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PC2-exam 1 > Infectious disease 1B > Flashcards

Infectious disease 1B Flashcards

1
Q

what are the two antibiotics to treat MRSA empirically before finding out culture results for a patient that has susceptibility to MRSA?

A

Bactrim DS and Doxycycline

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2
Q

Cytomegalovirus is apart of what virus family?

A

herpes virus family

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3
Q

Cytomegalovirus is a common cause of what type of infection?

A

Infectious mononucleosis
it is 2nd to Epstein Barr virus

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4
Q

A mother can infect her unborn with cytomegalovirus, what are the 2 birth defects that the child could have?

A

Mental retardation and hearing deficit

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5
Q

how is cytomegalovirus spread?

A

Saliva, breast milk, urine, blood

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6
Q

what is the most common complication of cytomegalovirus?

A

CMV retinitis
requires immediate referral to ophthalmology and infectious disease specialist

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7
Q

what are 4 common complications in immunocompromised patients with CMV?

A

GI ulcers, retinitis, pneumonitis, and dementia s/s

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8
Q

Patients diagnosed with mononucleosis caused by cytomegalovirus, will have what symptom that differs from mono caused by Epstein Barr virus?

A

Patients with mono caused by cytomegalovirus will have a sore throat that is non-exudative.

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9
Q

Although patients with cytomegalovirus are often asymptomatic, what symptoms can they present with?

A

Low-grade fever (99-100, recurrent)
non-exudative sore throat
fatigue
cervical lymphadenopathy
generalized body aches
skin rash–typically immunocompromised

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10
Q

If EBV antibodies are negative, what is the next test?

A

CMV antibodies

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11
Q

For CMV, IgM and IgG will be tested for. When will these labs be high?

A

IgM will be elevated in acute symptomatic phase

IgG will be elevated in later stage of infection

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12
Q

A tissue biopsy from a skin rash of a person with suspected CMV will have what?

A

“Owl’s eye” inclusion bodies will be present

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13
Q

what is the treatment for cytomegalovirus?

A

treatment is supportive therapy such as Tylenol, Motrin, fluids, rest.

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14
Q

What is the treatment for HIV positive patient who has CMV?

A

IV antiviral medication given by infectious disease specialist

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15
Q

what is the primary causative agent for infectious mononucleosis?

A

Epstein barr virus

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16
Q

What is important to know about the Epstein Barr virus?

A

The virus becomes dormant after initial infection and can re-activate

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17
Q

How long is the incubation period for the Epstein Barr Virus-Infectious mononucelosis?

A

4 to 6 weeks

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18
Q

How is the Epstein Barr virus spread?

A

Spread through infected body fluids, such as saliva

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19
Q

what are the triad of symptoms of the Epstein Barr Virus?

A

Fever, Sore throat (exudative), and posterior cervical lymphadenopathy

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20
Q

What abdominal organ should you check for when a patient could possibly have Epstein Barr Virus-Infectious mononucleosis?

A

Spleen

Check for Splenomegaly

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21
Q

what EBV antigen appears early and fades in 4-6weeks?

A

VCA IgM

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22
Q

What EBV antigen peaks at 2-4 weeks? always present after exposure

A

VCA IgG

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23
Q

What EBV antigen occurs 2-4 months after exposure and remains positive for life?

A

Epstein Barr Nuclear Antigen

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24
Q

What EBV antigen is associated with reactivation or chronic disease? This disappears weeks to months after onset

A

Early antigen

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25
Q

what is important education to parents of school-aged children with EBV?

A

Avoid contact sports due to possible risk of splenic rupture

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26
Q

what is the causative organism of Lyme disease?

A

Borrelia burgdorferi

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27
Q

in what areas are most common for Lyme disease infection to occur?

A

northeaster, mid-atlantic, and upper north central, northwestern california

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28
Q

in what areas are most common for Lyme disease infection to occur?

A

northeaster, mid-Atlantic, and upper north central, northwestern California

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29
Q

what months are common for lyme disease?

A

From May to November

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30
Q

How long is the incubation period for lyme disease?

A

3 to 31 days but can manifest months or years after infection

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31
Q

what is the goal of treatment for lyme disease?

A

to prevent progression of stages

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32
Q

what is the hallmark sign of stage 1–early localized stage of lyme disease?

A

Erythema migrans lesion that is at the site of the bite.

it looks like a red macule/papule that enlarges over days to weeks

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33
Q

what is stage 2 of lyme disease called and why?

A

Stage 2 is the early disseminated stage

There are multiple erythema migrans lesions that occur 3-5 weeks after the bite

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34
Q

Arthritis in large joints and encephalopathy/personality changes are associated symptoms of what stage of lyme disease?

