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PANCE 2024 > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

With cryptococcus think what 4 things

A

HIV CD4 less 100

Meningitis

Pigeon droppings

Pulmonary CNS sxs

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2
Q

What signs are often absent in cryptoccosis neoformans

A

Meningeal signs

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3
Q

What is the positive lab testing in cryptoccosis neoformans

A

Positive India ink = round encapsulated yeast

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4
Q

Because crytopcoccosis neoformans is yeast how can you think of treating it

A

FLUCONAZOLE

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5
Q

With cryptoccoal meningitis think what txm

A

Amphotericin

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6
Q

Location of histoplasmosis

A

Ohio and Mississippi River valley = inhaled SOIL or FECES

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7
Q

Describe histoplasmosis sxs

A

Flu sxs // headache // cough // night sweats

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8
Q

Histoplasmosis think what transmission

A

Bird droppings
Bats

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9
Q

Histo treatment

A

Itraconazole and severe = AMPHOTERICIN

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10
Q

Chlamydia can cause what 3 etiologies

A

Cervicitis / urethritis

PID

Lymphogranuloma Venereum

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11
Q

What type of discharge do you think with chlamydia

A

Watery in men // some to none in women — cervical mucopurulent discharge common

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12
Q

Chlamydia treatment // preg?

A

Doxy

Azithro in pregnancy

presumptive treatment of partners

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13
Q

With gonorrhea you’re thinking what kind of infections // 4

A

Conjunctivitis

Edpidymitis .. prostatitis

Pharyngitis

Urethritis

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14
Q

Lab staining for gonorrhea

A

Gram negative EXTRACELLULAR diplococci

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15
Q

Gonorrhea treatment

A

IM Ceftriaxone single dose

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16
Q

Lab findings in MRSA

A

Gram positive cocci in CLUSTERS

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17
Q

What drugs can treat MRSA

A

Bactrim
Clindamycin
Doxycycline

IV VANC

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18
Q

Rheumatic fever often presents in what age and how

A

5-14 years old

S/p untreated strep infection = INFLAMMATORY RXN in heart brain joints skin

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19
Q

Name the skin lesion associated with rheumatic fever

A

Erythema marginatum

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20
Q

What is spared in the rash of rheumatic fever

A

The face

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21
Q

What is the major criteria of rheumatic fever and how many do you need

A

1 and 2 minors or 2 majors alone.

Carditis
Polyarthritis
Sydenham Chorea
Eyrthema marginatum
Subq Nodules

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22
Q

Recent scarlet fever is indication of what

A

Recent strep infection

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23
Q

What valve is most effected in rheumatic heart disease

A

The mitral valve

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24
Q

Management of rheumatic fever

A

Penc G or Amox

ASA

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25
Q

What type of tick is involved in Rocky Mountain spotted fever

A

Dog tick

Wood tick

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26
Q

Describe Rocky Mountain spotted fever rash

A

Starts on palms and soles spreads towards the trunk
Blanching erythematous rash with macula and petechia

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27
Q

DOC for Rocky Mountain spotted fever

A

Doxy empirically

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28
Q

Lyme disease is caused by and lesion looks like ; must be attached for how long

A

Borrelia Burgodorferi

“Target” Bullseye lesion

24 hours or DONT TREAT

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29
Q

4 clinical manifestations of Lyme disease

A

Bilateral Bell’s palsy
Arthritis
Heart blocks
Erythema migrans

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30
Q

Talk about testing for Lyme Disease in the lab

A

ELISA OR IFA FIRST.

IgG for western blot if LESS 30 DAYS OF SXS

IgG and IgM western blot if GREATER 30 DAYS OF SXS

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31
Q

Lyme disease treatment ; if pregnant

A

Doxy

Amoxicillin if pregnant

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32
Q

When is doxy given prophylactically

A

Within 72 hours of tick REMOVAL

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33
Q

Syphillis primarily affects what heart structure

A

The aorta

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34
Q

Talk about serological testing for syphillis

A

Screen = RPR and VLDRL

Confirmatory = FTA -ABS ;; if positive this will remain positive for life.

you can also order direct visualization of T. Pallidum

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35
Q

Syphillis treatment and back up

A

Penc G ;; can even sensitize pregnant patients

All Others— with allergy = Doxy or Ceftriaxone

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36
Q

What rash is associated with rheumatic fever?

A

Erythema marginatum

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37
Q

What are the two ways of syphilis transmission?

