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STEP 2 CK FIRST AID > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

What are the most common causes of PNX in kids

A

Viruses (RSV)
Mycoplasma
C. and S. pneumoniae

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2
Q

Will tactile frem be increased or decreased in consolidation and Pleural effusion?

A

Consolidation = increased

pleural effusion = decreased

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3
Q 
What are the specific tests for:
legionella:
chlamydia pneumoniae:
mycoplasma:
s. pneumo:
A

legionella: urine legionella Ag
chlamydia pneumoniae: serologic testing
mycoplasma: clinical dx or serum cold agglutinins
s. pneumo: urine pneumo Ag

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4
Q

In addition to S. pneumo, what other bugs cause PNX in COPD pts?

A

H flu

Moraxella

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5
Q

What bugs cause PNX in neonates?

A

GBS, e.coli

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6
Q

What are the side effects of:
rifampin
ethambutol
INH

A 
rifampin = orange fluids
ethambutol = optic neuritis
INH = peripheral neuropathy and hepatitis (always give B6 with INH)
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7
Q

TB treatment for active and latent dz?

A 
active = RIPE x2months and IR x4 months
latent = INH x9 months OR INH x 6months OR rifampin x 4 months
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8
Q

Which strep do you have to be concerned about with acute pharyngitis? Dx test?

A

G.A.S. - dx w/ rapid GAS Ag test

early Abx therapy (PEN x 10 day) will prevent RHEUMATIC FEVER but can’t stop glomerulonephritis

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9
Q

What is Lemierre’s syndrome? what dz does it occur with?

A

The rare thrombophlebitis of the jugular vein

occurs due to Fusobacterium, an oral anaerobe

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10
Q

What bug are you concerned about with chronic sinusitis in a DM or hematologic malignancy pt?

A

Mucormycosis or rhizorpus

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11
Q

What is the tx for coccidioidomycosis infection?

A

PO fluconazole or itraconazole for mild or stable

IV Amp B for bad/disseminated cases

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12
Q

What accounts for why people can be infected with influenza (orthomyxovirus) multiple times?

A

Antigenic drift (slight point mutation changes)

Antigenic shifts describe a major change in the subtype and lead to PANDEMICS

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13
Q

Flu vaccine is recommended for…

A

everyone >6mo of age. kids 6mo to 9years need 2 doses of vaccine if it is their first time!

people ages 2-49yo who are healthy can get the live attenuated nasal spray. nOT WHILE PREGZ OR AIDS

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14
Q

What bacteria is responsible for most post viral PNX (occuring a week after being tx for influenza, particularly in old people.)

A

S.A.

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15
Q

What are the most common bugs that cause meningitis in newborns 0-6mo?

Tx

A

GBS
E.Coli & GNRs
Listeria

Tx

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16
Q

What are the 4 bugs that cause meningitis in old people >60yo?

Tx?

A

S. pneumoniae
GNRs
Listeria
N. Men

Tx = Amp, vanc, and cef (tx this way for alcoholics, chronically ill too.)

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17
Q

What medication should you give to people in close contact to a pt with meningococcal men?

A

Rifampin!

If they can’t do rifampin, do cipro or cef.

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18
Q

What stain do you do to detect trypanosomes?

HSv, CMV, EBV?

A

Giemsa stain

PCR for all those other viruses

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19
Q

Brain abscess in a young male caused by paranasal sinusitis (direct spread) - what organism?

A

Strep Milleri

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20
Q

What is the tx for a pregnant woman w/ aids who is not on retroviral therapy at time of delivery?

A

AZT intraop

Infant should get AZT for 6 weeks after birth

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21
Q

How low does the CD4 count get before you start antiretrovirals on an asymptomatic aids pt?

A
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22
Q

What is the only live vaccine you can give to AIDS pts?

A

MMR.

DONT GIVE THEM OR THEIR CONTACTS LIVE POLIO VACCINE

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23
Q

When do you pre-treat HIV pts for P.J. pneumonia? With what?

MAC? With what?

Toxo? With what?

A

P.J. - tx when CD4 200 for 3mo

MAC - tx when CD4 100 for 6mo

Toxo - tx when CD4

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24
Q

What dz are you thinking if the pt was exposed to pigeon poop? Dx? Tx?

A

Cryptococcal meningitis. WONT HAVE MENINGEAL SIGNS!
Will have HA, fever, malaise and INCREASED ICP SIGNS
INDIA INK WILL BE + w/ + Crypto Ag stain of CSF

Tx: IV AMP B + flucytosine x 2 weeks, then do fluconAZOLE x 8 weeks

25
Q

HIV pt who presents with nonproductive cough and dyspnea. CD4 count is VERY low. what disease? Dx?

A

PJ pneumonia

Dx: Silver stain and immunofluorescence show FOLDED CYSTS CONTAINING COMMA SHAPED SPORES

CXR will show b/l interstitial infiltrates with a ground glass appearance

Tx: high dose TMP-SMX for 21 days…if they are hypoxemic, use a prednisone taper as well.

26
Q

AIDS pt presents with “pizza pie” retinopathy, floaters, and visual field changes. very low CD4 count. What bug?

A

CMV

27
Q

AIDS pt presents with nonspecific GI symptoms, bloody diarrhea. what bug?

A

CMV, it is called AIDS cholangiopathy

28
Q

1* vs 2* MAC infection

Dx? Tx?

A

1* = pulmonary disseminated infection that occurs in healthy (HIV) nonsmokers

2* = same thing but in not healthy COPD pts

Dx takes 2 WEEKs for blood cx to come back +. LDH and alk phos will be elevated. BX OF BONE MARROW OR LIVER will show foamy macs with acid fast bacilli

Tx: Clarithro

29
Q

Tx vs prophylaxis of toxo?

