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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
gs dx for cholera
stool culture
26
tx for cholera
aggressive rehydration macrolides vs FQ vs tetracyclines
27
cryptococcus is a _ defining illness
AIDS
28
dx for cryptococcus (2)
CSF - india ink serology
29
transmission of cryptococcus
inhalation of budding yeast from contaminated soil w. pigeon/bird droppings
30
tx for cryptococcus
ampho B + flucytosine followed by fluconazole
31
cryptococcus prophylaxis for HIV pt
fluconazole if CD4 < 100
32
enveloped double stranded linear DNA virus in the herpes family - aka herpesvirus 5
CMV
33
CMV may mimic _ but lacks what sx
EBV lacks: severe pharyngitis
34
what is this showing
CMV retinitis
35
3 s/sx of CMV
PNA retinitis esophagitis (immunocompromised)
36
CMV is associated w. a CD4 count <
50
37
3 sx of CMV in neonates
hearing loss sz petechial rash
38
what is this showing
owl's eye inclusion -> CMV
39
tx for CMV
ganciclovir foscarnet cidofovir
40
URI w. thick gray pseudomembrane in the throat that bleeds if scraped
diphtheria
41
what is this showing
gray pseudomembrane of diphtheria
42
what is this showing
bull neck swelling due to enlarged cervical LAD -> **diphtheria**
43
vaccination schedule for diphtheria
2, 4, 6, 15-18 mos booster 4-6 yo
44
tx for diphtheria
antitoxin pcn vs macrolide
45
EBV triad
fever LAD pharyngitis
46
dx for EBV
(+) heterophile abs screen atypical lymphocytes w. enlarged nuclei
47
_ develops in 80% of pt's w. EBV
maculopapular rash
48
athletes w. EBV should avoid contact sports for _ weeks
3-4
49
describe the gonorrhea bacterium
gram negative diplococcus
50
gonorrhea in women is often asymptomatic, what are some sx of gonorrhea in men
yellow, creamy, profuse, purulent urethral d.c
51
tx for gonorrhea
ceftriaxone + azithro vs doxy (tx for chlamydia)
52
4 complications of gonorrhea
neonatal conjunctivitis septic arthritis tenosynovitis hand/feet pustules
53
2 hallmark sx of HSV infxns
prodrome burning/tingling > 24 hr followed by painful grouped vesicles on an erythematous base
54
name the HSV viruses type 1-8
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
55
histoplasmosis is a _ defining illness
histoplasmosis
56
transmission of histoplasmosis
soil containing bird/bat droppings in the mississippi and ohio river valleys
57
most significant rf for histoplasmosis
CD4 < 100
58
lab findings of histoplasmosis
elevated ALP (+) LDH
59
tx for histoplasmosis
1. itraconazole 2. ampho B
60
t/f: histoplasmosis prophylaxis for AIDS pt's is recommended
f
61
dz's associated with CD4 counts
-500-200: TB, kaposi sarcoma, thrush, lymhoma, zoster -<200: PJP, histoplasmosis -<100: toxoplasmosis, cryptococcus -<50: MAC, CMV
62
prophylaxis for different CD4 levels
-500-200: isoniazide -<200: bactrim, itraconazole -<100: bactrim, fluconazole -<50: valganciclovir
63
PEP administration guidelines
-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
64
full PEP reduces HIV transmission by up to _%
70%
65
influenza is caused by the _ virus
orthomyxo
66
everyone >/= _ yo should receive the influenza vaccination
6 mos
67
contraindications to the influenza vaccination
severe egg allergy previous rxn guillain barre hx w.in 6 weeks of prev vaccination GBS in past 6 weeks < 6 mos old
68
contraindication to flumist flu vaccine
asthma
69
CXR findings of influenza pna
bilat diffuse infiltrates
70
which 2 antivirals tx influenza a and b
oseltamivir zanamivir
71
indications for antiviral tx for influenza
hosiptalized op w, severe/progressive illness op and immunocompromised op w. chronic medical conditions >65 yo pregnant/2 weeks postpartum
72
describe borrlia burgdorferi
gram negative spirochete
73
what type of tick causes lyme dz
ixodes/deer