A

Sexual contact

And vertical transmission

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38
Q

Describe the syphillis lesion

A

Chancre papule painless ; 1-2 cm ulcer with raised undurated edges

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39
Q

Where does syphillis have a predilection for on the body

A

Palms and soles

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40
Q

What type of STI really effects the aorta

A

Syphilis

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41
Q

What is the difference between syphilis lesion and H. Ducryei lesion

A

H. Ducreyi hurts; multiple painful inguinal Bubo

Syphilis is painless … that’s why its on the RIZE

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42
Q

Patient presents with syphilis like lesion and treated with antibiotics and gets a ridiculous reaction ; what are you thinking?

A

Jarisch Herxhiemer Reaction

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43
Q

High cyclical fever and what is the worst genus

A

Malaria falciparum

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44
Q

Best lab studies for malaria

A

Thick and thin Geimsa stain

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45
Q

What do you see on CT for toxoplasmosis

A

Ring enhancing lesions

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46
Q

3 combo of medications to treat toxoplasmosis if a patient is immunocompromised

A

Sulfadiazine + Pyrimethamine + Leucovorin

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47
Q

EBV affects what two types of cells?

A

B cells

Pharyngeal Epithelial cells

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48
Q

Classic triad of EBV

A

Fever
Sore throat
Cervical LAD

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49
Q

If MONO is treated with amoxicillin what happens>

A

Get a RASH

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50
Q

Peripheral blood smears positive in MONO

A

Atypical lymphocytes

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51
Q

Why do you avoid contact sports in EBV

A

Splenic rupture!

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52
Q

What is the smear for HSV and what does it show?

A

Tzanck Smear and Multi Nucleated Giant Cells

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53
Q

We give antivirals for what in HSV

A

Primary infection and suppressive therapy

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54
Q

Describe the timeline and stages of sxs in
HIV infection

A

Infected and then asxs for 8-10 years
Sxs = weight loss ; high infection ; uncommon fungal infections
“Kaposi Sarcoma”
“Hairy Leukoplakia”

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55
Q

What usually follows opportunistic diseases in HIV patients

A

Death

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56
Q

What is the time frame that western blot will be positive in HIV

A

31 days

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57
Q

Treatment for HIV is what class of medications?

A

2 NRTI’s = Nucleotide Reverse Transcriptase Inhibitors

+

1 NNRTI = Non Nucleotide Reverse Transcriptase Inhibitors

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58
Q

3 diseases with any CD4 count in HIV

A

Kaposi’s
Herpes Zoster
Lymphoma

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59
Q

CD4 count in HIV less than 100 what are 3 common diseases

A

Cerebral toxoplasmosis
Military Tuberculosis
HIV encephalopathy

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60
Q

What is the only type of animal that transmits rabies

A

Mammals

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61
Q

Rabies effects what part of the body

A

Encephalitis of gray matter

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62
Q

What is the name of the finding in postpartum tissue in a rabies infected patient

A

Negri bodies

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63
Q

What are two severe sxs that often lead to death in Rabies

A

Respiratory depression
Ascending paralysis

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64
Q

What is the post exposure prophylaxis for rabies in an unvaccinated individual

A

Rabies vaccine 4 doses 0, 3, 7, 14.

And a single does of RSIG.

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65
Q

Describe the lesions in chicken pox on a child

A

Crops of vesicles in various stages of healing

HEAD and TRUNK and EXTREMITIES

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66
Q

When are you contagious with chicken pox

A

2 days before lesions
And 5 days after vesicle appears.

7 DAYS TOTAL

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67
Q

What cranial nerve is affected in Ramsey hunt syndrome

A

CN 7

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68
Q

What is Hutchinson sign in reference to shingles

A

Eye Shingles

With bumps near the tip of the nose.

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69
Q

3 parts of Ramsay hunt syndrome

A

Facial paralysis on one side

Ear pain

Vesicles in the auditory canal and auricle

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70
Q

What is the reason most should not have chicken pox parties anymore (3)

A

Secondary skin infections

Viral PNA

Encephalitis

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71
Q

When do kids get the chicken pos vaccine

A

1 and 4 yrs old

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72
Q

When do adults eat the chicken pox vaccine

A

Over 50 yrs old they should

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73
Q

Rotavirus is transmitted how

A

Infected food contaminated by feces

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74
Q

What two viral infections cause fever vomiting and diarrhea

A

Norovirus = #1

Rotavirus

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75
Q

What is the treatment of choice for giardia

A

Tinidazole

76
Q

What is the give away for giardia

A

Drinking water from a pond

77
Q

What foods are associated with vibrio cholera

A

Street foods and Seafoods

78
Q

What is the ABX of choice for moderate disease in vibrio cholera

A

Doxy

79
Q

What two infectious agents can cause abrupt onset N/V

A

B. Cerues

Staph A.

