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Infectious Disease Flashcards

1
Q

Which anti fungal should you use in a pulmonary patient with a presentation concerning for aspergillosis

A

voriconazole or ampho B

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2
Q

What infection do patients with AML have a greatly increased chance of catching?

A

Aspergillus infection

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3
Q

Patients with acquired humoral deficiencies are predisposed to infections with which organisms?

A

encapsulated organisms, gram negative rods, and giardia

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4
Q

splenectomy and functional asplenia increase the risk of infection with which types of organisms?

A

encapsulated, malaria, and babesiosis

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5
Q

What type of infections do you see in patients with IgA deficiency?

A

recurrent sinopulmonary disease from encapsulated organisms, recurrent giardiasis, and food/respiratory allergies.

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6
Q

What kind of infections do you see with C1, C2, and C4 classical pathway complement deficiencies?

A

recurrent sinopulmonary infections, otitis media with encapsulated bacteria (strep pneumo, h influenza, n meningitidis).
- Associated with development of systemic SLE at an early age

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7
Q

Seeing what bacteria in the blood should make you think of an underlying GI malignancy?

A
  1. Strep bovis

2. Clostridium septicum

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8
Q

What important bacteria do cephalosporins have no activity against?

A

Enterococci and Listeria

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9
Q

Name 3 bacteria that are common causes of food poisoning

A
  1. Bacillus cereus
  2. Clostridium perfringens
  3. Staph aureus
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10
Q

Name 2 infectious diseases for which aminoglycocides are the treatment of choice

A
  1. Plague (Yersinia pestis)

2. Tularemia

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11
Q

What 2 causes lead to bell’s palsy?

A
  1. HSV and 2. Lyme disease
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12
Q

What’s a rare cause of neutrophilic meningitis?

A

Nocardia or fungus

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13
Q

Vulvovaginal candidiasis can be a sign of what?

A

Undiagnosed diabetes or HIV

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14
Q

When you find proteus bacteria in the urine, what should you be thinking about?

A

Order imaging to look for stones

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15
Q

Name the only 2 fungal diseases that cause peripheral eosinophilia.

A
  1. Coccidioidomycosis and 2. Allergic Bronchopulmonary Aspergillosis
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16
Q

Rhizopus (a type of mucormycosis) is seen in what 3 medical conditions?

A
  1. DM 2. hemochromatosis 3. severely immunosuppressed
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17
Q

What fungus other than aspergillosis can cause a necrotizing, cavitating pneumonia?

A

Mucormycosis

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18
Q

Side Effects

  1. Zidovudine (ZDV’s) (azidothymidine AZT)
  2. Abacavir
  3. The D’s (ddI and d4T)
  4. Tenofovir
  5. Nevirapine
  6. Efavirenz
  7. All PI’s
  8. Atazanavir
  9. Indinavir
  10. Boosted saquinavir
  11. Nelfinavir
A
  1. bone marrow suppression and myopathy
  2. potentially fatal hypersensitivity reaction
  3. pancreatitis, peripheral neuropathy, mitochondrial toxicity
  4. azotemia and a fanconi like syndrome
  5. Rash
  6. Teratogenic; CNS side effects like bad dreams
  7. Lipodystrophy, hyperlipidemia, DM2, osteoporosis
  8. indirect hyperbilirubinemia
  9. Kidney stones
  10. prolonged QT
  11. diarrhea
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19
Q

All patients with HIV should be tested for what other virus?

A

HCV

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20
Q

How would you distinguish Babesia from Plasmodium on a slide?

A

Babesia (babesiosis) - intra-RBC pear shapes which occasionally form a tetrad appearing as a Maltese cross

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21
Q

What is the toxic shock syndrome triad?

A

fever, rash, hypotension and involvement of 3 or more organ systems

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22
Q

What are the dreaded organisms that can still thrive in immunosuppressed patients who are receiving very broad-spectrum antibiotics?

A

Fusarium and Aspergillus

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23
Q

What are some keywords to think about plague?

A
  • Reservoir is wild rodents; transmitted by fleas or direct contact from skinning animals
  • Think of for patients like homeless who may have come in contact with rodents
  • desert southwest
  • Bubonic form causes large, localized lymphadenopathy )buboes) that suppurate (discharge pus)
  • Also a pneumonic form that occurs after you inhale the organism via aerosols from infected animals or other humans
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24
Q

Keywords for Brucella

A
  • various strains found in goats, sheep, camels, cattle, pigs, and dogs
  • transmitted to humans via unpasteurized milk or cheese or by inhalation (work-related)
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25
Q

Keywords for francisella tularensis

A
  • especially seen in arkansas, missouri, and oklahoma
  • irregular ulcer at the site of inoculation and lymphadenopathy
  • Can get from:
    Tick and deer fly bites
    Skin contact with infected animals (rabbits/rodents)
    Ingestion of contaminated water
    Inhalation of contaminated aerosols or agricultural dusts
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26
Q

Keywords for Bartonella henselae

A
  • cat scratch disease or bacillary angiomatosis in immunocompromised
  • painful lymphadenopathy
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27
Q

What are 2 main causes of culture negative endocarditis?

A

Brucella and Coxiella are both causes of culture-negative endocarditis.

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28
Q

Keywords for Q Fever

A
  • due to Coxiella burnetii infection
  • transmitted through inhalation of aerosol released from the infected animal
  • Seen in slaughterhouse workers and people exposed to an infected animal’s products of conception during birthing
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29
Q

Keywords in vibrio

A

saltwater; seafood and shellfish

30
Q

Keywords in EBV infection

A
  • atypical lymphs

- 90% develop a macular rash if treated with ampicillin or amoxicillin

31
Q

Keywords in bacterial vaginosis

A 
fishy odor (+whiff test)
thin discharge
clue cells
32
Q

If a patient is found to have candida fungemia, what’s the next test you should order?

