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EOR - Internal Med > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

botulism is a gram _ bacteria

A

positive

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2
Q

presentation of botulism

A

respiratory paralysis
muscle weakness
floppy baby

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3
Q

in order to destroy botulism spores, they must be exposed to

A

moist heat at 120 C x 30 mins

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4
Q

when can you expose a kiddo to honey

A

12 months old

due to risk of botulism

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5
Q

tx for botulism

A

botulinum antitoxin

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6
Q

4 different types of candidial infxns to know

A

vaginal
esophageal
oral thrush
intertrigo

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7
Q

tx for vaginal candidiasis

A

miconazole cream
PO fluconazole

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8
Q

esophageal candidiasis is mc in _ pt’s

A

AIDS

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9
Q

sx of esophageal candidiasis

A

substernal dysphagia
GE reflux
nausea w/w.o pain

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10
Q

what is this showing

A

linear erosions on EGD -> esophageal candidiasis

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11
Q

tx for esophageal candidiasis

A

fluconazole

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12
Q

friable white plaques that bleed if scraped

A

oral thrush

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13
Q

tx for oral thrush

A

nystatin

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14
Q

what is this showing

A

intergrigo

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15
Q

hallmark rash of intertrigo

A

beefy red erythema w. distinct scallped borders and satellite lesions

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16
Q

tx for intertrigo

A

clotrimazole
ketoconazole
miconazole

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17
Q

mc STI:
most reported STI:

A

mc: HPV
most reported: chlamydia

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18
Q

describe chlamydia bacterium

A

gram negative rod

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19
Q

dx for chlamydia

A

NAAT

gram stain shows no organisms

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20
Q

tx for chlamydia

A

doxycycline
+
ceftriaxone (cover for gonorrhea)

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21
Q

tx for chlamydia in pregnancy

A

azithromycin
vs
amoxicillin

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22
Q

describe the vibrio cholerae bacterium

A

gram negative

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23
Q

hallmark sx of cholera

A

rice water diarrhea

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24
Q

2 mc modes of transmission for cholera

A

contaminated water
seafood

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25
Q

gs dx for cholera

A

stool culture

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26
Q

tx for cholera

A

aggressive rehydration
macrolides vs FQ vs tetracyclines

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27
Q

cryptococcus is a _ defining illness

A

AIDS

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28
Q

dx for cryptococcus (2)

A

CSF - india ink
serology

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29
Q

transmission of cryptococcus

A

inhalation of budding yeast from contaminated soil w. pigeon/bird droppings

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30
Q

tx for cryptococcus

A

ampho B + flucytosine
followed by
fluconazole

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31
Q

cryptococcus prophylaxis for HIV pt

A

fluconazole if CD4 < 100

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32
Q

enveloped double stranded linear DNA virus in the herpes family - aka herpesvirus 5

A

CMV

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33
Q

CMV may mimic _
but lacks what sx

A

EBV
lacks: severe pharyngitis

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34
Q

what is this showing

A

CMV retinitis

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35
Q

3 s/sx of CMV

A

PNA
retinitis
esophagitis (immunocompromised)

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36
Q

CMV is associated w. a CD4 count <

A

50

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37
Q

3 sx of CMV in neonates

A

hearing loss
sz
petechial rash

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38
Q

what is this showing

A

owl’s eye inclusion -> CMV

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39
Q

tx for CMV

A

ganciclovir
foscarnet
cidofovir

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40
Q

URI w. thick gray pseudomembrane in the throat that bleeds if scraped

A

diphtheria

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41
Q

what is this showing

A

gray pseudomembrane of diphtheria

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42
Q

what is this showing

A

bull neck swelling due to enlarged cervical LAD -> diphtheria

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43
Q

vaccination schedule for diphtheria

A

2, 4, 6, 15-18 mos
booster 4-6 yo

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44
Q

tx for diphtheria

A

antitoxin
pcn vs macrolide

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45
Q

EBV triad

A

fever
LAD
pharyngitis

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46
Q

dx for EBV

A

(+) heterophile abs screen
atypical lymphocytes w. enlarged nuclei

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47
Q

_ develops in 80% of pt’s w. EBV

A

maculopapular rash

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48
Q

athletes w. EBV should avoid contact sports for _ weeks

A

3-4

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49
Q

describe the gonorrhea bacterium

A

gram negative diplococcus

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50
Q

gonorrhea in women is often asymptomatic, what are some sx of gonorrhea in men

A

yellow, creamy, profuse, purulent urethral d.c

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51
Q

tx for gonorrhea

A

ceftriaxone
+
azithro vs doxy (tx for chlamydia)

