Infectious disease Flashcards
how long should you avoid sports with EBV
> 3weeks; heterophile can be positive for up to a year and spleen is palpable only when its 2 or 3x normal
symptoms of parvovirus B19 in adults
- nonspecific rash
- polyarticular, symmetric arthritis involving peripheral joints including MCP, PIP, wrist, knees, and ankles
- fatigue
- fever
- diarrhea
agents that can cause a viral arthritis
hepatitis B and C, HIV, rubella
Tx of PPD+ pts? regular and HIV+
isoniazid and pyridoxine for 9 months; pyridoxine for protection again neuropathy caused by isoniazid; needs greater than 5mm of induration in HIV pts and greater thn 10mm (recent immigrants, iv drugss, hospitals, prisons, nursing homes, homeless shelters, reactivation co morbidities, kids15mm in everyone else
symptoms of bartonella infection
bacillary angiomatosis in immunocompromised and pts have cutaneous and visceral angioma-like blood vessel ggrowths; Abx for tx
nonspecific symptoms: fever, wt loss, malaise, abd pain & characteristic lesions of skin and viscera - classsic cutaneous lesions are large pedunculated exophyticc papule with a collarette of scale that resembles a large pyogenic granuloma or cherry angioma
PCP pna tx mild and mod/sever
IV TMP-SMX for all cases; possible outpt oral if very mild disease; add corticosteroids if PaO235
organism in osteomyelitis after a puncture wound
pseudomonas
most ocmmon cause of pna in nursing homes
step pneumoniae
most common pneumonia in those with neurologic disorders
advanced dementia, parkinson’s disease, and stroke (think aspiration pneumonia)
indications for meningococcal vaccine
- primary vaccine: age 11-12 (or13-18 if previously not vaccinated), optional at age 19-21 (if not previously vaccinated) for high risk pts and first year college students entering residential housing
- booster: age 16-21 if primary vaccine before 16th bday
- age>21 consider if at high risk (complement deficiency, asplenia, hiv, exposure to community outbreak, travel to hyperendemic/epidemic countries, military recruits
live attenuated vaccines (6)
polio, MMR, rotavirus, influenza, yellow fever, varicella zoster
causes of esophagitis in HIV and what CD4 count:
candida, hsv(vesicles and round/ovoid ulcers, CMV (deep, linear ulcers), idiopathic/aphthous
tx for syphilis and penicillin allergy
doxycycline, for tertiary use ceftriaxone, for pregnancy desensitize with penicillin first
symptoms of malaria
cyclical fever with constitutional nonspecific signs and gastrointestinal manifestations with anemia and thromocytopenia on lab
common life threatening side effects of HIV therapy
- didanosine
- abacavir
- NRTIs
- NNRTIs
- nevirapine
- idinavir
- efavirenz, what class?
- didanosine= pancreatitis
- abacavir= hypersensitivity syndrome, lactic acidosis, hepatitis
- NRTI= lactic acidosis
- NNRTI= stevens-johnson syndrome
- nevirapine= liver failure
- idinavir= crystal-induced nephropathy
- efavirenz = NNRTI, vivid dreams and hallucinations in 50% of patients
vaccines for asplenic adult pts and when you should get them
- pneumococcus: PCV13 and PPSV23 (revaccination with PPSV23 5 years later and age 65)
- h.influenzae: 1 dose
- meningococcal and every 5 years
- influenza: inactivated annually
- HAV, HBV, Tdap once as a substitue for Td and Tc every 10 years
** when considering splenectomy administer 14 days before or 14 days after the surgery
endocarditis associated with UTIs
enterococcus faecalis
opportunic infection prophylaxis in HIV
- PCP
cirteria for lyme disease prophylaxis; must meet all 5
- tick is adult or nymphal ixodes/deer tick
- attached >36hrs or engorged
- no c/i to doxy (20% infection rate
- prophylaxis started within 72 hours of tick removal
symtoms of a necrotizing surgical site infection
- pain, edema, erythema spreading beyond site
- systemic symptoms
- parasthesias/anethesia at edges of wound
- purulent, cloudy-gray discharge (“dishwater drainage”)
- subQ gas or crepitus
elichiosis, vector, endemic region, symptoms, lab abn, tx
lone star deer tick, southeast and south central US, acute febril illness with AMS and no rash, thrombocytopenia and leukopenia, doxycycline
what is ecythema gangrenosum and what organism is it associated with
P. aeruginosa - lesions typically present with small erythematous macule that progresses to a larger nontender lesion with nodules with central necrosis; its caused by bacteria infiltrating media and adventitia of blood vessels
why would there be blood in the CSF of a HSV encephalitis patient
if there’s frontotemporal destruction
strep pharyngitis and impetigo are associated with what complications
strep pharyngitis = rheumatic fever
impetigo = post strep glomerulonephritis
Drug-induced esphagitis is caused by:
tetracyclines, aspirin and other NSAIDs, alendronate, KCL, quinidine, and iron
Tx for cat bite wounds:
amox/clav for 5 days (for pasturella), p. multocida is resistant to erythromycin 50% of the time
how does osteomyelitis spread in those with arterial insufficieny? how about it kids?
contiguously, not through lymphatics or hematogenous (this is for kids)
What do blood cultures show in disseminated gonococcal infection
Can be negative due to fastidious nature of infection