A

stage 3, late disease

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35
Q

Headache, fever, fatigue, arthralgias, stiff neck occasionally occur in what stage of lyme disease?

A

stage 1, early localized

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36
Q

facial palsy, meningitis, conjunctivitis, headache, fatigue, heart block (rare) are symptoms of what stage of lyme disease?

A

stage 2, early disseminated

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37
Q

how is the diagnosis made of lyme disease?

A

Typically diagnosed through clinical presentation

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38
Q

what is the 2 laboratory diagnosis of lyme disease?

A

Western blot IgM, IgG test

and

Skin biopsy of ertyhema migrans

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39
Q

what is the 2 laboratory diagnosis of lyme disease?

A

Western blot IgM, IgG test

and

Skin biopsy of erythema migrans

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40
Q

What should you do as a provider when diagnosing lyme disease?

A

Report the disease, it is a reportable condition

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41
Q

what is first line therapy for lyme diesase?

A

Doxycycline 100 mg BID for 14 to 21 days

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42
Q

what are some restrictions for first line therapy of lyme disease?

A

Can’t give to kids younger than 8 years of age or pregnant women

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43
Q

what is the second line therapy of lyme disease?

A

amoxicillin 500 mg TID for 14-21 days

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44
Q

If a patient has known exposure to Lyme disease and has no symptoms, what is the treatment?

A

one time dose of 200 mg doxycycline

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45
Q

what is the time frame to prescribe the one-time dose of Lyme disease exposure with no symptoms?

A

72 hours (3 days)

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46
Q

Is bacterial meningitis a reportable condition?

A

Yes

47
Q

what are some of the common symptoms of bacterial meningitis?

A

headache, stiff neck, low grade fever, photophobia, nausea/vomiting, myalgias

48
Q

what is the gold standard for diagnosis of bacterial/viral meningitis?

A

Lumbar puncture

49
Q

What other labs should be done in addition to a lumbar puncture for the diagnosis of meningitis?

A

blood cultures
CBC
CT head if question of other etiology

50
Q

What are some common symptoms of viral meningitis? list 2

A

Diarrhea
Skin rash

51
Q

what are some common causative organisms of bacterial meningitis?

A

Streptococcus pneumoniae
Neisseria meningitdis
Streptococcus agalactiae
Listeria monocytogenes
Haemophilus influenzae

52
Q

what is the treatment for bacterial meningitis in infants/children?

A

Ampicillin or third generation cephalosporin, IV

53
Q

what is the treatment for bacterial meningitis in adults up to age 50?

A

third generation cephalosporin

54
Q

what is the treatment for bacterial meningitis in older adults over 50?

A

Ampicillin or third generation cephalosporin

55
Q

Name some 3rd generation cephalosporins
what is a tip to remember about 3rd gen cephalosporins

A

CefexIME
CeftazidIME
CefotaxIME
CeftizoxIME
CefpodoxIME
CeftriaxONE
CefoperazONE
CeftibuTEN
ends in IME or ONE

56
Q

what is the treatment for viral meningitis?

A

Hydration
Fever-Tylenol and Advil
Anti-emetic
Rest

57
Q

how is hepatitis A transmitted?

A

fecal-oral route

58
Q

which hepatitis is a cause of traveler’s diarrhea?

A

Hepatitis A

59
Q

what the two most common symptoms of hepatitis A?

A

jaundice and fever

60
Q

What is the diagnosis of Hepatitis A?

A

IgM antibodies positive for anti-HAV

61
Q

what patient education should be taught for patients with hepatitis A?

A

avoid alcohol cosumption
limit use of hepatotoxic medications
avoid contact sports for 2-4 weeks

62
Q

For traveler’s, when are they fully protected after receiving the hepatitis A vaccine?

A

4 weeks

63
Q

What is hepatitis B method of tranmission?

A

spread through blood and body fluid exchange, and sexual contact
blood, serum, wound exudate

64
Q

what is the incubation period for hepatitis B?

A

60-90 days

65
Q

what are the risk factors for contracting hepatitis B?

A

frequent blood transfusions, IV drug use, high-risk sexual behaviors

66
Q

what is the dosing guidelines for hepatitis B?

A

1st dose upon birth
2nd dose at 1 month visit
3rd dose at 6 months

67
Q

what are the 3 symptoms of hepatitis B?

A

fever, arthralgias, jaundice

68
Q

what is the concern with children and acute hepatitis B?

A

In children it often progresses to chronic hepatitis B

69
Q

what are the diagnostics for hepatitis B?

A

Hepatitis B serology
LFTs
CBC
CMP

70
Q

what is the treatment for acute hepatitis B ?

A

Usually self-limiting
avoid hepatotoxic medications
encourage hydration

71
Q

what is the method of transmission for hepatitis C?

