Infectious disease Flashcards
HepB vs HepA clinical manifestation
HepB > extrahepatic manifestations such as symmetrical arthralgia/arthritis, macular rash, thrombocytopenia
Fever, sore throat, exudate, maculopapular rash on extremities, negative strep throat
Arcanobacterium Haemolyticum
Viral syndrome, unilateral upper extremity weakness, dysphasia
Acute flaccid myelitis (enterococcus D68)
Testing for CGD
DHR test (dihydrorhodamine test)
PCP prophylaxis
Bactrim, pentamidine, atovaquone, dapsone
Antibiotic prophylaxis for dental procedure
Prosthetic heart valves, previous IE, unrepaired cyanotic heart, repaired heart with residual defects, valvulopathy in transplanted heart, and first 6 months of a completely repaired heart with prosthetic material (NOT repaired VSD)
Peripartum maternal chickenpox infection
IgG if 5 days prior or 2 days after delivery
Early HIV confirmatory test
HIV RNA testing (Western blot, HIV p24 Ag, and HIV Ab are all poor in AIDS or acute HIV)
Reye syndrome organisms
VZV and flu, especially with salicylate use
4 week old presents with lethargy, poor feeding, and decrease tone. Admitted for rule out sepsis, got Amp/Gent/Acyclovir, then within 30 minutes developed respiratory arrest requiring mechanical ventilation. What happened?
Clostridium botulinum infection (aminoglycoside caused bacterial lysis release toxin)
Recurrent infections and elevated IgE
Dz: Job syndrome ()
Erythematous tonsils with membrane formation and petechiae at the junction of hard and soft palate (infx?)
Epstein-Barr virus
Ulcerative appearance and a small number of vesicular lesions covering the buccal mucosa and tongue (infx?)
Varicella
Mom with poor prenatal care gives birth to baby with severe malformation of both lower extremities and microphthalmia (dz?)
Congenital varicella syndrome (aka. varicella embryopathy). Path = maternal varicella infection before 20 weeks of gestation, Clx = severe limb malformation, cicatrix (dermatomal “zigzag” scarring), CNS/ocular abnormalities (microphthalmia, cataracts, chorioretinitis, and/or optic atrophy.
SLE and recurrent pyogenic infections
C2 complement deficiency = increase risk for strep, h. flu, and neisseria meningitidis infections. VS C5-9 and properdin deficiency = fulminent menigicoccus disease
Painful, inflamed, shallow ulcer on penis associated with grayish fibrinous membrane and ragged, undermined borders on the foreskin
Chancroid. Path- Haemophilus ducreyi (DO CRY = painful); Clx - with bubo (painful unilateral inguinal lymphadenitis).
VS lymphogranuloma venereum (erosive, painLESS papilla then ulcers on shaft of penis with painful lymphadenopathy)
VS syphilitic chancre (indurated, punched-out, painLESS ulcer with slightly elevated margins)
VS granuloma inguinale aka Donovanosis by klebsiella granulomatis (painLESS beefy red ulcers that bleed)
Penetrating eye trauma with ring abscess formation
B cereus (treat with IV and intravitreous vancomycin). Pseudomonas and proteus also present with ring abscess formation. vs. Acanthamoeba (contact lens and swimming)
Most common cause of serosanguinous/bloody vaginal discharge and vulvovaginitis
Shigella flexneri/sonnei and group A strep
Tenosynovitis, dermatitis, and polyarthralgia
Arthritis-dermatitis syndrome by disseminated gonorrhea infection (vs. chlamydia reactive arthritis = arthritis, urethritis, conjunctivitis/uveitis = cant’s see, can’t pee, cant’ climb a fucking tree)
Fever, fatigue, myalgias, headache, and rash (erythematous, maculopapular, and petechial rash includes trunk and most prominent on wrists, ankles, palms, and soles)
Rocky Mountain Spotted Feer
Rocky mountain spotted fever lab findings
Hyponatremia (endothelial damage => vasculitis => leakage), thrombocytopenia, leukopenia, anemia, elevated transaminases
PANDAS
Pediatric Autoimmune Neuropsychiatric disorder associated with group A Streptococci
Airborne pathogens
Measles, mumps, TB
Congenital syphilis (Clx)
IUGR, hydrops (also parvovirus), skeletal changes, rash on hands and sole, hepatomegaly, jaundice, rhinitis/snuffles with adjacent bone/cartilage destruction
Congenital syphilis bone findings
osteochondritis and periostitis of metaphysis and diaphysis, irregular bands of demineralization, focal circumscribed areas of bony destruction, Wimberger sign (destruction of the medial aspect of the proximal tibial metaphysis), painful and refused movement of involved bone (pseudoparalysis of Parrot)
Fever, headache, stomachache, sore throat, then 2 days later develops fine reddish-pink, papular rash on face, trunk, UE, and thighs, but spares palms and soles
Scarlet fever (also circumoral pallor)
Fever, headache, chills, malaise, with ulcerated lesion and tender local lymphadenopathy. Recent tick bite.
Francisella tularensis, treat with aminoglycosides
Unilateral conjunctival erythema without discharge or pain, ipsilateral preauricular lymphadenopathy, unilateral conjunctival granuloma (dz and tx)
Parinaud oculoglandular syndrome by Bartonella henselae, can give azithromycin for hasten resolution
Perceptual distortions of size/shape/colors/spatial relationships
“Alice in Wonderland syndrome” associated with infectious mononucleosis, migrainous ischemia, encephalitis, epilepsy, trauma
Fever, arthralgia, sudden onset pruritic erythematous symmetrical swelling of hands and feet that is well-demarcated at the wrist and ankles. Also with painful pruritic papules, petechiae, and purpura of hands and feet.
Papular purpuric gloves and socks syndrome (PPGSS) by parvovirus B19 => infectious thus be careful about close contact with preggos
Late finding of acute rheumatic fever
Chorea (months after initial infection vs other findings within weeks)
Colchicine (uses)
1st line treatment for familial mediterranean fever (prevents development of amyloidosis). Also prophylaxis in PFAPA if unresponsive to cimetidine or who have bad oral aphthae.
Clostridium septicum (dz)
Sepsis in cyclical neutropenia
Retorpharyngeal abscess tx
Unasyn
Fever, cough, and now rapidly evolving difficulty swallowing, chapped lips with oral mucosal erosions and sloughing, injected conjunctivae, and a few papulovesicles (dz)
Mycoplasma-induced rash and mucositis (MIRM)
Staph is more impetigo and STTS would have more sunburn-like rash with less mucosal involvement
Malaria prophylaxis
Chloroquine, doxyxycline, atovaquone/proguanil, mefloquine
