Infectious Disease Flashcards
WBC Interpretation CBC: Neutrophils \_\_\_\_ w/ BACTERIAL infection Monocytes: \_\_\_\_\_ Lymphocytes: \_\_\_\_ Eosinophils: \_\_\_\_\_ Basophils and Eosinophils: \_\_\_\_\_\_\_
WBC Interpretation
CBC:
Neutrophils increase w/ BACTERIAL infection
Monocytes: Bacterial
Lymphocytes: Viral
Eosinophils: worms, wheezes, weird diseases
Basophils and Eosinophils: DON’T RESPOND TO VIRAL or BACTERIAL
what does cbc shift to left mean?
Left shift= Increase band cells (immature immunity cells)= acute infection happening now
bacterial infection, causes by staph or strep Pyrogens, involving deeper layers of the tissue
warm, edema, pain, sharp demarcation
Systemic involvement; lymph, fevers, chills
Lymph streaking
Cellulitis
Diagnostics for cellulitis
Lab: CBC, creatonon, bicarb, creatine phosphokinse, gram stain
Imaging: eval osteomyelitis, US
Dx: blood cultures, needle aspirate, culture
managing cellulitis
Update tetanus
Meds: Kephlex
Regular people Antibiotics = Penicillin, Amox, Augmentin, Keflex (Class)
MRSA oriented - Doxycycline (class)
F:U 24-48 hours
Non-purulent SSTI infection of upper demis to include lymphatics - superficial cellulitis
Erythema, edema, pain
Lymphatic streaking
LE most common location
Erysipelas (strep)- cellulitis but superficial
How to tx Erysipelas (strep)- cellulitis but superficial
Pain- ibuprofen or tylenol
PCN first line
if allergies- macrolide/ cephalosporin
diagnostics for Erysipelas (strep)
Labs: CBC, ESR, CRP
Imagine- r/o necrotizing fasciitis
Honey crusted lesions
1-2mm lesions
Common in face and LE
Impetigo (bacterial)
how to manage Impetigo ?
Mupirocin 2% topical TID x 10 days (for mild)
Severe: amoxicillin/clavulanate (augmentin) 500 Q8
(oral) and (genital)- both can appear at any site
Stays on nerve roots and can reactivate infection
Risk Factors:
Stress, depression, anxiety, poor sleep
Herpes Simplex
How to tx Herpes Simplex?
Acyclovir 1g BID 10 days; abreva (topical OTC)
antibiotics are only used if there is an infection
Oral acyclovir is just for adults/ severe pediatric cases
topical acyclovir is for genital herpes infection and doesn’t do much for symptom relief
PAIN
Unilateral eruption within one dermatome
Herpes Zoster (chicken pox) shingles
How to manage Herpes Zoster/ shingles ?
Meds:’Valtrex 1g BID x 10 days, gabapentin- nerve pain, lidocaine spray
-> Post herpatic neuralgia
VACCINE - shingrix (2 doses, 6 mo apart)
Should get new one if they had old
highly contagious acute viral RR disease Flu a/ b 1-4 days- incubation Fall and spring PE: Nuccal rigidity and lymph
Influenza (rapid onset)
How to manage Influenza?
Flu shot
Tamiflu reduces sx by 1-2 days
No ASA- Reye’s syndrome
Supportive , hand washing
acute viral syndrome caused by EBV
Spread by saliva
Common in college
Triad: fever, pharyngitis, adenopathy
Sore throat, cough, chills, photophobia, posterior cervical, splenic enlargement
Infectious mononucleosis
Mono diagnostics? ‘
education/ management?
CBC- lymphocytes
Rapid step, LFTs
Education rest, no lifting, no ETOH and no sports due to enlarged spleen
Amoxicillin/ PCN- rash - Erythromycin if they have concurrent strep and mono
Painless, itching, flesh-colored, shiny, pearly white, or waxy dome-shaped papules with CENTRAL dimple
Molluscum Contagiosum
how to tx Molluscum Contagiosum?
Self-limiting in healthy… Watchful waiting -healthy
Immunocompromised- Cidofovir
How to manage verruca?
1st line?
flat warts?
genital/ face?
Prevention ?
Salicylic acid for 1st line
Tretinoin cream for flat warts
Genital/ face - Imiquimod cream
Prevention- HPV vaccine
On hands, feet and mouth
Fever, sore throat, malaise for 1-2 days, submandibular and vertical lymphadenopathy, oral lesions
Pathogen: Coxsackie - invades through GI tract
BENIGN but can cause problems
Hand-Foot-Mouth (Virus)
Droplet Transmission: Fever, blanching rash (in later stages doesnt blanch), presents in hairline, forehead, and behind ears and spreads cephalocaudally and centrifugally
dx= 4x specific IgG antibody
Measles
Abrupt onset of fever
Rash from trunk to extremity
Cold symptoms with it: dry cough, runny nose
… Afebrile before returning to daycare
Roseola (rose pink rash)
Fungal caused by candida
Cottage cheese on tounge- thrush, angular cheliltie
Red moist patches surrounded by thin scale patches
Acts up if immunosuppression, obesity, abx, steroids, malnutrition
Candidiasis
How to tx tinea capitis?
ketoconazole 2x / week for 4 weeks
How to tx Onychomycosis (fungal nail infection) ?
terbinafine 250 mg daily
spirochete borrelia ( cork screw bacteria- can affect any part of body) Not all ticks transmit the disease
Tick bite
Incubation- 1-32days
Needs to be attached to human for 48 hrs to be transmitted
April- October
Lyme Disease
Fatigue, HA, myalgias
Late: cardiac problems, neuro
PE:
Bulls eye
Lyme Disease
How to tx / manage Lyme Disease ?
Reg? And with nuro sx?
Abx: Doxycycline, amoxicillin
Neurological manifestations: ceftriaxone 2g daily IV
pruritic eruption often with linear burrows in the web spaces of the fingers.
Risk Factors: Crowded living conditions
Scabies
