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Clinical Prep > Infectious > Flashcards

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
Q

Other tx options for Gas gangrene

A

Hyperbaric O2 therapy

Alt abx: Metro, Tetracycline

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26
Q

Inhibition of Ach release

Sx: WEAKNESS and Flaccid paralysis

A

Botulism

Clostridium Botulinum
anaerobic, gram +

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27
Q

Types of Botox poision

A

Adult: canned foods
Infant: honey
Wound; RARE (this one is treated differently)

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28
Q

Foodborne Botox poisoning

A

GI upset followed by 8 Ds
-Diplopia, Dysphagia, Dry mouth, Dilated fixed pupils, Dysarthria, Dysphonia, Desc decreased muscle strength, Decreased DTRs

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29
Q

Tx of Botulism poison

A

Antitoxin 1st line

DO NOT GIVE ABX unless wound type

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30
Q

If wound cause of Botulism poison

A

Antitoxin + Pen G

Wound debridement

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31
Q

Diptheria

A

rare now bc of DtaP vaccination

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32
Q

Diptheria

A

Transmisson: resp secretions
Sx: sore throat, exudate on pharynx, fever, malaise
SERIOUS CONCERN: Arrhythmia, Heart failure, Myocarditis

33
Q

White, friable exudate on pharynx

“Bull neck” cervical lymphadenopathy

A

Diptheria

34
Q

Tx for Diptheria

A

Antitoxin + PCN (Or Erythromycin)

35
Q

What to consider ordering in someone with Diptheria

A

EKG and Cardiac markers!!!

Caution looking for Myocarditis

36
Q

Proph for Diptheria for Close contacts

A

Same Abx as tx:

Erythromycin or Pen G

37
Q

MRSA tx

A

“B,C,D” and then Linezolid

38
Q

MRSA tx

A

Bactrim
Clinda
Doxy

and Linezolid

39
Q

IV tx options for Mrsa

A

Vanco

Linezolid

40
Q

Gonorrhea has the risk of becoming

A

Disseminated

Triad of: skin Dermatitis, Arthralgia, and Tenosynovitis (tendon inflammation and pain)

Skin, Joints, Tendons

41
Q

Diagnosing Gonorrhea

A

Nucleic acid amplification test

Synovial fluit NAAT

42
Q

Tx for Gonorrhea STI

A

Azithro AND Ceftriaxone (Rocephin)

43
Q

Tx for Gonorrhea if it’s just joint stuff

A

Ceftriaxone (Rocephin)

44
Q

Most common bacterial STI in the United States

A

Chlamydia

45
Q

Sx of Chlamydia

A

Pain w sex
D/c, Pruritis, dysuria, Hematuria
Often A-sx (esp men)

46
Q

Can have Reactive Arthritis w Chlamydia

A

Urethritis
Uveitis
Arthritis

“can’t pee, can’t see, can’t climb a tree”

47
Q

Diagnosing Chlamydia

A

Nucleic acid amplification

48
Q

Tx of Chlamydia

A

Azithro OR Doxy

49
Q

Dosage of Chlamydia tx

A

Azithro 1 gram x 1 dose
Doxy 100 mg bid x 10 days

Retest in 3 weeks

50
Q

Lymphogran Venereum

A

caused also by Chlamydia Trachomatis

PAINLESS genital ulcer –> groin Lymphadenopathy (buboes)

51
Q

Tx of Lymphogran Venereum

A

Doxy x 21 days

maybe IandD of the Lyphadenopathy (Buboes)

52
Q

Group A Streptococcus is AKA

A

Strep Pyogenes

53
Q

2 unique Dz caused by GAS “Strep Pyogenes”

A

Acute Rheumatic Fever
Scarlet Fever

They are DIFFERENT

54
Q

Diff b/w Rheumatic fever and Scarlet fever

A

Rheumatic: Autoimmune MULTI SYSTEM
Scarlet: Skin eruption

55
Q

Rheumatic fever follows a Strep infection

A

2-6 wks later

The antibodies are damaging the host tissue and organs directly

56
Q

Sx of Rheumatic Fever

multisystem, 2-6 wks after strep infection

A

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
Q

Rheumatic fever breakdown

A

Joints
Heart
Chorea jerky movements
Rash w central clearing

58
Q

Jones Criteria

consists of Major (JONES) criteria and Minor

A 
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
Q

Minor criteria a/w Jones

A

Clinical:

  • fever
  • joint pain

Labs:

  • elevated ESR/CRP, leukocytosis
  • prolonged PRI on EKG
60
Q

What is often a backup if someone is PCN allergic?

A

Erythromycin

61
Q

What is a positive Rheumatic fever dx based on the Jones criteria?

A

2 major criteria (JONES)
OR
1 major + 2 minor

62
Q

Tx for Rheumatic fever

A

ASA, Steroids, and Pen G

63
Q

Aspirin, PCN G, and Steroids are tx for

A

Rheumatic fever

64
Q

Complication of Rheumatic fever

A

Cardiac valvular dz- YIKES

usually Mitral

65
Q

Flushed face w Circumoral pallor
“Strawberry tongue”
Pastia lines

A

Scarlet fever!

66
Q

Scarlet fever

A

Sandpaper rash

+ fever, chills, sore throat

67
Q

The rash of Scarlet fever

A

Diffuse redness, blanches w pressure + multiple small raised sandpaper lesions

Starts in armpits

68
Q

What are Pastia lines

A

linear petechial lesions seen at pressure points- Armpits, antecubital, abdominal, inguinal

69
Q

Tx for Scarlet Fever

A

PCN G or PCN VK

either way, PENICILLIN

70
Q

Scarlet fever rash is diff from Rheumatic fever bc

A

Scarlet fever is more diffuse, and Sandpaper-y

71
Q

Where does Scarlet fever rash start?

A

Armpits

72
Q

Tx for both Rheumatic and Scarlet is

A

PENICILLIN

except Rheumatic needs to add Aspirin and Steroids

73
Q

RMSF

spring and summer months
fever + joint pain + rash

A

Treat with DOXY

74
Q

RMSF

A

Vascular injury
Tiny clots–> infarcts
HA, fever, pedal edema, conjunctivitis, encephalitis, ARDS (respiratory distress), cardiac or bleeding disorders!!!
BIG YIKES

75
Q

RMSF labs may show

A

Thrombocytopenia
Pancytopenia
Hyponatremia

LOW EVERYTHING

76
Q

Tx for RMSF

A

Doxy

Chloramphenicol if pregnant

77
Q

When should you begin RMSF tx?

A

within 5 days of sx onset

78
Q

HA, fever, chills, myalgia, arthralgia, n/v, lethargy

RECENT CAMPING or outside in summer/spring months

A

RMSF

dont wait for rash to appear. Tx w Doxy

Clinical Prep (41 decks)

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