Infectious Disease Flashcards
How do you diagnose Legionella?
Urine legionella antigen test
How do you diagnose chlamydophila pneumonia?
PCR
What type of pneumonia presents with serum cold agglutinins?
Mycoplasma
How do you diagnose pneumococcal pneumonia?
Urine pneumococcal antigen testing
What are the CURB-65 criteria for hospital admission for pneumonia?
-Confusion
-Uremia (BUN over 19)
-Respiratory rate over 30
BP lower than 90 / 60
-Age over 65
What are the top three causes of pneumonia in neonates?
GBS
E. Coli
Listeria
(GEL)
What is the most common cause of pneumonia in children? Young adults?
Elderly?
Children = viruses or strep
YA = Mycoplasma pneumonia
Elderly = S. pneumo
What are the three major bacteria that cause atypical pneumonia?
Mycoplasma
Legionella
Chlamydophila
What are the top three nosocomial causes of pneumonia?
GNRs
Staph anaerobes
Pseudomonas
What is the most common infectious agent(s) implicated in aspiration pneumonia?
Anaerobes
What is the treatment for outpatient pneumonia?
Macrolide or doxycycline
What is the treatment for inpatient pneumonia with multiple relevant comorbidities?
Fluoroquinolones
or beta-lactam+macrolide
What is the treatment for CAP requiring hospitalization?
Fluoroquinolone or antipseudomonal beta-lactam + macrolide
What is the treatment for CAP requiring ICU care?
Antipneumococcal beta lactam + (azithromycin or fluoroquinolone)
What is the treatment for hospital/institution acquired pneumonia?
Cephalosporin
Aminoglycoside or flouroquinolone
What is the treatment for MRSA pneumonia?
Vanco
What marks an active infection of TB?
Mycobacterial culture of sputum or blood
What is the TB drugs that turns urine, sweat, and tears orange?
Rifampin
What is the classic side effect of ethambutol?
optic neuritis
What are the classic side effects of INH? (2)
Peripheral neuropathy
Hepatitis
What qualifies as latent TB diagnosis?
+ PPD or GOLD, but negative sputum cultures
What is the treatment for active TB?
RIPE x 2 months
INH+rifampin x 4 months
What is the treatment for latent TB?
INH x 9 months
True or false: early treatment for strep pharyngitis can prevent both rheumatic fever and glomerulonephritis
False–not glomerulonephritis
What is the hemolytic pattern of GAS?
ALpha
What are the common viral causes of pharyngitis?
Rhinovirus
Coronavirus
What amount of induration indicates a positive PPD for: HIV, or close to TB
5 mm
What amount of induration indicates a positive PPD for: Indigent/homeless, residents of developing nations
10 mm
What amount of induration indicates a positive PPD for: healthcare workers
10 mm
What amount of induration indicates a positive PPD for: healthy with no known risk factors?
15 mm
What is the treatment for GAS pharyngitis?
Amoxicillin x 10 days
What are the two major nonsuppurative complications of strep pharyngitis?
Rheumatic fever
glomerulonephritis
What are the two major suppurative complications of strep pharyngitis?
Cervical LAD
Mastoiditis
Simusitis
OM
What is the difference in timeframe for acute vs chronic sinusitis?
- Acute = less than 1 month
- Chronic = more than 3 months
What two infectious agents are diabetic and immunosuppressed patient particularly susceptible to in terms of sinusitis?
Mucor
Rhizopus
Where is coccidioidomycosis found geographically?
Southwest US
What is the treatment for acute coccidioidomycosis?
- azole for mild
- IV amp B for disseminated
What is antigenic drift?
Small, gradual changes in surface proteins through point mutations, which are the cause of seasonal variance
What is antigenic shift?
Acute, major change in the influenza A subtype leading to pandemics
What are the histologic findings of coccidioidomycosis?
Spherules
At what age can kids get their first flu vaccine?
6 months for injectable
2 years for LAV
What are the top three most common causes of meningitis in newborns?
- GBS
- E.coli
- Listeria
What are the top three most common causes of meningitis in children (6 months - 6 years)?
- Strep pneumo
- N, meningitidis
- H. flu
What are the top three most common causes of meningitis in 6-60 year olds?
- N meningitidis
- Strep pneumo
- Enterovirus
What are the top three most common causes of meningitis in 60+?
- Strep pneumo
- GNRs
- Listeria
What are the classic CSF findings of multiple sclerosis?
Increased gamma globulins
monoclonal bands
What is the prophylaxis for people in close contact to a pt who has contracted meningococcal meningitis?
Rifampin or cipro
What are the 2 abx of choice to treat neonatal meningitis?
Ampicillin + gentamicin (cefotaxime)
What are the 2 abx for treating 1-3 mo with meningitis?
Vanco + Ceftriaxone (cefotaxime)
What are the 2 abx for treating meningitis in 3 mo to adulthood?
Vanco + ceftriaxone (cefotaxime)
What are the three abx for treating meningitis in a 60 yo +?
Ampicillin + vanco + ceftriaxone (cefotaxime)
RBCs in a LP without a h/o trauma strongly suggests what cause of meningitis?
HSV
With what cause of meningitis is dexamethasone given?
Strep pneumo
What are the two most common causes of encephalitis?
HSV and arboviruses
What are the usual s/sx of encephalitis? (4)
- AMS
- HA
- Fever
- Seizures
What are the five causes of encephalitis that are diagnosed with PCR of CSF?
VZV HSV EBV CMV Enteroviruses
What infectious process can cause focal neurologic symptoms?
Brain abscess
What is the treatment for HSV and CMV encephalitis respectively?
HSV = acyclovir CMV = ganciclovir
What is the treatment for RMSF encephalitis? Lyme disease?
RMSF = doxycycline Lyme = ceftriaxone
What is the appearance of brain abscesses on imaging?
Ring enhancing lesions (d/t fibrotic capsule)
What are the common infectious etiologies of brain abscesses?
Strep
Staph
Anaerobes
What is the bacteria that is usually implicated in brain abscesses that spread from the paranasal sinuses?
Strep milleri
If a brain abscess is the result of hematologic spread of bacteria, where in the brain are they usually found?
Middle cerebral artery distribution (usually multiple) at the Gray-white junction
What are the s/sx of brain abscesses?
- Increased ICP
- Focal neurologic deficits
- HA
Which CNs are often affected by brain abscesses?
CN III and VI
Why is CSF analysis contraindicated in most cases of brain abscesses?
High ICP 2/2 abscess can cause herniation
What are the lab values that are often elevated with brain abscesses?
ESR and CRP
What is the treatment for brain abscesses?
IV abx and surgical drainage
-Dexamethasone or mannitol if increased ICP
What is the difference in the clinical value of CD4 counts and viral load for HIV pts?
CD4 = degree of immunosuppression
Viral load = rate of disease progression
What is the screening test for HIV? Confirmatory?
Screening = ELISA Confirmatory = western blot