Infectious Disease Flashcards
Gold standard test for tuberculosis
Mycobacterial culture of sputum
Side effects of TB drugs
Rifampin : turns body fluids orange
Ethambutol : optic neuritis
INH : peripheral neuropathy and hepatitis
Treatment of active TB
RIPE x 4 months
than
RI x 2 months
Early antibiotic treatment of streptococcal pharyngitis can prevent rheumatic fever but not …
Glomerulonephritis
The centor criteria for identifying streptococcal pharyngitis are fever, … , tender anterior cervical lymphadenopathy, and lack of cough ( 3 of 4 are required )
Tonsillar exudate
Lemierre’s syndrome
Thrombophlebitis of the jugular vein ( due to Fusobacterium )
In patients with hematologic malignancy or poorly controlled diabetes mellitus, with chronic sinusitis; … should be considered
Mucormycosis
Potential complications of sinusitis include meningitis, frontal bone osteomyelitis, cavernous sinus thrombosis and …
Abcess formation
Although other medications may be used, … is the frequently tested prophylaxis of choice for close contact of patients with meningococcal meningitis
Rifampin
The presence of RBCs in CSF without a history of trauma is highly suggestive of ….
… should be started ASAP if the diagnosis is suspected
HSV encephalitis
IV acyclovir
HSV and … are the most common causes of encephalitis
Arboviruses
The classic clinical triad of headache, …, and a … is present in 50% of cases of brain abcess
Fever, focal neurologic deficit
Medical treatment for brain abcess
3rd generation cephalosporin + metronidazole +/- vancomycin. Give IV therapy for 6 - 8 weeks
Relationship from CD4 count to development of opportunistic infections. < 200 < 50
< 200 : pneumocystis , toxoplasmosis, cryptococcosis, coccidiodomycosis, cryptosporidiosis
< 50 : disseminated MAC infection , histoplasmosis, CMV retinitis, CNS lymphoma
If a pregnant HIV-(+) patient is not on antiretroviral therapy at the time of delivery, she should be treated with … intrapartum. Infants should receive AZT for … weeks after birth.
Zidovudine (AZT)
6
… is the only live vaccine that should be given to HIV patient
MMR
The major pathogens concernig complete T - cell collapse
Toxoplasma gondii Mycobacterium avium-intracellulare Pneumocystis jiroveci Candida albicans Cryptococcus neoformans Tuberculosis CMV Cryptosporidium parvum
Treat CMV infection with
Gancyclovir
Ring enhancing lesions in patients with AIDS should prompt consideration of … and CNS lymphoma
Toxoplasmosis
Chlamydia species cause arthritis,neonatal conjunctivitis, pneumonia, non gonococcal urethritis/PID and …
Lymphogranuloma venereum
Treatment of chlamydia infections
Dox x7days or azithromycin once
Use azithromycin or amoxicillin in pregnant women
Reiter’s syndrome
Conjunctivitis, arthritis, urethritis
… is the gold standard for any site of the gonococcal infection
Gram stain and culture
Treatment for gonorrhea
Ceftriaxone IM or cefixime PO
Also treat for presumptive chlamydia coinfection
Fluoroquinolones should not be used because of emerging resistance
Stages of syphillis infection
1 : painless ulcer (chancre) ( 10 - 90 days after infection )
2 : maculopapular rash on the soles and palms, condylomata lata. ( 4 - 8 weeks after chancre)
3 : granulomatous gummas , neurosyphillis ( tabes dorsalis, meningitis, Argyll Robertson pupil)
VDRL false (+) are seen with
Viruses (mononucleiosis, HIV, HSV, hepatitis)
Drugs / IV drug use
Rheumatic fever/ Rhumatoid arthritis
SLE / Leprosis
Neurosyphillis should be suspected and ruled out in patients with …
AIDS, neurologics symptoms and a (+) RPR
Treatment of syphillis
1-2: Benzathine Penicillin IM x 1 day
(Tetracycline or doxyxycline x 14 days PO if penicillin allergy)
Latent infection : benzathine penicillin ( 1 dose for early latent, 3 doses for late latent)
Neurosyphillis : penicillin IV 10 - 14 days
Common UTI bugs
SEEKS PP
Serratia E coli Enterobacter Klebsiella pneumoniae S saprophyticus Pseudomonas Proteus mirabilis
Urosepsis should be considered in any … patient with altered mental status
Elderly
… is the most common serious medical complication of pregnancy
Pyelonephritis
Quid: Sepsis, severe sepsis, septic shock
Sepsis : SIRS + documented infection
Severe sepsis : sepsis with end-organ dysfunction due to poor perfusion
Septic shock : sepsis + hypotension and organ dysfunction from vasodilatation
A … should be performed in children < 12 months old after their first febrile seizure
Lumbar puncture
Classic triad of congenital toxoplasmosis infection
Chorioretinitis, hydrocephalus, intracranial calcifications
The most widely accepted treatment of infected neonates with toxoplasmosis is …
Pyrimethamine, sulfadiazine and leucovorin
Up to 17 % of patients taking fluoroquinolones experience some degree of …
Gastrointestinal upset
… is the most common cause of neonatal meningitis
GBS
Physical examination of children with Streptococcus viridans infection is notable for …
Petechias, splinter hemorrhages, Osler nodes, Janeway lesions and Roth spots
Measles is characterized by a … prodrome of low grade to moderate fever. The 3 “Cs”
3-day
Cough, Coryza, Conjunctivitis
Koplik’s spots
Beginning of the lesions in roseola vs in the measles vs varicella
Roseola : rash starts on the trunk and then spreads to the face and extremities
Measles : blanching, maculopapular rash that begins on the head and then descends over the rest of the body like rubella
Varicella : rash begins on the scalp, face or trunk and spreads to peripherally
Doxyxycline ( as other tetracyclines ) should be avoided in children < 8 years old because of the risk that … may occur
Permanent tooth discoloration