74
what 3 body systems are mc affected by lyme
joints heart nervous
75
3 stages of lyme dz
-localized: 3-30 days -> erythema migrans -disseminated: days-months: flu like, myalgias, arthralgias, AV block -late/chronic: months-years: HA, fatigue, joint pain
76
dx for lyme dz
1. ELISA vs IFA 2. IgM and/or IgG - western blot
77
tx and prophylaxis for lyme
doxycycline
78
helminth infxns to know
nematodes cestodes trematodes
79
2 nematode infxns
pinworm ascaris (roundworm)
80
what sx are associated w. nematode infxns
GI cough
81
tx for nematode infxns
mebendazole
82
AM anal pruritis in a kiddo
pinworm
83
dx for pinworm
scotch tape test
84
mc intestinal helminth infxn worldwide
ascaris (roundworm)
85
cestodes infxn is same same
tapeworm
86
2 sx of cestodes/tapeworm
GI wt loss
87
tx for cestodes/tapeworm
praziquantel
88
trematodes infxns include
avian and mammal schistosoma
89
swimmers itch makes you think
trematodes/schistosoma
90
tx for trematodes/schistosoma
praziquantel
91
lab finding that may be characteristic of any parasitic infxn
eosinophilia
92
pinworm and roundworm are treated w.: tapeworms and flukes are tx w:
pinworm/roundworm: mebendazole tapeworms/flukes: praziquantel
93
4 pathogens that cause malaria
plasmodium vivax p.malaria p.ovale p.falciparum
94
most virulent strain of malaria
p.falciparum
95
what type of mosquito transmits malaria
anopheles
96
hallmark sx of malaria
periods of chills/fever/sweats q 3 days splenomegaly after > 4 days of infxn
97
gs dx for malaria
giemsa stain peripheral smear (think and thick)
98
tx for malaria
chloroquine vs mefloquine
99
triad of toxoplasmosis
encephalitis chorioretinitis incracranial calcifications
100
what 2 pt pop makes you think toxoplasmosis
HIV w. CD4 < 100 pregnant w. litter box
101
what is this showing
ring enhancing lesion -> toxoplasmosis
102
prophylaxis for toxoplasmosis
CD4 count < 100: bactrim
103
severe hacking cough followed by a high pitched intake of breath
pertussis
104
pertussis is caused by
bortadella pertussis - gram negative bacteria
105
consider pertussis in what 2 pt pops
adults w. cough > 2 weeks pt's < 2 yo
106
3 stages of pertussis
catarrhal: cold like sx, poor feeding.sleeping paroxysmal: whooping cough convalescent: residual cough (up to 100 days)
107
dx for pertussis
nasopharyngeal culture
108
tx for pertussis
macrolide steroids SABA
109
prophylaxis for pertussis
infant-11 yo: DTap 11-18 yo: Tdap Tdap for moms during each pregnancy
110
mc opportunistic infxn in HIV pt's w. CD4 count < 200
pneumocystis jirovecii (PCP)
111
what is this showing
diffuse, bilat perihilar infiltrates -> PCP
112
tx and prophylaxis for PCP
bactrim
113
indications for steroids w. PCP
PaO2 < 70 alveolar gradient > 35 on RA
114
who should get PCP prophylaxis
HIV w. CD4 < 200
115
tx for PCP if bactrim allergy
pentamidine vs atovaquone
116
virus that causes rabies
RNA rhabdovirus
117
6 mc vectors for rabies
raccoons skunks bats foxes coyotes dogs
118
4 s/sx of rabies
hydrophobia pharyngeal spasms aerophobia hyperactivity
119
dx for rabies
**negri bodies:** eosinophilic inclusion bodies on the cytoplasm of hippocampal n cells *pathognomonic for rabies*
120
management of rabies
post exposure: rabies immunoglobulin + in activated vaccine
121
rabies is fatal when _ are present
neuro sx
122
what causes rocky mtn spotted fever
rickettsia rickettsii spread by the dog tick (dermacentor variabillis)
123
stages of RMSF
-2-14 days: flu like -red maculopapular rash on hands/feet that spreads centrally
124
gs test for RMSF
IFA (indirect fluorescent abs)
125
tx for RMSF
doxycycline
126
2 categories of salmenollosis
induce typhoid and enteric fever indyce GI sx
127
GI sx of salmonellosis
constipation pea soup diarrhea papular rash on trunk
128