80
Q

Foods and type of abdominal sxs associated with C. Perfergins.

A

Reheated meats

Cramping abdominal pain

81
Q

Saying for bloody diarrhea

A

Shiga Shiga Salmonella went Campylobacter C. Diff

82
Q

What infectious agent can cause GBS

A

Campylobacter

83
Q

Shigella can only be transmitted how>

A

Food or water ;; no animal reservoir

84
Q

4 ways to transmit salmonella

A

Eggs
Milk
Dairy
REPTILES

85
Q

Yersenia mimics what?

A

Appendicitis

86
Q

What extraintentisinal sxs are common in yersenia

A

Erythema nodosum
Poly arthritis

87
Q

E. Histolytica can cause what

A

Liver disease

88
Q

2 drug types commonly associated with c. Diff

A

Clindamycin

Cephalosporins

89
Q

EHEC 0157 : H7 can cause what in kids

A

Hemolytic uremic syndrome

90
Q

Gray patches that coalesce into a pseudo membrane leaving a red space in the pharynx and flu like sxs are concerning for what ? And what is the treatment

A

Diphtheria

Erythromycin or PCN G

91
Q

Describe the way intestinal helminths may present; treatment?

A

Pulmonary sxs + GI sxs with fecal blood positive + eosinophilia !!!

Travel to Guatemala

TXM = albendazole

92
Q

What is the timeframe for rabies exposure

A

It usually takes about 1-3 months before experiencing myriad of sxs that last up to week ending in ascending paralysis.

Myriad of sxs : fever chills followed by mood changes, refusal to drink, grimacing.

93
Q

When and how often do you give the herpes zoster vaccine?

A

Administered at 50 and after in 2 doses; 2-6 months apart

94
Q

3 talking points for disseminated gonorrhea

A

Patient often has vague fever malaise and
1) migratory joint pain
2) tenosynovitis
3) vesicular non tender extremity lesions

95
Q

is herpes associated with anogenital carcinoma

A

NO!

96
Q

With blastomycosis think

A

Inhaled yeast that attacks the skin and then the bones

SKIN AND BONESSSSS

97
Q

Cryptoccosu noeformans is what type of infection

A

Encapsulated yeast that is an opportunistic HIV infection

98
Q

Talk about the syphilis rash

A

Begins on the TRUNK
Diffuse and Maculopapular
Spreads to the palms and soles

WIDESPREAD LAD

99
Q

What is the name of the test for MONO

A

Monospot = heterotrophile antibbody

100
Q

Common type of throat exudates seen in scarlet fever

A

Grey-white exudates

101
Q

HHV 6 is associated with?

A

Roseola infantum

102
Q

Epitrochelar LAD is pathaneumonic for what?

A

Syphilis infection ; on the arm above the elbow

103
Q

What signifies adequate treatment for after syphilis infection

A

4 fold decrease in serologic titers at 6-10 months

104
Q

What is the main complication of non bullous impetigo

A

Post strep glomerulonephritis

105
Q

How can disseminated gonoccal infection affect one joint ?

A

Purulent mono arthritis

106
Q

What 3 things do you think of with CMV

A

Newborn baby
Microcephaly
Sensorineural hearing loss/periventricualr calcifications

107
Q

Is there a vaccine for hepatitis C?

A

NO! ONLY A and B.

108
Q

Toxo usually affects folks with a CD4 count less than what?

A

100

109
Q

3 ways to get Toxo

A

Eating undercooked meat

Cat feces

Contaminated soil

110
Q

Best way to prevent HSV transmission

A

Daily antiviral therapy

111
Q

Typhoid disease is spread how

A

Contaminated water or food, Typhoid Mary was NANNY that COOKED hella food

112
Q

N. Meningitidis present with what smear

A

Gram positive cocci in pairs ;; prophylaxis is with rifampin = close contacts of someone infected

113
Q

Funagal infection in immunodeficiency pt may express what

A

Neutropenia - PMNs

T cell suppression

114
Q

MOA of azoles

A

Inhibits fungal cell wall formation

115
Q

Amphotericin B is what type of medication

A

Polyene

116
Q

Candiadiasis can cause what in men

A

Balanitis

117
Q

Esophageal candida TXM

A

FLUCONAZOLE

118
Q

Balanitis candida TXM

A

Topical nystatin

119
Q

Cutaneous mild candidiasis txm

A

Nystatin ointment / Clotrimazole cream + 1% hydrocortisone

120
Q

1st line for candidemia

A

IV echinocandin

121
Q

Encapsulated budding yeast

Acquired by

A

Inhalation - pigeon droppings

122
Q

Cryptoccous staining

A

Mucicarmine // INDIA INK

123
Q

Cryptococcus TXM

A

FLUCONAZOLE 6-12 months = pulmonary

AMPHOTERICIN B x 14 d —> FLUCONAZOLE x 8 weeks

124
Q

LP findings in crypt.