A

IV drug use is the most common mode of transmission

72
Q

what are the diagnostics for hepatitis c staging?

A

Liver biopsy

73
Q

what labs are apart of the hepatitis C diagnostics?

A

hepatitis c antibody panel
liver function tests
CBC
CMP
Consider referral for liver biospy

74
Q

what is the treatment for hepatitis C?

A

Avoid hepatotoxic meds
dose adjustment of meds if they are metabolized by the liver
referral to a specialist for interferon therapy
discourage alcohol use

75
Q

what vaccine is the only FDA approved vector borne related disease?

A

yellow fever

76
Q

How is CMV infection spread?

A

Direct contact with urine or saliva, (especially from baby and children), through sexual contact, and via breast milk

77
Q

Epstein Barr virus is spread how?

A

Primarily through saliva

78
Q

What is another name for the monspot test?

A

Heterophile antibody test

79
Q

What immunoglobulin does the monospot test for?

A

IgM antibodies (acute infection)

80
Q

Erythema migrans “bulls eye” rash is associated with what disease?

A

Lyme disease

81
Q

Borrelia burgdorferi is associated with what disease?

A

Lyme disease

82
Q

What is the diagnosis of Lyme disease to do treatment ?

A

The erythema migrans rash “bulls eye” rash

83
Q

how is measles spread?

A

airborne and contact-droplet

84
Q

what are common complications from measles?

A

otitis media
diarrhea
bronchopneumonia
laryngotracheobronchitis

85
Q

what are the three c’s of measles?

A

cough, coryza, conjunctivitis

children can have a high fever-up to 105

86
Q

a person is considered infectious with measles when?

A

4 days of exposure and 4 days after onset of rash

87
Q

what kind of rash does measles have?

A

maculopapular rash

88
Q

the combination measles mumps rubella varicella vaccine can be used for children of what ages?

A

12 months to 12 years

89
Q

when can the MMR be given?

A

at 12 months

90
Q

what vaccine (MMRV or MMR) be given a 2nd dose within 28 days?

A

MMR

91
Q

what is the minimal interval to give MMRV after the 1st dose?

A

at least 3 month interval

92
Q

infants who are 6-11 months who are traveling should receive what vaccine?

A

MMR one dose

93
Q

what vitamin should children be given if diagnosed with measles?

A

vitamin A

94
Q

when do measles symptoms occur after exposure?

A

7 to 14 days after contact

95
Q

what are the white spots in the mouth called? that is associated with measles, and when do they occur?

A

koplik spots
occurs 2-3 days after symptoms begin

96
Q

how does the rash of measles begin?

A

rash begins at the hairline with flat red spots that spread down to the trunk and the rest of the body

97
Q

west nile virus is spread by what method?

A

mosquito

98
Q

what are environment protection agency (EPA) registered insect repellents?

A

DEET
Picardin
IR3535
oil of lemon eucalyptus
paramethane diol (PMD)
2-undecanone

99
Q

what insect repellents can’t be used on children ages 3 and under?

A

oil of lemon eucalyptus (OLE)
PMD

100
Q

what are the three most common symptoms of meningitis?

A

fever
headache
stiff neck

101
Q

what are symptoms meningitis?

A

fever
headache
stiff neck
nausea
vomiting
photophobia
AMS-confusion

102
Q

in babies with meningitis what is a physical sign that is an indicator?

A

bulging anterior fontanelle

103
Q

at what age should the MenACWY vaccine be given?

A

at 11-12 years

104
Q

how is hepatitis A transmitted?

A

fecal oral route

105
Q

what are some risk factors for hepatitis A?

A

prisons, nursing homes, day care centers, poor sanitation. contaminated food or water, raw shellfish, foods, veggies, other uncooked foods that may have become contaminated in handling

106
Q

what are some viral causes of hepatitis?

A

CMV,EPV, herpes virus, rubella, varicella-zoster, yellow fever virus, hep a-e

107
Q

how is hep B transmitted?

A

through blood or body secretion sexual contact

108
Q

how is hep C transmitted?

A

through IV drug use, needlestick injury

109
Q

which hepatitis has the longest incubation period?

A

hepatitis B
12-14 weeks

110
Q

when does the immunoglobulin IgM antibody occur?

A

appear at about 4 weeks

111
Q

what is the diagnostic gold standard for acute hepatitis A?

A

IgM anti HAV

112
Q

what is the first test to order when hepatitis B is suspected?

A

HBsAg (hepatitis B surface antigen)

113
Q

Hepatitis A vaccine is available for children at what age?

A

At 1 year or 12 months

114
Q

when is HBsAg elevated?

A

upon acute hepatitis diagnosis and chronic state
if chronic state-refer to hepatologist

PC2-exam 1 (4 decks)

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