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52
Q

4 complications of gonorrhea

A

neonatal conjunctivitis
septic arthritis
tenosynovitis
hand/feet pustules

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53
Q

2 hallmark sx of HSV infxns

A

prodrome burning/tingling > 24 hr
followed by
painful grouped vesicles on an erythematous base

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54
Q

name the HSV viruses type 1-8

A

HSV 1: oral HSV
HSV 2: genital herpes
HHV 3: varicella zoster: chickenpox, shingles
HHV 4: EBV, hodgkin lymphoma
HHV 5: CMV
HHV 6/7: roseola infantum
HHV 8: kaposi sarcoma

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55
Q

histoplasmosis is a _ defining illness

A

histoplasmosis

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56
Q

transmission of histoplasmosis

A

soil containing bird/bat droppings in the mississippi and ohio river valleys

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57
Q

most significant rf for histoplasmosis

A

CD4 < 100

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58
Q

lab findings of histoplasmosis

A

elevated ALP
(+) LDH

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59
Q

tx for histoplasmosis

A
  1. itraconazole
  2. ampho B
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60
Q

t/f: histoplasmosis prophylaxis for AIDS pt’s is recommended

A

f

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61
Q

dz’s associated with CD4 counts

A

-500-200: TB, kaposi sarcoma, thrush, lymhoma, zoster
-<200: PJP, histoplasmosis
-<100: toxoplasmosis, cryptococcus
-<50: MAC, CMV

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62
Q

prophylaxis for different CD4 levels

A

-500-200: isoniazide
-<200: bactrim, itraconazole
-<100: bactrim, fluconazole
-<50: valganciclovir

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63
Q

PEP administration guidelines

A

-w.in 72 hr of exposure
-chances of contracting HIV from needle stick injury in knwon HIV pt is <0.3%
-test worker and pt at 6 weeks, 3 mos, 6 mos
-if retrovirals: combo therapy w. drugs from 2 different classes x 4 weeks

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64
Q

full PEP reduces HIV transmission by up to _%

A

70%

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65
Q

influenza is caused by the _ virus

A

orthomyxo

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66
Q

everyone >/= _ yo should receive the influenza vaccination

A

6 mos

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67
Q

contraindications to the influenza vaccination

A

severe egg allergy
previous rxn
guillain barre hx w.in 6 weeks of prev vaccination
GBS in past 6 weeks
< 6 mos old

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68
Q

contraindication to flumist flu vaccine

A

asthma

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69
Q

CXR findings of influenza pna

A

bilat diffuse infiltrates

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70
Q

which 2 antivirals tx influenza a and b

A

oseltamivir
zanamivir

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71
Q

indications for antiviral tx for influenza

A

hosiptalized
op w, severe/progressive illness
op and immunocompromised
op w. chronic medical conditions
>65 yo
pregnant/2 weeks postpartum

72
Q

describe borrlia burgdorferi

A

gram negative spirochete

73
Q

what type of tick causes lyme dz

A

ixodes/deer

74
Q

what 3 body systems are mc affected by lyme

A

joints
heart
nervous

75
Q

3 stages of lyme dz

A

-localized: 3-30 days -> erythema migrans
-disseminated: days-months: flu like, myalgias, arthralgias, AV block
-late/chronic: months-years: HA, fatigue, joint pain

76
Q

dx for lyme dz

A
  1. ELISA vs IFA
  2. IgM and/or IgG - western blot
77
Q

tx and prophylaxis for lyme

A

doxycycline

78
Q

helminth infxns to know

A

nematodes
cestodes
trematodes

79
Q

2 nematode infxns

A

pinworm
ascaris (roundworm)

80
Q

what sx are associated w. nematode infxns

81
Q

tx for nematode infxns

A

mebendazole

82
Q

AM anal pruritis in a kiddo

83
Q

dx for pinworm

A

scotch tape test

84
Q

mc intestinal helminth infxn worldwide

A

ascaris (roundworm)

85
Q

cestodes infxn is same same

86
Q

2 sx of cestodes/tapeworm

87
Q

tx for cestodes/tapeworm

A

praziquantel

88
Q

trematodes infxns include

A

avian and mammal schistosoma

89
Q

swimmers itch makes you think

A

trematodes/schistosoma

90
Q

tx for trematodes/schistosoma

A

praziquantel

91
Q

lab finding that may be characteristic of any parasitic infxn

A

eosinophilia

92
Q

pinworm and roundworm are treated w.:
tapeworms and flukes are tx w:

A

pinworm/roundworm: mebendazole
tapeworms/flukes: praziquantel

93
Q

4 pathogens that cause malaria

A

plasmodium vivax
p.malaria
p.ovale
p.falciparum

94
Q

most virulent strain of malaria

A

p.falciparum

95
Q

what type of mosquito transmits malaria

96
Q

hallmark sx of malaria

A

periods of chills/fever/sweats q 3 days
splenomegaly after > 4 days of infxn

97
Q

gs dx for malaria

A

giemsa stain peripheral smear (think and thick)

98
Q

tx for malaria

A

chloroquine
vs
mefloquine

99
Q

triad of toxoplasmosis

A

encephalitis
chorioretinitis
incracranial calcifications

100
Q

what 2 pt pop makes you think toxoplasmosis

A

HIV w. CD4 < 100
pregnant w. litter box

101
Q

what is this showing

A

ring enhancing lesion -> toxoplasmosis

102
Q

prophylaxis for toxoplasmosis

A

CD4 count < 100: bactrim

103
Q

severe hacking cough followed by a high pitched intake of breath

104
Q

pertussis is caused by

A

bortadella pertussis - gram negative bacteria

105
Q

consider pertussis in what 2 pt pops

A

adults w. cough > 2 weeks
pt’s < 2 yo

106
Q

3 stages of pertussis

A

catarrhal: cold like sx, poor feeding.sleeping
paroxysmal: whooping cough
convalescent: residual cough (up to 100 days)

107
Q

dx for pertussis

A

nasopharyngeal culture

108
Q

tx for pertussis

A

macrolide
steroids
SABA

109
Q

prophylaxis for pertussis

A

infant-11 yo: DTap
11-18 yo: Tdap
Tdap for moms during each pregnancy

110
Q

mc opportunistic infxn in HIV pt’s w. CD4 count < 200

A

pneumocystis jirovecii (PCP)

111
Q

what is this showing

A

diffuse, bilat perihilar infiltrates -> PCP

112
Q

tx and prophylaxis for PCP

113
Q

indications for steroids w. PCP

A

PaO2 < 70
alveolar gradient > 35 on RA

114
Q

who should get PCP prophylaxis

A

HIV w. CD4 < 200

115
Q

tx for PCP if bactrim allergy

A

pentamidine
vs
atovaquone

116
Q

virus that causes rabies

A

RNA rhabdovirus

117
Q

6 mc vectors for rabies

A

raccoons
skunks
bats
foxes
coyotes
dogs

118
Q

4 s/sx of rabies

A

hydrophobia
pharyngeal spasms
aerophobia
hyperactivity

119
Q

dx for rabies

A

negri bodies: eosinophilic inclusion bodies on the cytoplasm of hippocampal n cells

pathognomonic for rabies

120
Q

management of rabies

A

post exposure: rabies immunoglobulin + in activated vaccine

121
Q

rabies is fatal when _ are present

122
Q

what causes rocky mtn spotted fever

A

rickettsia rickettsii spread by the dog tick (dermacentor variabillis)

123
Q

stages of RMSF

A

-2-14 days: flu like
-red maculopapular rash on hands/feet that spreads centrally

124
Q

gs test for RMSF

A

IFA (indirect fluorescent abs)

125
Q

tx for RMSF

A

doxycycline

126
Q

2 categories of salmenollosis

A

induce typhoid and enteric fever
indyce GI sx

127
Q

GI sx of salmonellosis

A

constipation
pea soup diarrhea
papular rash on trunk

128
Q

what is enteric fever

A

flu like bacterial infxn characterized by fever, GI sx, and HA

129
Q

how is enteric fever transmitted

A

consumption of fecally contaminated food/water

130
Q

what is this showing

A

papular trunk on the rash -> salmonella enteric fever

131
Q

major food source associated w. salmonella gastroenteritis

132
Q

tx for salmonellosis

A

cipro
ceftriaxone

133
Q

what pathogen is associated w. dysentery

A

shigellosis

134
Q

hallmark sx of shigellosis/dysentery

A

frequent/painful passage of small amts of stool that contains blood/pus/mucus

135
Q

tx for shigellosis

A

bactrim
vs
cipro

136
Q

what spirochete causes syphilis

A

treponema pallidum

137
Q

3 phases of syphilis

A
  1. primary: painless chancre in genital/groin area x 3-6 weeks
  2. secondary: erythematous rash on palms/soles vs condyloma lata
  3. tertiary: neurosyphilis - permanent CNS changes, gummas - benign mucosal growths
138
Q

