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infectious disease 2 Flashcards

1
Q

rocky mountain spotted fever vector

A

Dog ticks

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2
Q

clinical features + lab features of rocky mountain spotted fever

A
  • fever, headache, rash
  • rash beginning in ankles and wrists
  • thrombocytopenia, mild transaminitis, ***hyponatremia
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3
Q

rocky mountain spotted fever treatment

A

doxycycline

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4
Q

rocky mountain spotted fever geography

A

South central and southeast states

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5
Q

most all tic borne diseases are treated with

A

doxycycline

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6
Q

treatment of complete heart block from lyme disease

A

CTX

- NOT pacemaker

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7
Q

only tic borne disease not treated with doxy

A

babesia (parasite, not TIC)

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8
Q

treatment of babesiosis

A

azithromycin + atovaquone

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9
Q

most common cause of transfusion related infection in US

A

Babesiosis

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10
Q

anaplasmosis lab features

A
  • thrombocytopenia + elevated liver enzymes + leukopenia

* morulae in granulocytes

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11
Q

diseases with black legged tick as vector

A
  • Babesiosis
  • Anaplasmosis
  • Lyme disease
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12
Q

ehrlichiosis lab features

A
  • Thrombocytopenia + elevated liver enzymes

- morulae in monocytes

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13
Q

anasplasmosis vs. ehrlichiosis

A

murulae are in monocytes in ehrlichiosis, granulocytes in anaplasmosis

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14
Q

Unique clinical features of dengue fever

A
  • after inflating BP cuff, petechia are present

- headache localized behind the eyes

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15
Q

Chikungunya clinical features

A
  • severe polyarthralgia affecting small distal joints
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16
Q

other clinical + lab features of dengue

A
  • joint pain
  • macular rash sparing palms and soles
  • leukopenia
  • elevated liver enzymes
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17
Q

norovirus clinical features

A
  • outbreaks in nursing home

* *Vomiting predominant, rather than diarrhea predominant

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18
Q

most common cause of traveler’s diarrhea

A

ETEC

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19
Q

deli meats, unfermented

A

listeria

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20
Q

reheated rice syndrome pathogen

A

bacillus

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21
Q

rapid onset vomiting after eating potato salad

A

staph aureus

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22
Q

swimming in recreational facility with treated water with treated water

A

cryptosporidium (not killed by chlorine)

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23
Q

unpasteurized milk pathogen

A

brucellosis

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24
Q

direct exposure to TB or recent TB contact cutoff

A

greater than 5 mm

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25
Q

Caveat about treating TB for patients on warfarin

A

Can’t use rifampin or rifapentine

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26
Q

TB drug least likely to cause LFT elevation

A

ethambutol

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27
Q

organisms requiring airborne precautions

A

TB
VZV
measles
SARS

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28
Q

hanta virus clinical features

A

see memory palace

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29
Q

francissela tularemia clinical features

A
  • Francis has wings on + is sweating profusely + has a ulcer like below on his hand/variable presentation  severe febrile pulmonary infection OR ulcerative disease at inoculation site).
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30
Q

cutaneous larva migrans clinical features

A

parasite living in intestines of dogs + larvae in sandy soil + red intensely pruritic eruption that looks like twirling lesions

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31
Q

Lyme disease treatment

A

doxycycline

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32
Q

Lyme disease treatment if neurologic or cardiac involvement

A

CTX

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33
Q

Management of patient testing PCR positive for anaplasmosis and treated with doxy but fails to improve

A
  • likely has babesiosis, treat or babesiosis
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34
Q

babesiosis treatment

A

azithromycin + atovaquone

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35
Q

Cryptosporidium watery or bloody diarrhea

A

watery

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36
Q

salmonella watery or bloody diarrhea

A

bloody

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37
Q

campylobacter watery or bloody diarrhea

A

bloody

38
Q

cyclospora watery or bloody diarrhea

A

watery

39
Q

Shigella watery or bloody diarrhea

A

bloody

40
Q

Enterobacter watery or bloody diarrhea

A

bloody

41
Q

Chitlins (chitterlings) + association

A
  • pork intestines

- yersinia

42
Q

Yersinia watery or bloody diarrhea

A

bloody

43
Q

yersinia clinical features

A

Ben is there in a bathtub next to her dancing around/causes acute diarrhea or pseudoappendicitis (right lower abdominal pain due to mesenteric adenitis and/or terminal ileitis). + bloody diarrhea

44
Q

Yersinia treatment

A

supportive care

45
Q

Shigella clinical features

A

Shitting into bucket + Spenser’s sweating profusely + eyes super sunken in/causes bloody diarrhea + abdominal pain + high fever + severe dehydration.

