Infectious Disease Flashcards
What is the likely cd4 count of an aids patient p/w cryptococcal meningitis?
<50
Pt with history of bird exposure p/w fever, cough, dyspnea. Diagnosis? Tx?
Cryptococcus treat with diflucan for 10+ weeks
Pt with exposure to bats/birds with pulm symptoms and oral ulcers with punctate lesions on X-ray?
Histoplasmosis
Tx of choice for PJP?
Bactrim
How does botulism act?
Inhibits the release of acetylcholine
Rice water stool
Cholera
Pt with gastroenteritis with fever, and pain and vomiting. Likely which pathogen?
Salmonella
Pea soup floating diarrhea
Salmonella
Blood in diarrhea with fever with punctate lesions on colonoscopy
Shigella
India ink stain positive
Cryptococcus
Fever with rash/petechiae, hyponatremia, thrombocytopenia, elevated LFTs. Diagnosis? Treatment?
Rocky Mountain spotted fever, treat with doxy unless pregnant: chloramphenicol
At what temperature fever is irreversible brain damage caused?
> 106.8
What are the diagnostic criteria for fever of unknown origin (3)?
Fever > 101.8, > 3 weeks with at least 1 weeks work up for a cause
What medium does streptococcus grow on in the micro lab?
blood agar
Pt presents with fever, diffuse erythematous rash that blanches and is rough like sandpaper or goose bumps. Her face is flushed with circumoral pallor and strawberry tongue. Diagnosis?
Scarlet fever induced by strep pharyngitis
Thick honey colored crust skin lesions
strep/staph impetigo - must be treated with antibiotics
15 yo patient presents with a lacunar rash with central clearing and strange purposeless movements. Diagnosis? Names for these sypmtoms. What is the greatest mortality risk of this position.
Acute Rheumatic fever - erythema marginatum and sydenham chorea. Mortality risk: carditis leading to death or irreversible valvular injury
What is the treatment for strep pharyngitis for a PCN allergic patient?
macrolides
Pt presents with severeal lesions that are vesicular with a purple-to-black center which the patient says were just red bumps before. Cultures of the contents of the vesicle yield gram-positive box-shaped rods in chains. Diagnosis?
Anthrax
What is the treatment of choice in a patient with anthrax?
cipro
What is the composition of oral rehydration solution?
I cup water, 1 tsp salt, 4 tsp sugar
What is the treatment of choice for Shigella?
Bactrim
What is the treatment of choice in diphtheria?
PCN or emycin
What is the treatment of choice for pertussis?
emycin
Pt presents with acute onset fever, malaise, HA and sore throat. On exam, vesicles are seen in the posterior pharynx. What is the likely cause?
Herpes initial infection
Pt presents with fever, HA, altered mental status. CSF fromLP shows elevated protein and normal glucose. What is the next step in establishing the diagnosis?
send HSV DNA by PCR and get an MRI
What is the risk to the fetus of a mother with herpes? What can be done?
visceral and CNS infection, often C-section is performed
11 yo F has just gotten over the flu and presents with vomiting, jaundice and new onset seizures. Labs show increased LFTs, ammonia levels and prolonged PTT. Diagnosis? Tx?
Reye’s syndrome reactive to influenza, treatment is supportive
What is the recommended time frame to start antiviral medications in a patient with influenza?
48 hours
What are the indications/contraindications to zostavax?
indications: > 60, contra: allergy to gelatin or neomycin or other contraindications for live vaccine
How is an animal tested for rabies?
Brain dissection and testing using fluorescent antibody markers
What is the treatment for a confirmed rabies bite?
infiltration of the wound with immunoglobulin + IM injection and vaccine administrations on days 0, 3, 7, 14 and 28
How often is CD4 count monitored in HIV/AIDS patients?
if > 350 q6 months otherwise q3 months
What is the typical medication course and effectiveness of post HIV exposure prophylaxis?
4 weeks, 70% effective
What should an HIV (+) mother be counseled about with her infant?
Transmission methods including breast milk
Pt presents with fever, malaise, splenomegaly no throat pain. Likely diagnosis?
CMV
HIV patient has neovascularization on ophthalmic exam looking almost like a pizza pie. Likely diagnosis?
CMV retinitis
Tissue biopsy of a patient with vague symptoms and myalgias shows intracytoplasmic inclusions (owl’s eyes), diagnosis?
CMV
What is the treatment of choice in candidal fungemia?
amphotericin B
What is the treatment of choice for histoplasmosis?
Itraconazole PO for weeks to months
What is the treatment for cryptococcus?
amph B
What do you treat PJP with who have sulfa allergies?
Dapsone pr petamidine
What medication should a pregnant woman traveling to a malaria risk country take for prophylaxis?
Chloroquine
How long after initial infection are the VDRL/RPR tests effective for syphilis?
4-6 weeks
What follow up test is performed with a positive RPR/VDRL to confirm syphillis?
FTA-ABS
What is the treatment of syphillis?
PCN
What is the treatment of choice for Gonorrhea?
Im Ceftriaxone or Oral cefixime - treat for chlamydia as well with either doxycycline or azithromycin
What is the treatment for chlamydia in pregnancy?
Emycin
Pt presents with vaginal pruritus and yellow-green malodorous discharge. Red macular lesions are visible on the cervix and flagellates are seen on wet mount. Dx? Tx?
Trichomonas - Flagyl 2g single dose