what is this

A

chancre: primary syphilis

139
Q

what is this

A

palmar rash: secondary syphilis

140
Q

what is this

A

gumma: tertiary syphilis

141
Q

dx for syphilis

A

initial: RPR/VDRL
confrimed w.: FTA-ABS

142
Q

tx for syphilis

A

primary/secondary: IM benzathine pcn
tertiary/congenital: IV pen G

143
Q

what toxin causes tetanus

A

clostridium tetani - gram positive anaerobe

144
Q

pathophys for tetanus

A

spores in soil infect wound -> bacteria produce a neurotoxin -> interferes w. neuron synapses -> uncontrolled spasm/exaggerated reflexes

145
Q

what type of wound is most susceptible to tetanus infxn

146
Q

progression of tetanus

A
  1. tingling at inoculation site
  2. muscle spasms
  3. tetany/lockjaw
147
Q

tx for tetanus

A

wound debridement
benzos
tetanus immune globulin + tetanus toxoid
metronidazole vs pcn

148
Q

s/sx of TB

A

cough
night sweats
wt loss
post tussive rales
endemic area
immunocompromised

149
Q

XR findings of TB

A

cavitary lesions
ghon complexes in lung apices

150
Q

what is this showing

A

cavitary lesions -> TB

151
Q

what is this showing

A

ghon complex: TB

152
Q

dx for TB

A

gs: acid fast bacilli stain
bx: caseating granulomas

153
Q

mantoux skin test positive parameters:
>5mm, >10mm, >15mm

A

> 5mm: CXR findings, past TB infxn, HIV, organ transplant, close contacts of known infected

> 10mm: IVDU, recent immigrants from endemic regions, communal living, myobacterial lab workers, comorbidities, kids < 4 yo,

> 15mm: no known rf

154
Q

dx for TB

A
  1. PPD/IGRA
  2. if positive -> CXR
  3. if CXR is negative -> latent TB
  4. if CXR is positive -> active TB
155
Q

tx options for latent TB

A

-isoniazid + rifapentine x 3 mos
-rifampin x 4 mos
-isoniazid + rifampin x 3 mos

156
Q

tx options for active TB

A

-4 mos: rifapentine + moxifloxacin + isoniazide + pyrazinamide
-6 or 9 mos: RIPE -> rifampin + isoniazid + pyrazinamide + ethambutol

157
Q

what TB drug causes orange body fluids

158
Q

what TB med causes peripheral neuropathy

159
Q

give _ w. isoniazid for peripheral neuropathy

A

pyridoxine (B6)

160
Q

what TB med causes hyperuricemia/gout

A

pyrazinamide

161
Q

which TB med causes optic neuritis/red-green blindness

A

ethambutol

162
Q

all TB meds are _toxic

163
Q

pt’s w. active TB need _ for tx cessation

A

negative AFB smear + cultures x 2

164
Q

prophylaxis for household contacts of TB

A

isoniazid x 1 year

165
Q

when to d/c TB tx

A

transaminases > 3-5x UNL

166
Q

varicella rash starts on the _

167
Q

acute varicella zoster = _
and it lies dormant in the _

A

chickenpox
dorsal root ganglion

168
Q

what is this showing

169
Q

gs dx for varicella zoster

A

tzanck smear showing multinucleated giant cells

170
Q
A

tzanck smear -> giant multinucleated cells -> varicella zoster

171
Q

dendritic lesions on slit lamp exam

A

zoster ophthalmicus

172
Q

zoster ophthalmicus involves CN

173
Q

CN VII otalgia
lesions on the ear, auditory canal, TM
facial palsy

A

zoster oticus (ramsay hunt)

174
Q

tx for shingles

A

acyclovir vs valacyclovir vs famciclovir w.in 72 hr

175
Q

what is postherpetic neuralgia

A

pain/paresthesias/decreased sensation > 3 mos post zoster infxn

176
Q

tx for postherpetic neuralgia

A

gabapentin
TCA
topical lidocaine/capsaicin

177
Q

zoster vaccine is recommended for

A

all immunocompetent adults > 60 yo

EOR - Internal Med (13 decks)

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