A

HIGH opening pressure

Incr Protein

Dec glucose

125
Q

Type of histoplasmosis

A

Dimorphic fungus

OHIO MISS RIVER VALLEY

Both yeast and mold depends on location of growth

Acute = self limited —> Progressive :

-CD4 less than 100 ; adrenal insuff. / CNS involvement

Chronic:

-Elderly folks - cavities and nodules

126
Q

Histoplasmosis Dx

A

Urine and serum antigen
Blood bone marrow culture

127
Q

TXM histoplasmosis

A

Mild : Itraconazole x 6-12 weeks
*AIDS —> continue until CD4 over 150 ; 1 yr of txm ; 6 months ART

Severe : Amphotericin B [liposomal]

128
Q

PJP transmission

A

Airborne ; can colonize the airway

CD4 less than 200! Increased in STEROID USERs

129
Q

CXR findings in PJP

A

Diffuse interstitial infiltration ; nodules ; cavitations ; cystic changes

130
Q

PJP TXM =

A

Bactrim perferred x 14-21 days

131
Q

Botulism [4]

A

Gram positive ROD ; anearobic

Paralytic disease : blocks Acetycholine

Vacuum packed ; smoked ; canned food

Symmetric descending weakness —> paralysis/respiratory distress w/ NML sensorium

132
Q

TXM Botulism

A

Antitoxin w/ 24 hours

Ventilate ; remove toxin from GUT

133
Q

Campy [4]

A

Raw milk; contaminated food

Gastroenteritis ; fever ; abd pain

Immune compromised TXM = Azithromycin

Assoc with GUillen BArre

134
Q

Cholera [4]

A

Gram negative rod ; intestinal epithelial cell target

Sudden RICE WATER ; water diarrhea

R2 fluids // PO—>IV

Severe illness= tetracycline
there is a vaccine

135
Q

Diphtheria [4]

A

Exotoxin producing GRAM POS coccobacillus

TXM by respiratory secretions

Gray tenacious membrane MC

TXM = antitoxin ; PCN ; Azithromycin

136
Q

Diphtheria prevention and isolation measures

A

Prevention : vaccination w/ Dtap = 6 weeks to 6 yrs old ; Tdap - over 6 yrs old ; Td- every 10 yr booster

—> can boost w vax if exposed

Isolation : until 3 negative pharyngeal cultures

137
Q

Salmonellosis [4]

A

Gram neg rod Fecal to ORal

Enteric fever = typhoid

+/- bloody

TXM = immune compromised/sickle cell —> ciprofloxacin ; Ceftriaxone; Azithromycin

138
Q

Bacteremic salmonellosis TXM

A

Cipro+ drain abscess + suppression

139
Q

Salmonella typhi incubation

A

6-30 days

140
Q

Pink blanching papules + pea soup diarrhea + fever

A

Typhoid fever

141
Q

TXM of salmonella typhi for carrier and acute ; prevention

A

Carrier = CIPRO x 4 weeks ; cholecystectomy

Acute = cipro/levo x 10-14 days —> Ceftriaxone alternate

Prevention : immunize

142
Q

Typhoid fever like to hide where

A

In the gallbladder

143
Q

Shigellosis [4]

A

Gram negative rod

Oral anal sexual contact

Blood and mucous diarrhea ; ulceration ; engorged mucosa

TXM =
Cipro/Levo

144
Q

3 complications assoc with shigellosis

A

Reactive arthritis = HLA b27 positive

HUS = kids rare

Disaccharide deficiency

145
Q

Tetanus [4]

