Infectious Disease Flashcards
when to prophylax?
CD4+
less than 200: Pneumocystis jirovecci
less than 100: toxoplasmosis
less than 50: MAC
Prophylaxis and tx for Pneumocystis pneumonia?
- TMP-SMX
- Dapsone
- Atovoquone
- pentamidine
- clinda + primaquine
Prophylaxis and tx for toxo?
see ring-enhancing lesion on MRI
proph: TMP-SMX
tx: pyrimthamine/sulfadoxine + folate
Prophylaxis and tx for MAC?
this is AIDS diarrhea
proph: azithromycin
tx: clinda + ethambutol +/- rifampin
the 3 AIDS diarrheas?
- CMV
- MAC
- Cryptosporidium parvum
CMV?
AIDS diarrhea dx: coloscopy w/ biopsy - need to see intranuclear inclusions diarrhea +/- bloody tx: ganciclovir (AE: neutropenia) or foscarnet (AE: renal tox)
Cryptosporidium parvum?
AIDS diarrhea
dx: see acid fast oocysts
watery/mucousy diarrhea
A solitary ring enhancing lesion that doesnt get better with toxo tx?
Can be CNS lymphoma
assc with EBV
AIDS pt with seizure and deja-vu aura?
HSV encephalitis
see bloody lumbar puncture
likes the temporal lobe
tx: acyclovir ASAP
AIDS meningitis
mc: s. pneumo
opportunistic: cryptococcus neoformans
tx for cryptococcus = amphotericin IV 2wks, then fluconazole
cryptococcus neoformans vs cryptosporidium parvum
neoformans = AIDS meningitis (stains + with india ink)
parvum = AIDS diarrhea ("acid fast oocysts)Use this for dental endocarditis prophylaxis
what are the indications for dental endocarditis proph?
need proph if: hx of prosthetic valve/valve replaced, hx of endocarditis, or hx of uncorrected congen heart lesion
proph with amoxicillin
Does coccidioides need prophylaxis?
no. not according to UpToDate
tx: clinda + ethambutol +/- rifampin?
MAC diarrhea
tx: pyrimethamine/sulfadoxine + folate?
toxo
tx: ganciclovir or foscarnet
CMV
ganciclovir (AE: neutropenia)
foscarnet (AE: renal tox)
Hydatid cyst disease of the liver?
howd they get it?
whats it called?
Hydatid cyst: big liver cyst with little cysts in the middle. May see splenomegaly
origin: sheep (shepherds at high risk) and dog poo
Echinococcosis
Pig tape worm?
disease it causes?
Taenia solium
causes neurocystocosis
Lyme?
what if pt is pregnant?
what if pt is younger than 8?
lyme meningitis?
standard - doxy
pregnant, less than 8 =amoxicillin
(can’t have Doxy bc AE = tooth abnormalities)
Lyme meningitis = IV ceftriaxone
remember Lyme = Borrelia Burgdorferi
epididymitis:
young men, sexually active (up to 35)
old dudes?
young: chlamydia mc
old: E.coli
remember Prehn sign (relief of pain with elevation of the testiticle) hints at epididymitis as dx
