Infectious Disease Flashcards
DIAGNOSIS- STIFF NECK PHOTOPHOBIA, MENINGISMUS
MENINGITIS
DIAGNOSIS- CONFUSION
ENCEPHALITIS
DIAGNOSIS- FOCAL NEUROLOGICAL FINDINGS
ABSCESS
DIAGNOSIS- PROBABLE MENINGITIS AGNENTS IN ORDER
S. PNEUMONIA-60, MINIGIOCCOCUS-15, GBS-14, HIB-7, LISTERIA-2, OTHER
DIAGNOSIS- AIDS WITH 100 CD4 CELLS/MIC.L
CRYPTOCOCCUS
DIAGNOSIS-CAMPER/HIKER, TARGET RASH, JOINT PAIN, FACIAL PALSY
LYME DISEASE
DIAGNOSIS-CAMPER/HIKER, RASH FROM ARMS/LEGS TO TRUNK
RICKETTSIA
DIAGNOSIS-PULMONARY TB
TB
DIAGNOSIS-SPONTANOUS
VIRAL
DIAGNOSIS-ADOLESCENT, PETECHIAL RASH
NEISSERIA
- INITIAL TEST- MENINGITIS
* ACC. TEST- MENINGITIS
- LUMBAR PUNCTURE
* LUMBAR PUNCTURE
DIAGNOSIS- LP (CELLCT.-1000S, NEUTROPHILES, PRO.-ELEVATED, GLU.-DECR., ST/CLT- 50-70%ST/CULTURE90%)
DIAGNOSIS- LP (CELLCT.-10-100S, LYMPHO., PRO.-ELE. MAYBE, GLU.-DECR. MAYBE, ST/CLT-NEGATIVE)
DIAGNOSIS- LP (CELLCT.-10-100S, LYMPHO., PRO.-ELE. ALOT, GLU.-DECR. MAYBE, ST/CLT-NEGATIVE)
DIAGNOSIS- LP (CELLCT.-10-100S, LYMPHO., PRO.-ELE. MAYBE, GLU.-DECR. MAYBE, ST/CLT-NEGATIVE)
BACTERIAL MENINGITIS
CRYPTOCOCCUS, LYME, RICKETTSIA
TB
VIRAL
INITIAL TEST- MENINGITIS WITH PAPILLEDEMA, SEIZURES, FOCAL CNS PRB., CONFUSION
INITIAL STEP- MENINGITIS WITH CONTRAINDICATED LP
INITIAL STEP- POST ANTIBIOTECS, LP AND CULTURE MAYBE FALSELY NEGATIVE
CT
ANTIBIOTICS
BACTERIAL ANTIGEN DETECTION (LAT)
ACC. TEST- MENINGITIS LP-TB
ACC. TEST- MENINGITIS LP-LYME AND RICKETTSIA
ACC. TEST- MENINGITIS LP-CRYPTOCOCCUS
ACC. TEST- MENINGITIS LP-VIRUS
ACID FAST CULTURE ON 3 HIGH VOLUMES
SPECIFIC SEROLOGIC TESTING, ELISA, WESTERN BLOT, PCR
CRYPTOCOCCAL ANTIGEN, INDIA INK ONLY 60-70% SENSITIVE
EXCLUSION
INITIAL TREAT- MENINGITIS CELL COUNT WITH NEUTROPHILES?
INITIAL TREAT- MENINGITIS, ELDERLY, NEONATES, STEROID USE, AIDS, IMM.COM. ALC., PREGNANT?
