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Boards > Infectious disease 3 > Flashcards

Infectious disease 3 Flashcards

1
Q

Clinical features of fusariosis

A
  • immunocompromised patient
  • inoculated from tap water or soil
  • skin nodules + pulmonary disease + persistent fever
  • mold
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2
Q

Treatment of fusariosis

A

amphotericin

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3
Q

Diagnosis of anaplasmosis

A

serology + peripheral blood smear examination showing intraleukocytic morale

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4
Q

Specific features of anaplasmosis

A
  • leukopenia + high fever
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5
Q

Ehrlichiosis vector + location

A
  • Lone star tick

- Southeast and south central US

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6
Q

Typhoid fever clinical features + lab features

A
  • high fevers + abdominal pain + characteristic erythematous macular rash (rose spots)
  • can have elevated LFTS
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7
Q

Lemierre’s disease other term

A

septic thrombophlebitis of the internal jugular vein

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8
Q

Lemierre’s disease clinical features

A

patient with hx of recent pharyngitis + then develops sepsis + neck pain/swelling/persistent fever (infection may extend to lateral pharyngeal space or involve carotid sheath) + cavitary lung lesions

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9
Q

Typical cause of lemierre’s disease

A
  • anaerobic organism fusobacterium necrophorum
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10
Q

imaging of pulmonary aspergillosis

A
  • nodules with or without cavitation + ground-glass infiltrates
  • *halo sign (“nodules surrounded by ground-glass infiltrates)
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11
Q

other clinical feature of cdiff

A

right lower quadrant or lower quadrant abdominal pain

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12
Q

How to reduce VAP risk

A
  • semi recumbent positioning
  • oral antiseptics
  • avoid PPIs
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13
Q

Necrotizing fasciitis clinical features

A
  • commonly after surgery in a diabetic or immunocompromised patient
  • *exquisite tenderness to palpation
  • crepitus
  • hemorrhagic blisters
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14
Q

First step in management of suspected nec fasc

A

surgery consult for debridement

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15
Q

Indication for PCP pox

A

CD4 greater than 200

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16
Q

Indication for toxo ppx

A

CD4 less than 100

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17
Q

Initial therapy of neutropenic fever

A
  • anti-pseudomonal beta-lactam (cefepime OR zosyn)
  • Addition of vancomycin IF
  • Hemodynamic instability
  • severe sepsis
  • pneumonia
  • positive blood cultures for a gram-positive organism
  • suspected catheter-related infection
  • skin or soft-tissue infection
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18
Q

Presentation of acute HIV

A
  • mono-like syndrome (fever, lymphadenopathy, sore throat, athralgias)
  • generalized macular rash
  • GI symptoms
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19
Q

Management of acute HIV

A
  • combination antiretroviral therapy
  • notify partner and consider secondary ppx
  • don’t wait until resistance and genotype testing is done because people are highly infectious and the regimen can be modified as needed after it comes back
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20
Q

Treatment of leptospirosis

A

Doxy or penicillin

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21
Q

Additional intervention needed after culture with streptococcus bovis

A

colonoscopy (anaerobe)

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22
Q

Additional intervention needed after culture with clostridium septicum

A

colonoscopy (anaerobe)

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23
Q

Additional intervention needed after culture with nontyphoidal salmonella

A

HIV test

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24
Q

Additional intervention needed after diagnosis of candidemia

A

ophthalmologic examination

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25
Q

CMV esophagitis EGD + biopsy features

A

EGD: sharply demarcated, linear ulcers in distal one third of esophagus
Bx: intranuclear inclusions

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26
Q

HSV EGD features

A

EGD: well circumscribed shallow ulcers

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27
Q

CMV esophagitis treatment

A

IV ganciclovir

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28
Q

legionella PNA clinical features

A
  • relative bradycardia (would expect higher for degree of fever)
  • no response to beta lactam abx or aminoglycoside abx **outbreaks in nursing homes
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29
Q

legionella PNA treatment

A

ONLY quinolone or macrolides

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30
Q

RMSF vs. ehrlichiosis

A
  • Ehrlichiosis = leukopenia + rash starting on trunk + southeeastern and south central US
    RMSF = rash starting on extremities
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31
Q

Centor criteria

A

tender anterior cervical LAD
*fever
tonsillar exudates
absence of cough

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32
Q

Infectious mono vs. Group A strep

A

mono = younger patient, fatigue, splenomegaly, posterior LAD

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33
Q

Epiglottitis clinical features

A
  • SEVERE sore throat (out of proportion to findings on exam) + dysphagia
  • may or may not have drooling and stridor
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34
Q

Work up of epiglottitis

A

IF stable (no stridor) – lateral neck x-ray

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35
Q

treatment of epiglottitis

A

CTX + vancomycin

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36
Q

disseminated gonorrhea presentation

A
  • asymmetric migratory joint pain

- pustular lesions

37
Q

cervicofacial actinomycosis clinical features

A
  • mandibular swelling + can form abscesses, fistulas, and sinus tracts
  • sulfur granules
38
Q

treatment of cervicofacial actinomycosis

A

IV penicillin initially then oral penicillin for 6-12 months

39
Q

Abx associated with a high risk of Cdiff

A
  • quinolones
  • clinda
  • cephalosporins
  • penicillins
40
Q

treatment of complicated cystitis

A

quinolones

41
Q

Problem with NAAT for chlamydia

A
  • high rate of false-positive results within 3 weeks of treatment so you shouldn’t retest within this time period (it’s amplifying the dead organism)
42
Q

