Infectious Disease Flashcards
Treatment for Pneumocystitis Jiroveci
Bactrim
Rheumatic Fever Diagnosis
complication of group a beta hemolytic strep
immune rxn that happens 2-3 weeks after strep throat
Jones criteria (2 major or 1 major and 2 minor)
J-joints
o- heart
n- nodules (usually on extensor surface)
e- erythema marginatum
s- syndeham chorea
P- prolonged PR e- esr elevation a- arthralgia c- crp elevation e- elevated temp
Botulism
toxin inhibits release of acetylcholine at neuromuscular junction
spore forming
4 types
1. infant- honey
2. wound
3. food borne- canned food
4. Botox- salivation, twitches, spasms
sxs 4 d’s- diplopia (double vision), dysarthria, droopy eyes, dilated pupils, dysphagia, dry mouth (paralytic disease so no mental status changes)
Respiratory paralysis is what will kill you
Tx- antitoxin
Cholera
toxin activates adenyl cyclase- causes hyper secretion of chloride and water resulting in hypovolemia
war times, overcrowding, famine overcrowding
sx- rice water diarrhea
tx- oral rehydration (severe dehydration), abx to shorten duration (bactrim, ampicillin)
Diphtheria
corn flake membrane (gray membrane that covers tonsils and pharynx)
pseudomembrane, pharyngitis
exotoxin causes neuropathy and myocarditis
tx- antitoxin, vaccine is key (Tdap)
Salmonella
Gastroenteritis-fever, abdominal pain, bloody diarrhea, Bactrim
Enteric Fever-(Typhoid fever)- viral sxs, Pea soup diarrhea, fever for a week that gets better over a week, rash in week 2- pink papular rash that blanches, paradoxical bradycardia (slow HR w/ fever), ceftriaxone or fluoroquinolone
Bacteremia
Shigella
DYSENTERY, sudden onset diarrhea, tenesmus (feeling you need to constantly need to evacuate bowels)
TX Bactrim
Tetanus
produce neurotoxin which inhibit GABA (so get blockage of inhibitory and get a spasm for over excitatory discharge)
jaw or neck stiffness (lock jaw/trismus)
no MS changes
tx- vaccine and booster, Tetanus Immunoglobulin
Pertusis
whooping cough vaccination is NOT lifelong think about this in adult with cough for 2 weeks 3 phases 1. catarrhal- virus like sxs, hacking cough, most infectious 2. Paroxysmal- whooping cough stage 3. Convalescent Tx- erythromycin. vaccinate
if women have recurrent yeast infection
think about HIV or Diabetes
cryptococcus
pigeon poop fungal infection usually get in HIV when CD 4 counts drop causes cryptococcus meningitis India Ink stain- shows yeast balls tx with oral fluconazole for 10 weeks
Histoplasmosis
in Ohio and Mississippi river valley
associated with splunking
Pneumocystis Jiroveci
most common opportunistic infection in HIV
presents with SOB, non productive cough
cxr shows bat wing pattern (diffuse interstitial infiltrates)
Tx bactrim
Chlamydia
leading cause of infertility
causes lymphgranuloma venereum (lgv)- vesicular lesions or ulcers that spread to inguinal nodes. Once they get to the nodes they are called buboes
TB
Most common cause of hemoptysis world wide (bronchitis is most common in US)
when inhale you get primary TB. Your body mounts an immune response to prevent from getting active TB
latent TB sits in apex of lungs
sxs- cough, fever, night sweats, weight loss, hemoptysis
diagnosis- acid fast bacilli
tx- RIPE- rifampin, INH, pryrazinamide, ethambutol. If positive PPD treat for 9 months
ethambutol- optic neuritis. loss of red green vision
INH- need pyridoxine. Injures Nerves and Hepatocytes
Rifampin turns body fluid orange
Ghon complex and Ranke complex
calcified primary focus
Ghon plus calcified hilar lymph nodes
these equal healed primary TB
Treatment for hookwork/ helminths
mebendazole
pinworms
perianal pruritus (worse at night) diagnose with scotch tape on 3 nights tx- albendazole single dose and then again in 3 weeks
Toxoplasmosis
in hiv causes an encephalitis with focal brain lesions (most common cause of focal brain lesions in aids)
from cat poop
tx pyrimethamine
Malaria
4 types 1. vivax 2. ovale 3. malariae 4. falciparum
falciparum is the worse. associated with cerebral malaria
transmitted by anopheles mosquito
lives in rbc
fever, chills, sweat, tired, gi sxs, headache
tx- chloroquine
lyme disease
borrelia burgdorferi transmitted by ixodes tick most common vector borne disease in US 3 stages 1. erythema migrans (bulls eye), 2. skin, cns (bells palsy), cardiac (heart block), arthralgias 3.late -chronic arthritis and synovitis dx antibodies tx doxy
rocky mountain spotted fever
ricketsia rickettsii
transmitted by wood tick
rash starts on extremities and then spreads to trunk (hailey mnemonic about living outside and have to come in for stuff)
tx doxy
Syphillis
treponema pallidum
primary syphillis- chancre- painless genital ulcer (raised rolled edge)
tertiary syphillis- Gummatous lesions, Neurosyphillis- tabes dorsalis (demylination of dorsal columns- hard to balance and loss of proprioception and vibratory).
Argyll- robertson pupil- accommodate but does not react (constricts when bring fingers in but does not constrict when shine light)
dx- vdrl or rpr (can get false positive so confirm with FTA- ABS)
tx- pcn 2.4 million units 1 time. if late dose need this once a week for 3 weeks
can get jarisch-herxheimer rxn- due to massive destruction of spirochetes- fever and toxic
where does the herpes viral lay dormant
dorsal root ganglion
Herpes virus
Herpes 1- mouth
Herpes 2- genitals
painful lesions
recommend c section if mom has active lesions
Herpes virus 3
Varicella-zoster
varicella- come up in crops (lesions at different stages). dew drop on a rose petal
can get trigeminal nerve zoster that involves eye (herpes opthalmacus)- hutchinson sign
Hutchinson sign
herpes lesion on nose.
worry about eye involvement
Ebstein bar virus
mononucleosis
Herpes virus 4
associated with burkitts lymphoma
triad- pharyngitis, fever, posterior lymphadenopathy
Antibodies with Mono
Heterophil antibodies
Can give false positive syphillis test (rpr and vdrl)
CMV
Herpes virus 5
problem with congenital and post transplant
can get Pizza pie lesion- Retinitis in Aids patients
Roseola
really high fever and then fever goes away and then gets a rash.
Rash starts on trunk and spreads (rash after fever)
common cause of febrile seizures
Rubella
German measles
starts on face and then spreads down
bad in pregnant women (congenital rubella- microcephaly, PDA, cataracts)
Rubeola
Measles
Koplik spots
cough, coryza, conjunctivitis
rash starts on face and spreads (as it fades it can stain skin brown)
Fifth’s disease
slapped cheek disease
parvovirus b 19
Tx for rabies
if bitten 1/2 of immunoglobulin in wound and half at other site.
then rabies vaccine
Human papilloma virus
HPV 16, 18,31,33 - cervical cancer
HPV 11 and 6 cause warts
tx of choice for shigella
ciprofloxacin
tx of choice for campylobacter jejuni
erythromycin