A

Gram positive rod ; spore forming

Uncontrolled spasms ; IVDU unvax ; migrant workers ; glottis spasms

Pain and tingling avg incubation 8-12 days

TXM = human tetanus IG IM in 24 hours +/- sedate and intubate

—> wound : metronidazole + debridement

146
Q

LV incubation

A

5-21 days

147
Q

Dx and TXM for LV

A

Dx : complement fixation ab testing

TXM = doxy

avoid doxy in pregnancy

148
Q

MAC

A

Acid fast bacilli

Think chronic slow : bronchiectasis ; fibrocavitary

TXM = clarithro/azithro + rifampin + ethambutol

CRE = TXM

149
Q

Disseminated MAC

A

CD4 less than 50

Dx = blood culture

150
Q

Entamoeba

A

Histolytica MC in humans

Hyperparalystalsis + hepatomegaly + mucosal sloughing

Extra intestinal MC: Liver abscess // fever // pain // wt loss

Dx —> stool sample // TXM : luminal agent = diloxanide

151
Q

Hookworms common in what regions

A

Tropical / Subtropical regions

Attach to small bowel and suck the blood

GI sxs 1 month after infection

Dx: stool sample ; microcytic anemia ; dec albumin

TXM : albendazole

152
Q

1st line for non falciparum malaria

A

Chloroquine

153
Q

Pinworms transmission

A

Fecal to oral route via ingestion of eggs

154
Q

Pinowrms dx

A

Scotch tape in the AM —> microscope findings

155
Q

Toxoplasmosis type of pathogen

A

Olbilaget intracellular protozoan

156
Q

MC late presentation of congenital toxoplasmosis

A

Retinochorioditis

Painful photophobia

157
Q

Vector Lyme disease

A

Ixodes : deer tick

158
Q

Cardiac and Neuro findings with Lyme disease

A

Cardiac : myopericarditis with AV arrhythmias and heart block

Neuro : asepctic meningitis and Bell’s palsy

159
Q

Paresthesia in Lyme disease

A

Stocking glove distro

160
Q

Pregnant female Lyme disease treatment

A

Amoxicillin

Cefuroxime = if cant do doxy

161
Q

3rd recurrence Lyme disease treatment

Prophylaxis

A

NSAIDs synovectomy

Pro = Tick attached for greater 36 hours —> TXM in 3 days doxy PO once

162
Q

Rocky mounted spotted fever locations:

A

Think NC Oklahoma Tennessee Arkansas

NOTA

163
Q

Rash for Rocky Mountain fever

A

Wrist ankle—> palms soles —> central spreading

Facial flushing —> conjunctival injection

SEVERE = DIC

Labs = incr LFTs / incr Bili / low Na+ ‘ low platelets

CSF = low glucose ; pleocytosis

TXM = doxy 3-5 days w/ 3 days past sxs

Pregn = doxy or chloramphenicol

164
Q

Syphillis rash includes

A

Palms and soles

165
Q

What is argyll robertson pupils

A

React poorly to light but accommodate to near focus

think Syphillis

166
Q

CMV is

A

HHV - 5

167
Q

MC congenital infection

A

CMV ; mono - like syndrome BUT. Heteropile ab negative

168
Q

CMV disease treatment

A

IV ganciclovir —> PO valganciclovir

169
Q

Resistant CMV disease treatment

A

IV foscarnet

170
Q

EBV is

A

HHV - 4

171
Q

LAD where for EBV

A

Posterior cervical chain

172
Q

EBV airway obstruction can treat with

A

CC

173
Q

EBV is associated with what in cancer

A

Burkitts ; Nasopharyngeal carcinoma ; T cell lymphoporliferative d/o

174
Q

Third trimester HSV infection consider what

A

C section delivery

175
Q

Encephalitis / meningitis TXM

A

IV acyclovir

176
Q

Shingles is

A

HHV - 3

177
Q

When is shingles disseminated

A

Greater than 3 dermatomes

178
Q

Zostavax is

A

Live attenuated shingles vaccine

179
Q

Pep for rabies

A

Rabies Ig around wound —> IM
[HRIG]

Then 4 injections with vaccine on days :

0 , 3 , 7 , 14 and 28if immune compromised.

*previous vac no need for HRIG and vaccine only day = 0 , 3.

180
Q

HIV is

A

Retrovirus with reverse transcription requires reverse transcriptase for replication

181
Q

Screen and confirmation HIV tests

A

Elisa —> western blot

182
Q

PEP HIV

A

Counseling testing at 6 wks ; 3 mos ; 6 mos

ART : emtricicitabine/tenofovir/raltegravir within 72 hours

183
Q

PrEP HIV

A

Emtricicitabine/tenofovir

[truvada/descovy]

184
Q

Perinatal HIV concerns 2

A

ART : 3 drugs during preg L&D and x6 weeks for newborns

C -section if VL > 1000; avoid breast feeding

185
Q

ART starting regimen

A

Dolutegravir + TAF + emctricitabine

186
Q

Kaposi may consider what therapy

A

Chemo

187
Q

Toxo with HIV CD4 count less 100 TXM

A

Bactrim

PANCE 2024 (15 decks)

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