46
Q

Other clinical associations of anthrax

A
  • exposure to animal hair, hides

- mediastinal widening on CXR

47
Q

Parapneumonic effusion vs. empyema or complicated parapneumonic effusion

A

Parapneumonic effusion = effusion in pleural space.

*Complicated parapneumonic effusion and empyema occur when bacteria infect the pleural space

48
Q

Empyema definition

A

Collection of pus within the pleural space

49
Q

Complex effusion definition

A

effusion with internal locations

50
Q

initial treatment of invasive aspergillosis

A

voriconazole

51
Q

Other distinguishing features of conjunctivitis

A 
Bacterial = purulent discharge
Viral = viral prodrome, other viral URI symptoms
Allergic = itching of eyes, nasal congestion, sneezing, wheezing
52
Q

botulism presentation

A

Gram is stuffing sword down throat + he has big headphones on + he has eyes in is forehead/is four-eyed (diplopia code) + duck tape over his mouth + darts all over his body/classic presentation = 3 D’s: diplopia + dysphagia + dysphonia + skeletal muscle weakness + dysarthria (*key to differentiating presentation from anticholinergic effects). Also, dry mouth + mydriasis.

53
Q

Treatment of botulism

A

Antitoxin

54
Q

Timing of antiviral therapy for VZV

A
  • Start therapy within 72 hours of onset

- IF after 72 hours, only start antiviral therapy if new lesions are appearing (indicating ongoing viral replication)

55
Q

Treatment of varicella

A

acyclovir, valacyclovir, famciclovir

56
Q

HPV vaccination age

A

11-26 (can be administered starting at age 9)

*after age 26 on individual basis, recommended if new sexual partners.

57
Q

Chagas disease presentation

A

massive colon hanging across top of courtyard + huge Mr. Farrington with the top of his head cut off + Massive head with esophagus + huge ureters hanging from courtyard and dripping piss/presentation = dilated cardiomyopathy with apical atrophy + megacolon + megaesophagus + megaureter (all by below pathophys mechanism) + achalasia. His right eye is swollen like below/unilateral periorbital swelling (Romana sign) characteristic of acute stage.

58
Q

Haemophilus ducreyi (Chancroid) presentation

A

Walls of room covered in grey and yellow exudate + shenk with a painful, draining abscess on his dick/multiple and deep ulcers + base may have gray to yellow exudate. Draining buboes.

59
Q

Pasteurella multocida clinical features

A
  • Location: kitchen at M&D’s house
  • Picture the nipper/kuma with eye glasses on/looking like louie Pasteur + he’s biting dad in the calf causing a large skin abscess + an eel in dad’s leg/part of normal flora in cats and dogs and bits cause skin abscesses + cellulitis + osteomyelitis.
60
Q

Pasteurella multocida treatment

A

Terry is fucking kuma in the butt/treat with penicillin.

61
Q

leprosy treatment

A

Nate at the top of a ramp + daphne doing a dab + chloe from Dartmouth as a centar/treatment = dapsone + rifampin AND add clofazimine.

62
Q

Nocardia treatment

A
  • Location: asteroid

- Jan playing a DJ set/treat with sulfonamides (TMP-SMX).

63
Q

Nocardia clinical features

A
  • Big caves all around asteroid with Neil walking out of them + magic Johnson with wings flying next to helicopter/pulmonary nocardiosis occurs in immunocompromised + can present as cavitary pneumonia and is commonly confused with TB.
  • Big holes/depressions in her head + circular rays of light coming out of her head/imaging reveals abscesses in brain (ring-enhancing focal lesion).
64
Q

presentation of MAC + imaging

A
  • similar to TB (cough, fever, *weight loss)
  • typical occurs in patients with underlying lung disease but can also occur in absence of prior lung disease
  • nodular or cavitary opacities
  • HRCT: multifocal bronchiectasis + small nodules
65
Q

Treatment of pulmonary MAC

A

combination therapy with clarithromycin + ethambutol + rifampin

66
Q

pulmonary MAC diagnosis

A

2 positive sputum cultures
OR
1 bronchial lavage wash with positive culture
OR
bronch with lung biopsy with histopathological features of mycobacterial infection and positive culture