what is enteric fever
flu like bacterial infxn characterized by fever, GI sx, and HA
129
how is enteric fever transmitted
consumption of fecally contaminated food/water
130
what is this showing
papular trunk on the rash -> salmonella enteric fever
131
major food source associated w. salmonella gastroenteritis
egg yolks
132
tx for salmonellosis
cipro ceftriaxone
133
what pathogen is associated w. dysentery
shigellosis
134
hallmark sx of shigellosis/dysentery
frequent/painful passage of small amts of stool that contains blood/pus/mucus
135
tx for shigellosis
bactrim vs cipro
136
what spirochete causes syphilis
treponema pallidum
137
3 phases of syphilis
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
what is this
chancre: primary syphilis
139
what is this
palmar rash: secondary syphilis
140
what is this
gumma: tertiary syphilis
141
dx for syphilis
initial: RPR/VDRL confrimed w.: FTA-ABS
142
tx for syphilis
primary/secondary: IM benzathine pcn tertiary/congenital: IV pen G
143
what toxin causes tetanus
clostridium tetani - gram positive anaerobe
144
pathophys for tetanus
spores in soil infect wound -> bacteria produce a neurotoxin -> interferes w. neuron synapses -> uncontrolled spasm/exaggerated reflexes
145
what type of wound is most susceptible to tetanus infxn
puncture
146
progression of tetanus
1. tingling at inoculation site 2. muscle spasms 3. tetany/lockjaw
147
tx for tetanus
wound debridement benzos tetanus immune globulin + tetanus toxoid metronidazole vs pcn
148
s/sx of TB
cough night sweats wt loss post tussive rales endemic area immunocompromised
149
XR findings of TB
cavitary lesions ghon complexes in lung apices
150
what is this showing
cavitary lesions -> TB
151
what is this showing
ghon complex: TB
152
dx for TB
**gs: acid fast bacilli stain** bx: caseating granulomas
153
mantoux skin test positive parameters: >5mm, >10mm, >15mm
>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
dx for TB
1. PPD/IGRA 2. if positive -> CXR 3. if CXR is negative -> latent TB 4. if CXR is positive -> active TB
155
tx options for latent TB
-isoniazid + rifapentine x 3 mos -rifampin x 4 mos -isoniazid + rifampin x 3 mos
156
tx options for active TB
-4 mos: rifapentine + moxifloxacin + isoniazide + pyrazinamide -6 or 9 mos: RIPE -> rifampin + isoniazid + pyrazinamide + ethambutol
157
what TB drug causes orange body fluids
rifampin
158
what TB med causes peripheral neuropathy
isoniazid
159
give _ w. isoniazid for peripheral neuropathy
pyridoxine (B6)
160
what TB med causes hyperuricemia/gout
pyrazinamide
161
which TB med causes optic neuritis/red-green blindness
ethambutol
162
all TB meds are _toxic
hepato
163
pt's w. active TB need _ for tx cessation
negative AFB smear + cultures x 2
164
prophylaxis for household contacts of TB
isoniazid x 1 year
165
when to d/c TB tx
transaminases > 3-5x UNL
166
varicella rash starts on the _
face
167
acute varicella zoster = _ and it lies dormant in the _
chickenpox dorsal root ganglion
168
what is this showing
shingles
169
gs dx for varicella zoster
tzanck smear showing multinucleated giant cells
170
tzanck smear -> giant multinucleated cells -> varicella zoster
171
dendritic lesions on slit lamp exam
zoster ophthalmicus
172
zoster ophthalmicus involves CN
V
173
CN VII otalgia lesions on the ear, auditory canal, TM facial palsy
zoster oticus (ramsay hunt)
174
tx for shingles
acyclovir vs valacyclovir vs famciclovir w.in 72 hr
175
what is postherpetic neuralgia
pain/paresthesias/decreased sensation > 3 mos post zoster infxn
176
tx for postherpetic neuralgia
gabapentin TCA topical lidocaine/capsaicin
177
zoster vaccine is recommended for
all immunocompetent adults > 60 yo

EOR - Internal Med (13 decks)

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