A

An eye exam to eval for endophthalmitis

33
Q

Keywords for babesiosis

A
  • causes febrile hemolytic anemia
  • transmitted via the Ixodes tick from rodents
  • Hemoglobinuria
  • Has classic intra-RBC pear shapes called Maltese crosses
34
Q

Keywords for trichinosis

A
  • due to Trichinella spirali

- Key words: undercooked bear, wild boar, pig meat

35
Q

What are some of the sources of infection for non-typhoidal Salmonella?

A
  • Spread by frozen food (chicken), milk, and eggs
  • Peanut butter and alfalfa sprouts
  • Baby chicks, iguanas, turtles, and other exotic pets like snakes are also sources of infections
36
Q

What part of the country are these found?

  • Coccidioides
  • Histoplasmosis
  • Blastomycosis
A
  • Coccidio - the southwest US and northern Mexico (found in the soil)
  • Histo - the Mississippi and Ohio River valleys (bad and bird droppings)
  • Blasto - the Mississippi and Ohio River valleys and those near the great lakes and the st. lawrence river (hunting in the Midwest)
37
Q

What infection should you think of if someone who works around fish tanks develops non healing skin ulcers?

A

Mycobacterium marinum

38
Q

Keywords associated with Nocardia infection

A
  • weakly acid fast
  • beaded, branching, filamentous gram positive rod
  • starts as a lung infection - a thin walled cavitary lesion
  • causes focal brain abscesses and chronic neutrophilic meningitis
  • nodular skin lesions are common
39
Q

What are 2 causes of bloody diarrhea that may not present with fever? What are 2 causes that may present with fever?

A

Non febrile - campylobacter and EHEC

Febrile - salmonella and shigella

40
Q

Key words for histoplasmosis

A

Farm buildings, caves, bird-roosting locations, bat guano, and “spelunking” (cave exploration) with exposure to the southeast and south central U.S (Mississippi and Ohio river valleys)

41
Q

If I see a pneumonia on the exam associated with a bird exposure, what should I think of?

A
  1. Hypersensitivity pneumonitis - recurrent PNA’s

2. Psittacosis from Chlamydia psittaci - acute illness after one exposure

42
Q

If I see a pneumonia case with splenomegaly and a bird exposure, what should I consider?

A

Chlamydia psittaci

43
Q

What 4 things define measles?

A

cough, coryza, conjunctivitis, koplik spots

44
Q

Bacteria that gardeners, especially those who are pricked by a thorn, get.

A

Sporothrix schenckii

45
Q

What should I think if I see a description of disseminated skin lesions with central necrosis in an immunosuppressed person

A

ecthyma gangrenosum and Pseudomonas bacteremia

46
Q

What diarrhea is seen with chitlins?

What diarrhea is seen with brown gravy and meats?

A

Yersinia enterocolitica

Clostridium perfringens

47
Q

What mimics strep pharyngitis in a younger patient?

A

Arcanobacterium haemolyticum; usually has an erythematous rash

48
Q

What infection should you think of in an an uncontrolled diabetic with multiple episodes of DKA?

A

The zygormycosis such as mucormycosis

49
Q

What bacteria do you find with animal bites?

A

staph aureus, eikenella, and pasteurella multocida

50
Q

Between the 2, which do you treat with abx and which don’t you treat with abx?

A

Shigella - treat

Salmonella - don’t treat unless very young, very old, or immunocompromised

51
Q

What are some characteristics of CMV retinitis in an HIV+ patient?

A

floaters) . His funduscopic exam shows large hemorrhages and exudates consistent with CMV retinitis
- See if CD4

52
Q

They give you a question with geography of new england?

A

Babesiosis - spread by ticks

53
Q

Which fungus cavitate?

A

Histo and aspergillus

54
Q

Hawaii, triathlon or Ironman

A

Leptospirosis - tx with doxy

55
Q

Erythema migrans

A

Lyme dz

56
Q

PAS positive foamy macrophages

A

Trophermyma whipplei

57
Q

Arkansas/Missouri/Oklahoma, tick bite, LAD, no pancytopenia

A

tularemia due to Francisella tularensis

58
Q

“box car” Gram positive rods

A

inhalation anthrax

59
Q

vibrio vulnificans has ______ lesions

A

bullous

60
Q

A nail through a tennis shoe

A

pseudomonas osteomyelitis

61
Q

Nasal polyp in young person with recurrent sinus and bronchial infections

A

Think CF, especially if infected with pseudomonas

62
Q

Wisconsin

A

lyme dz

63
Q

Palatal ulcer in an HIV patient

A

Histoplasmosis

64
Q

What do you think about if someone has recurrent bacteremia with salmonella or strep pneumo?

A

HIV

65
Q

fever, headache, and,conjunctival suffusion and an obstructed jaundice picture

A

leptospirosis

  • think swimming with animal in infected water
  • Hawaii/recreational water exposure
  • heavy rain and flooding
66
Q

hearing loss in a sexually active young person

A

neurosyphilis

67
Q

An ampicillin/amoxicillin induced rash should make me think of?

A

Mono (EBV); also has palatal petechiae and exudative pharyngitis

68
Q

petting zoo

A

e coli 0157:h7

69
Q

What states are tularemia and ehrlichia?

A

Arkansas, Missouri, Oklahoma

70
Q

What states have plague?

A

Arizona

71
Q

Isolated inguinal LAD

A

plague

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