67
Q

Differential + management of patient with positive RPR titer after treatment for syphilis

A
  • reinfection vs. inadequate treatment vs serofast reaction
  • IF titer significantly decreased –> prob serofast reaction, so repeat RPR in 6 months to make sure its stable and not rising + check HIV
  • IF failure to fall 4 fold or persistent symptoms – LP to rule out neurosyphilis
    IF reinfection (new parters or new symptoms) – treat again
68
Q

epidemiology of blastomycosis and histoplasmosis

A

Both in Mississippi and Ohio River Valley

- Blasto more in Midwestern US

69
Q

Blastomycosis clinical features

A
  • cutaneous plaques/ulcerations
  • bone lesions with sinus tracts
  • pulmonary involvement (cough, dyspnea)
  • GU involvement (epididymo-orchitis)
70
Q

Coccidioidomycosis clinical features

A
  • skin lesions
  • lymph node involvement
  • meningitis
71
Q

Treatment of blastomycosis

A

IF mild to moderate – itraconazole

If severe – amphotericin B

72
Q

Other clinical feature of histoplasmosis

A

Pulmonary involvement with hilar or mediastinal adenopathy

73
Q

antibiotic regimen for patient who is flu positive with superimposed PNA

A

Azithro + CTX + vanc
(cover for strep and staph)
*just add vanc

74
Q

Treatment of jarisch-herxheimer reaction

A
  • supportive (tylenol, NSAIDS, IV fluids) (self-limiting)
75
Q

Management of bell palsy

A
  • prednisone ASAP
76
Q

clinical features of meningococcal meningitis

A
  • severe myalgia
  • rapid deterioration within 22 hours of symptom onset
  • nonspecific: fever/HA/vomiting
  • specific: petechia, meningeal signs, AMS
77
Q

treatment of meningococcal meningitis

A

CTX

*chemoprophylaxis for close contacts

78
Q

isolation precautions for meningococcal meningitis

A

droplet precautions

79
Q

chemoprophylaxis for contacts of meningococcal meningitis infected patients

A

Rifampin + cipro + CTX

80
Q

P jirovecii pneumonia presentation + imaging

A
  • subacute: dyspnea, dry cough, fever
  • similar to TB: weight loss, headache, night sweats
  • immunocompromised patient
  • high LDH
  • imaging = interstitial infiltrates + can have cavitary lesions
  • can have spontaneous PTX
81
Q

parvovirus presentation

A
  • asymptomatic or flulike

- acute symmetric arthralgia (hands, wrists, knees and feet (resembling RA)

82
Q

syndrome caused by parvovirus in SCD patients

A
  • pure red cell aplasia
83
Q

parvovirus diagnosis

A

*IgM (a lot of people have IgG from previous infection, which documents immunity)

84
Q

acute rheumatic fever presentation

A
  • fever + migratory arthritis involving large joints + chorea + erythema marginatum + pancarditis + subcutaneous nodules
85
Q

mono presentation

A

fever + pharyngitis + LAD + atypical lymphocytosis

86
Q

Toxo plasmodia treatment in HIV patients

A

pyrimethamine + sulfadiazine + *leucovorin (pyrimethamine is a folic acid antagonist)

87
Q

Drugs that interfere with folic acid metabolism

A
  • MTX
  • phenytoin
  • pyrimethamine
  • trimethoprim
88
Q

west-nile encephalomyelitis presentation

A
  • patient in hot, humid weather in summer
  • *Asymmetric flaccid paralysis
  • Extrapyrimidal symptoms
  • maculopapular rash (20-50%) in chest, arms, back
  • can have parkinsonism symptoms (rigidity)
89
Q

Post-polio syndrome clinical features

A
  • history of paralytic polio, then develop worsening of previous weakness later in life
  • weakness, fatigue, muscle, or joint pain (no infectious symptoms)
90
Q

lung abscess clinical features + CXR findings

A
  • fever, night sweats, weight loss, cough with foul-smelling sputum
  • *weeks or months of above symptoms
  • cavitary lesion with air-fluid level
91
Q

first-line treatment of lung abscess

A

Ampicillin-sulbactam
OR
carbapenem
*clinda no longer recommended due to risk of treatment-associated Cdiff
*bronch not required (unlike other abscesses, lung abscesses don’t require drainage and frequently respond to antibiotics)
*treat until repeat CXR is clear or shows small, stable residual lesion

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