Glucose

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9
Q

What will CXR show on someone who has Cocci

A

Persistent cavitations
Miliary PNA
Abscess
Nodules***

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10
Q

Tx of Cocci

A

None if mild dz and localized lung dz- just symptomatic

CNS: Fluconazole or Itraconazole

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11
Q

How is CNS Meningitis from Cocci treated?

A

like a fungal dz

Fluconazole or Itraconazole

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12
Q

How to treat Severe case of Cocci or a Pregnant woman in 1st trimester

A

Amphotericin B

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13
Q

Transmission: Soil, crush and puncture injuries

Trismus, Lockjaw, muscle spasm, inc DTR

A

Tetanus

(Clostridium tetani) gram +

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14
Q

Risus sardonicus

a/w Tetanus

A

Facial contractions

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15
Q

Spatula test

a/w Tetanus

A

Masseter muscle spasms when the posterior pharynx is touched w tongue blade/ spatula instead of the Normal gag reflex

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16
Q

Tx of Tetanus

A

Metro + Tetanus immunoglobulin (5000 units)

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17
Q

What can you give for muscle spasms a/w Tetanus

A

Benzos

Magnesium, may prevent

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18
Q

If adult was never vaccinated, what is Tetanus recommendation

A

Tetanus IG 250 u + initiation of tetanus toxoid vaccine

2nd dose at 4-8 weks
3rd dose 6-12 months later

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19
Q

Normal TdaP booster schedule

A

2,4,6 mo
1 year
5 year

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20
Q

TdaP booster

A

11-12 yo
Pregnant mothers
then every 10 year interval

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21
Q

Life threatening muscle infection
Traumatic injury, IVDU, puncture, Post op: risks
Crepitus