Treatment of chlamydia in women

A

azithro OR doxycycline

43
Q

Follow up of PNA

A

1) **IF high risk characteristics (age over 50, smoking history) – follow up CXR 7-12 weeks after treatment is recommended to document resolution and exclude underlying malignancy
2) smoking cessation counseling
3) PNA vaccination

44
Q

Best way to reduce transmission of HSV between partners

A
  • chronic antiviral suppression therapy (transmission can occur with asymptomatic shedding and during prodromal phases)
45
Q

Schistosomiasis presentation

A

1) Urinary – hematuria, dysuria, frequent urination
2) Intestinal – diarrhea, abdominal pain
3) Hepatic – hepatomegaly, splenomegaly

46
Q

Nocardia clinical features

A
  • immunocompromised patients

- lung and brain abscesses

47
Q

treatment of nocardiosis

A

bactrim

48
Q

Mycoplasma pneumonia isolation precaution order

A

droplet

49
Q

RSV isolation precaution order

A

contact

50
Q

Heamophilus influenza isolation precaution order

A

droplet

51
Q

Measles isolation precaution order

A

airborne

52
Q

Medical term for genital warps from HPV

A

condyloma acuminata

53
Q

What are condyloma lata?

A

manifestation of secondary syphilis

54
Q

treatment of condyloma acuminata

A

topical therapy (trichloroacetic acid, podophyllotoxin)

55
Q

clostridium perfringens gastrointestinal illness clinical features

A
  • watery diarrhea + undercooked or unrefrigerated food
56
Q

antibiotics for meningococcemia

A

3rd generation cephalosporin (CTX or cefotaxime) + vancomycin (added for pneumococcal infection until final culture results are available

57
Q

what are the encapsulated organisms?

A
  • neisseria meningitidis
  • strep pneumo
  • h influenza
58
Q

Management of candida from respiratory culture

A
  • no anti fungal treatment (rarely indicates invasive candidiasis, typically just bronchial tree colonization), no need to repeat respiratory culture
59
Q

Treatment of histoplasmosis presenting as an asymptomatic nodule

A
  • no treatment (anti fungal therapy has no effect on nodule)
60
Q

histoplasmosis treatment

A

IF mild –> itraconazole

IF moderate or severe –> amphotericin

61
Q

Management of patient with partner testing positive for syphilis

A

Treat empirically with single dose of penicillin

62
Q

meaning of life

A

?

63
Q

Common lab abnormalities of dengue fever

A
  • leukopenia + thrombocytopeia
64
Q

Treatment of symptomatic zenker divertiuclum

A

surgery

65
Q

common cause of PNA in immunocompromised patients following prolonged hospitalization in early transplant period

A
  • nosocomial infection from VRE, pseudomonas, staph, candida

* pseudomonas commonly colonizes hospital equipment

66
Q

Yersinia pestis clinical features

A
  • swollen and painful lymph nodules (bubo)
  • high grade fever
  • rapid progression to sepsis with PNA, meningitis, shock
67
Q

Yersinia pestis (bubonic plague) treatment

A
  • tetracyclines or streptomycin
68
Q

Management of patient with exposure to bubonic plague patient

A

doxycycline

69
Q

Management of asymptomatic candiduria (candida in urine culture) in patient with chronic indwelling catheter

A
  • don’t treat, remove or exchange catheter
70
Q

gram-positive bacilli in CSF + treatment

A
  • listeria

- ampicillin or penicillin g

71
Q

strep pneumo microbiologic classification

A

gram positive cocci

72
Q

core features of fibromyalgia

A

diffuse MSK pain + tenderness on exam

73
Q

Clinical features of chancre of primary syphilis

A
  • recent intercourse
  • develops at inoculation site (*can also be mouth or pharynx, anus)
  • painless + indurated + nontender lymphadenopathy
74
Q

Clinical features of septic pulmonary emboli

A
  • multiple bilateral cavitary lesions

- typically due to right-sided infective endocarditis

75
Q

Clinical features of AIDS-related lymphomas

A
  • low Cd4 count + long standing HIV + class NHL presentation – B symptoms, extra nodal disease
  • AIDS-related lymphomas are common in advanced HIV
76
Q

Most common AIDS-related lymphomas

A

DLBCL and Burkitt lymphoma

77
Q

Time it takes for tic to be attached prior to borrelia transmission

A
  • 48 hours
78
Q

CD4 count at which patients are at increased risk of pneumocystis infection

A

CD4 less than 200

79
Q

Immune reconstitution inflammatory syndrome (IRIS) clinical features

A
  • Patient diagnosed with HIV, started on HAART, then presents with infectious symptoms (due to unmasking of underlying infection)
80
Q

Management of IRIS

A
  • continue HAART

- Rule out underlying infection (sputum cultures, etc.)

81
Q

Intertrigo clinical features

A
  • erythematous plaques and erosions in skin folds of intertiginous areas (fungal infection)
82
Q

DRESS presentation

A
  • fever, generalized LAD, facial edema, diffuse morbilliform skin rash
83
Q

Chikungunya virus clinical features

A
  • fevers

- severe polyarthralgias

84
Q

Malaria clinical features

A
  • GI (vomiting, diarrhea) + anemia + thrombocytopenia + *cyclical fevers
85
Q

Treatment of latent syphilis

A
  • benzathine penicillin weekly x 3 weeks
86
Q

First line for neurosyphilis

A

Penicillin G IV x 10-14 days

*CTX is second line

87
Q

First line for tertiary syphilis

A

Penicillin G IM x 3 doses

88
Q

First line for primary and secondary syphilis

A

Penicillin G IM x 1 dose

89
Q

who needs prophylaxis for contacts of meningococcal disease

A
  • close contacts + healthier workers with prolonged duration or exposure to respiratory secretions
  • regardless of vaccination status

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