INITIAL TREAT- MENINGITIS NEISSERIA +
CEFTRIAXONE, VANCOMYCIN, STEROIDS
AMPICILLIN, CEFTRIAXONE, VANCOMYCIN, STEROIDS
RESPIRATORY ISOLATION, RIFAMPIN, CIPROFLOXACIN OR CEFTRIAXONE
P. ASS.- CN 8 DIF. OR DEAFNESS
BACTERIAL MENINGITIS
FEVER AND CONFUSION + NECK STIFFNESS
- DIAGNOSIS-
- ACC. TEST- HERPES ENCEPHALITIS
- INITIAL TREAT- HERPES ENCEPHALITIS
- HSV ENCEPHALITIS
- PCR OF CSF
- ACYCLOVIR, FOSCARNET
TIP-BEST MAN- RENAL TOXIC ACYCLOVIR FOR ENCEPHALITIS?=REDUCE DOSE
REDNESS, IMMOBILITY, BULGING AND DCR. LIGHT REFLEX OF TYMPANIC MEMBRANE
*SEN. PHYSICAL FINDING IMMOBILITY OF TYMAPNIC MEMBRANE
DIAGNOSIS-
ACC. TEST-
INITIAL TREAT-
OTITIS MEDIA
TYMPANOCENTISIS
AMOXIACILLIN
FACIAL PIAN, DISCOLORED NASAL DISCHARGE, BAD TASTE AND FEVER
- DIAGNAOSIS-
- ACC. TEST-
- BEST MAN-
- SINUSITIS
- SINUS BIOPSY OR ASPIRATE
- SINUSITIS PHYSICAL SYMPTOMES=AMOXIACILLIN OR DOXY,TMP-SMX + NASAL DECONGESTIANT
TIP-BIOPSY SINUSITIS WHEN…=RECURS, NO RESPONSE TO THERAPY
PAIN SWALLOWING, LYMPH N. IN NECK, EXUDATE IN PHARYNX, FEVER, NO COUGH AND HOARSNESS
DIAGNOSIS-
INITIAL TEST-
INITIAL TREAT-
BACTERIAL PHARYNGITIS 90% GAS
RAPID STREP TEST
AMOXICILLIN
DIAGNOSIS- PHARYNGITIS VESICLES OR ULCERS
HSV OR HERPANGINA
DIAGNOSIS- PHARYNGITIS EXUDATES
DIPHTHERIA OR VINCENT ANGINA OR EBV
*5 TYPES OF NON BACTERIAL PHARYNGITIS
HSV, HERPANGINA, DIPHTHERIA, VINCENT ANGINA OR EBV
ARTHRALGIAS/MYALGIAS, COUGH , FEVER, HEADACHE AND SORE THROAT, GI/DIARRHEA
- DIAGNOSIS-
- BEST MAN-
- INITIAL TREAT-
- INFLUENZA
- WITHIN 48HRS FLU SYMPTOMES=NASOPHARYNGEAL SWAB
- WITHIN 48HRS FLU SYMPTOMES=OSELTAMIVIR, ZANAMIVIR
AFTER 48HRS FLU SYMPTOMES= TX SYMPTOMS
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, POULTRY
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, ASSOCIATED WITH GBS
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, HUS
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, HUS ASSOCIATED
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, SHELLFISH AND CRUISE SHIPS
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, SHELLFISH, LIVER PROBLEMS, SKIN LESIONS
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, IRON AFFINITY, HEMOCHROMATOSIS, BLOOD TRANSFUSION
DIAGNOSIS- DIARRHEA BLOOD AND WBCS IN STOOL, ANTIBIOTICS
SALMONELLA
CAMPYLOBACTER
E COLI
SHIGELLA
VIBRIO PARAHAEMOLYTICUS
VIBRIO VULNIFICUS
YERSINIA
C. DIFF.
INITIAL TEST- DIARRHEA BLOOD AND WBCS IN STOOL
*TIP- BLOOD AND WBCS IN STOOL GREATER SENSITIVITY AND SPESIFISITY
ACC TEST- DIARRHEA BLOOD AND WBCS IN STOOL
STOOL LACTOFERRIN OR FECAL LEUKOCYTES
LACTOFERRIN
STOOL CULTURE
DIAGNOSIS- DIARRHEA NO BLOOD AND WBCS IN STOOL
DIAGNOSIS- DIARRHEA NO BLOOD AND WBCS IN STOOL, CAMPING/HIKING AND UNFILTERED FRESH WATER
DIAGNOSIS- DIARRHEA NO BLOOD AND WBCS IN STOOL, AIDS LESS THAN 100 CD4 CELLS, ACID FAST
DIAGNOSIS- DIARRHEA NO BLOOD AND WBCS IN STOOL, VOMITING 24-48HR SYMPTOMS, RICE, STEWS, VANILLA
DIAGNOSIS- DIARRHEA NO BLOOD AND WBCS IN STOOL, VOMITING 24-48HR SYMPTOMS, PATATO SALAD, COLD MEAT
DIAGNOSIS- VOMIT, MOST RAPID ONSET, WHEEZING, FLUSHING, RASH, ATE BIG FISH
DIAGNOSIS-VOMIT MOST RAPID ONSET, WHEEZING, FLUSHING, RASH, ATE REEF FISH AND/OR SEA WEEDS
VIRUS
GIARDIA
CRYPTOSPORIDA
B. CEREUS
S. AERUS
SCOMBROID (LARGE FISH DECAY HISTADINE
ACCUMULATION)
CIGUETERIA