A

Gas Gangrene, Myonecrosis

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22
Q

Sudden onset of extreme swelling and muscle pain

Skin color: pale–> brown–> dark purple

A

Gas Gangrene

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23
Q

X ray shows: Air in soft tissues

Culture: gram + bacilli

A

Gas Gangrene

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24
Q

Tx for Gas Gangrene other than Urgent Surgical Debridement

A

PCN + Clinda

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25
Other tx options for Gas gangrene
Hyperbaric O2 therapy | Alt abx: Metro, Tetracycline
26
Inhibition of Ach release | Sx: WEAKNESS and Flaccid paralysis
Botulism Clostridium Botulinum anaerobic, gram +
27
Types of Botox poision
Adult: canned foods Infant: honey Wound; RARE (this one is treated differently)
28
Foodborne Botox poisoning
GI upset followed by 8 Ds -Diplopia, Dysphagia, Dry mouth, Dilated fixed pupils, Dysarthria, Dysphonia, Desc decreased muscle strength, Decreased DTRs
29
Tx of Botulism poison
Antitoxin 1st line DO NOT GIVE ABX unless wound type
30
If wound cause of Botulism poison
Antitoxin + Pen G | Wound debridement
31
Diptheria
rare now bc of DtaP vaccination
32
Diptheria
Transmisson: resp secretions Sx: sore throat, exudate on pharynx, fever, malaise SERIOUS CONCERN: Arrhythmia, Heart failure, Myocarditis
33
White, friable exudate on pharynx | "Bull neck" cervical lymphadenopathy
Diptheria
34
Tx for Diptheria
Antitoxin + PCN (Or Erythromycin)
35
What to consider ordering in someone with Diptheria
EKG and Cardiac markers!!! | Caution looking for Myocarditis
36
Proph for Diptheria for Close contacts
Same Abx as tx: Erythromycin or Pen G
37
MRSA tx
"B,C,D" and then Linezolid
38
MRSA tx
Bactrim Clinda Doxy and Linezolid
39
IV tx options for Mrsa
Vanco | Linezolid
40
Gonorrhea has the risk of becoming
Disseminated Triad of: skin Dermatitis, Arthralgia, and Tenosynovitis (tendon inflammation and pain) Skin, Joints, Tendons
41
Diagnosing Gonorrhea
Nucleic acid amplification test | Synovial fluit NAAT
42
Tx for Gonorrhea STI
Azithro AND Ceftriaxone (Rocephin)
43
Tx for Gonorrhea if it's just joint stuff
Ceftriaxone (Rocephin)
44
Most common bacterial STI in the United States
Chlamydia
45
Sx of Chlamydia
Pain w sex D/c, Pruritis, dysuria, Hematuria Often A-sx (esp men)
46
Can have Reactive Arthritis w Chlamydia
Urethritis Uveitis Arthritis "can't pee, can't see, can't climb a tree"
47
Diagnosing Chlamydia
Nucleic acid amplification
48
Tx of Chlamydia
Azithro OR Doxy
49
Dosage of Chlamydia tx
Azithro 1 gram x 1 dose Doxy 100 mg bid x 10 days Retest in 3 weeks
50
Lymphogran Venereum
caused also by Chlamydia Trachomatis PAINLESS genital ulcer --> groin Lymphadenopathy (buboes)
51
Tx of Lymphogran Venereum
Doxy x 21 days | maybe IandD of the Lyphadenopathy (Buboes)
52
Group A Streptococcus is AKA
Strep Pyogenes
53
2 unique Dz caused by GAS "Strep Pyogenes"
Acute Rheumatic Fever Scarlet Fever They are DIFFERENT
54
Diff b/w Rheumatic fever and Scarlet fever
Rheumatic: Autoimmune MULTI SYSTEM Scarlet: Skin eruption
55
Rheumatic fever follows a Strep infection
2-6 wks later The antibodies are damaging the host tissue and organs directly
56
Sx of Rheumatic Fever multisystem, 2-6 wks after strep infection
Polyarthritis: Large joints, red, hot, swollen, PAINFUL !!!CARDITIS!!!!: Valve dysfx, Myocarditis, Pericarditis Sydenham's chorea: jerky movements Erythema marginatum: rash w central clearing to trunk
57
Rheumatic fever breakdown
Joints Heart Chorea jerky movements Rash w central clearing
58
Jones Criteria consists of Major (JONES) criteria and Minor
``` for Rheumatic Fever MAJOR CRITERIA are the "Jones" J: joint O: oh my heart N: nodules (subcutaneous) E: erythema marginatum S: sydenham's corea ```
59
Minor criteria a/w Jones
Clinical: - fever - joint pain Labs: - elevated ESR/CRP, leukocytosis - prolonged PRI on EKG
60
What is often a backup if someone is PCN allergic?
Erythromycin
61
What is a positive Rheumatic fever dx based on the Jones criteria?
2 major criteria (JONES) OR 1 major + 2 minor
62
Tx for Rheumatic fever
ASA, Steroids, and Pen G
63
Aspirin, PCN G, and Steroids are tx for
Rheumatic fever
64
Complication of Rheumatic fever
Cardiac valvular dz- YIKES usually Mitral
65
Flushed face w Circumoral pallor "Strawberry tongue" Pastia lines
Scarlet fever!
66
Scarlet fever
Sandpaper rash | + fever, chills, sore throat
67
The rash of Scarlet fever
Diffuse redness, blanches w pressure + multiple small raised sandpaper lesions Starts in armpits
68
What are Pastia lines
linear petechial lesions seen at pressure points- Armpits, antecubital, abdominal, inguinal
69
Tx for Scarlet Fever
PCN G or PCN VK | either way, PENICILLIN
70
Scarlet fever rash is diff from Rheumatic fever bc
Scarlet fever is more diffuse, and Sandpaper-y
71
Where does Scarlet fever rash start?
Armpits
72
Tx for both Rheumatic and Scarlet is
PENICILLIN except Rheumatic needs to add Aspirin and Steroids
73
RMSF spring and summer months fever + joint pain + rash
Treat with DOXY
74
RMSF
Vascular injury Tiny clots--> infarcts HA, fever, pedal edema, conjunctivitis, encephalitis, ARDS (respiratory distress), cardiac or bleeding disorders!!! BIG YIKES
75
RMSF labs may show
Thrombocytopenia Pancytopenia Hyponatremia LOW EVERYTHING
76
Tx for RMSF
Doxy | Chloramphenicol if pregnant
77
When should you begin RMSF tx?
within 5 days of sx onset
78
HA, fever, chills, myalgia, arthralgia, n/v, lethargy RECENT CAMPING or outside in summer/spring months
RMSF dont wait for rash to appear. Tx w Doxy

Clinical Prep (41 decks)

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