A

Prophylaxis = TMPSMx or Pyrimethamine+dapsone given to pts with

30
Q

What will the gram stain look like for chlamidia?

A

Nothing (PMNs but no bacteria) b/c the bugs are inside the cells!

31
Q

Chlamidia tx in pregnant pts?

A

Azithro or Amox. Everyone else can get Doxy 7d.

Also, treat all sexual partners. For Gonn too probably

32
Q

Cant pee, cant see, cant climb a tree

A

Reiters syndrome (can be caused by bad chlamydia infection.)

33
Q

1, 2, 3* syphilis

A

1* - days 10-90 ; painless chancre on penis
2* - weeks 4-8 ; F/HA/LAD w/ rash on SOLES AND PALMS and highly infectious condylomata lata. can progress into early latent (no symptoms but +serology, up to first year) and late latent phase (no symptoms, + or - serology, after first year.) and 1/3 of cases will go to 3*

3* - 1-20 yrs ; destructive granulomatous gummas, tabes dorsalis, robertsons pupil, aortic root aneurysms

34
Q

Tx for 1/2* syphilis

A

IM Pen Benz x1 day, doxy 14d for allergies (but if they are pregnant with allergies, you gotta sensitize to the pen)

35
Q

What is the confirmatory test for syphilis?

A

FTA-Abs, TP-PA Abs

36
Q

Flu like illness when syphilis is treated?

A

acute illness called Jarisch-Herxheimer reaction

37
Q

Genital lesion - painless papule that becomes a beefy red ulcer w/ rolled edge of granulation tissue w/ white boarder. Dz? Dx? Tx?

A

Klebsiella Granulomatosis (granuloma inguinale)

Dx: bx shows donovan bodies
Tx: doxy or azithro

38
Q

Genital lesion - painful papule or pustule/changroid that has irregular, deep, well demarcated necrotic apperance. May have inguinal LAD. Dz? Tz?

A

Haemophilus Ducreyi

Tx: Azithro or ceftriaxone

39
Q

Big thing you gotta rule out in bed wetting kids?

A

UTI

40
Q

What is the cause of gram + septic shock?

gram - septic shock?

A

Gram + septic shock = fluid loss caused by EXOtoxins (SA and strep)

Gram - septic shock = vasodilation caused by ENDOtoxins lipopolysachs (Ecoli, kleb, proteus, pseudomonas.)

41
Q

Is septic shock warm or cold?

A

warm skin and extremities.

CARDIOGENIC SHOCK IS COLD

42
Q

What mosquito transmits malaria? What organisms? Dx?

A

Anopheles mosquito

organisms - plasmodium (falciparum, vivax, ovale, malariae)

falciparum is the deadliest, but the other ones can cause symptoms MONTHS TO YEARS after initial infection

Dx = Giemsa and Wright stained blood films

43
Q

What does the anemia look like on labs for malaria?

A

Normo Normo anemia with reticulocytosis

44
Q

Patient with mono symptoms develops a pruritic rash after treatment…

A

It was misdiagnosed as strep pharyngitis and treated with ampicillin. This will cause a rash in mono pts everytime that could be mistaken for an allergy against amp.

45
Q

What causes the lymphocytosis in EBV?

A

B cells, but the atypical cells are the T cells!

46
Q

What one physical exam step do you skip on a neutropenic pt?

A

Rectal examination - bleeding risk

47
Q

What symptoms characterize 3* (late disease) lyme disease?

A

arthritis and subacute encephalitis (memory loss and mood change)

This occurs after the erythema migrans rash, the bells palsy, and the meningitis/myocarditis risk

48
Q

Where does rocky mountain spotted fever rash start? what bug?

A

starts on the wrists and ankles and moves centrally.

Due to rickettsia rickettsii

49
Q

What do you treat DM pts with eye infection concerning for mucor/rhizopus?

A

Amp B and surgical debridement

50
Q

What is the most common cause of otitis externa (swimmers ear)

A

Pseudomonas

Enterobacteriaceae

51
Q

Person with recent gonorrhea infection gets an eye infection?

A

This is an emergency, person could go blind. Tx w/ IM cef, inpatient if needed

52
Q

Eye infection w/ copius watery discharge, severe occular irritation, preauricular LAD. Dx?

A

Adenovirus conjunctivitis. Occurs in epidemics. Self limited

53
Q

What is the most common bug in prosthetic valve endocarditis?

A

coag (-) strep

54
Q

Difference between otitis media and otitis externa?

A

Pain when pulling on the tragus/pinna with otitis externa

55
Q

What is the tx of choice for most infective endocarditis?

A

Vancomycin

56
Q

Cutaneous pruritic papule in a farmer/wool handler/mailman that turns into a black eschar with regional LAD. bug? Dx? Tx?

A

Bacillus anthracus

ELISA or CXR if inhaled (will have widened mediastinum)

Tx: cipro or doxy + 2 more Abx for 2wks

57
Q

What is the most common form of osteomylitis in DM pts? Foot puncture?

What can a chonic draining sinus tract lead to?

A

Polymicrobial. (Gram + and anaerobic Abx will kill them)

Pseudomonas

SqCC (marjolin’s ulcer)

58
Q

What can you not do on metronidazole?

A

Drink alcohol (this can cause a disulferam rxn - hypotension, flushing, vomiting!)

59
Q

Who cant get doxy?

A

kids

STEP 2 CK FIRST AID (15 decks)

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