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Clin Med II > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

What type of infection should you think about if a patient has been using catheters and is immunocompromised?

A

Candida albicans

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2
Q

What infectious should you think of if a patient has been on broadspectrum antibiotic therapy and is a female?

A

Candida albicans

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3
Q

Involvement of what tissue is most significant in the development of mucosal candidiasis?

A

esophagus

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4
Q

Mucosal candidiasis treatment

A
  • Oral fluconazole

- IV voriconazole

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5
Q

Patient presents with pruritis in genital area, white-curdy discharge, and complaints of dyspareunia. Diagnosis?

A

vulvovaginal candidiasis

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6
Q

vulvovaginal candidiasis treatment

A
  • Topical clotrimazole vaginal table
  • Miconazole suppository
  • fluconazole
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7
Q

Most common cause of fungal meningitis

A

cryptococcosis

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8
Q

Tools used for diagnosing cryptococcosis

A
  • india ink

- serum antigen

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9
Q

Patient presents with severe headache, stiff neck, and altered mental status. History reveals the pt was taking prednisone. Diagnosis?

A

Fungal meningitis

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10
Q

Patient presents with stiff neck and severe headache after working in the garden all day. Diagnosis?

A

Meningitis from cryptococcus neoformans

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11
Q

In what type of patient may a cryptococosis infection disseminate and progress to lung disease?

A

-IC from HIV, long-term steroid, cancer treatment

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12
Q

After suspecting a patient has cryptococcosis meningitis, you do a LP and sent it to the lab. What would you order and what would you expect to find?

A
  • Protein: increased
  • Glucose: decreased
  • White cells: increased lymphocytes
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13
Q

Cryptococcosis meningitis tx

A
  • Amphotericin B x 14 days

- Then fluconazole x 8 weeks

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14
Q

Patient presents with URI after cave spelunking along the Ohio River. Likely infecting organism?

A

Histoplasmosis (Histoplasma capsulatum)

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15
Q

Primary problem with histoplasmosis infection

A

Respiratory illness

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16
Q

Presentation of histoplasmosis infection

A
  • mild flu-like illness

- if severe: fever, cough, mild chest pain

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17
Q

Tx for progressive localized histoplasmosis infection

A

-itraconazole

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18
Q

Patient presents with fever, dyspnea, and nonproductive cough. You suspect pneumocystosis. What would you expect to find on CXR and ausculation?

A
  • bilateral interstitial infiltrate (CXR)

- crackles at the base of both lungs

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19
Q

At what point would you decide to prophylactically treat against pneumocystosis in an AIDS patient?

A

When CD4 cells drop <200

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20
Q

Most common opportunistic infection in an AIDS patient

A

Pneumocystosis (pneumocystis jiroveci)

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21
Q

Patient presents with nonproductive cough and fever. You find an isolated increased in LDH on their lab results. Diagnosis?

A

Pneumocystosis

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22
Q

Pneumocystosis treatment

A
  • Trimethoprim0sulfamethoxazole x 14-21 days
  • Clindamycin + Primaquine
  • Prednisone if PaO2 < 70mmHg
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23
Q

Acute rheumatic fever can follow an infection of what pathogen?

A

S. pyogenes (GAS)

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24
Q

In what patient population is acute rheumatic fever most common?

A

Children 5-15 years

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25
Q

What tissues does acute rheumatic fever affect?

A
  • heart
  • joints
  • skin
  • brain
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26
Q

Describe the pathophysiology of acute rheumatic fever

A
  • the body is infected with some GAS organism
  • we produce antibodies in response to the infection
  • then the antibodies react to our own tissues
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27
Q

Acute rheumatic fever treatment

A
  • ASA
  • steroids (only if the heart is involved)
  • penicillin
  • erythromycin
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28
Q

Patient presents with diplopia, dry mouth, dysphonia, dysphagia, and muscle weakness. What relevant history would you ask about?

A
  • if the patient had recently ingested home-canned or smoked foods
  • or about injection drug use
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29
Q

If untreated, what can botulism progress to?

A

Respiratory paralysis

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30
Q

What nerves does Clostridium botulinum affect?

A

The cranial nerves

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31
Q

What does Clostridium botulinum’s toxin do in the body?

A

Blocks acetylcholine release

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32
Q

Three types of botulism

A
  • food-borne from canned, smoked, or vacuum-packed food
  • infant < 1 year from honey
  • wound from injection drug use
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33
Q

How would you differentiate between botulism and Guillain-Barre syndrome?

A

Guillain-Barre’ syndrome involves peripheral neuropathy, while botulism involves palsy of cranial nerves (dysphagia, diplopia, dysphonia, etc.)

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34
Q

How do you treat botulism?

A
  • Antitoxin (BIG)

- Intubation if patient is in respiratory failure

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35
Q

Three disease states that Chlamydia trachomatis can cause

A
  • Lymphogranuloma venereum
  • Chlamydial urethritis
  • Chlamydial cervicitis
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36
Q

Presentation of lymphogranuloma venereum

A
  • evanescent primary genital lesion
  • lymphadenopathy
  • proctitis (rectal inflammation)
  • rectal stricture
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37
Q

Chlamydia trachomatis incubation period

A

5-21 days

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38
Q

Female patient presents with proctitis, tenesmus, and bloody discharge. Diagnosis?

A

Chlamydia lymphogranuloma venerum

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39
Q

Chlamydia lymphogranuloma venerum tx options

A

-Doxycycline x 21 days
-Erythromycin x 21 days
Azithromycin x 3 weeks

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40
Q

How would you expect a patient with chlamydia urethritis or cervicitis to present?

A
  • possibly burning with urination
  • nonpurulent and non-painful discharge
  • possible S&S of cervicitis, salpingitis, or PID
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41
Q

Clamydia urethritis/cervicitis treatment

A
  • Single dose of Azithromycin
  • Doxycycline x 7days
  • Levofloxacin x 7 days
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42
Q

How long should a patient being treated for chlamydial urethritis/cervicitis wait to have intercourse?

A

5 days

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43
Q

Patient presents with massive diarrhea described as looking like “rice water” and doesn’t seem to have a fecal odor. Patient denies the presence of blood or pus in it. Diagnosis?

A

Cholera

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44
Q

If you suspect a diagnosis of cholera, what relevant history should you ask about?

A

History of travel or contact with an infected individual

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45
Q

What disease may occur in times of overcrowding or war when sanitation is inadequate?

A

Cholera

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46
Q

Cholera treatment

A
  • replace fluids

- tetracycline, ampicillin, bactrim, chloramphenicol, fluoroquinolones, azithromycin antibiotics

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47
Q

Patient presents with a sore throat, hoarseness, and a gray color on the back of the throat. Diagnosis?

A

Diptheria

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48
Q

What is an essential finding when considering a diagnosis of Diptheria?

A

Tenacious gray membrane at the portal of entry in the pharynx

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49
Q

What part of the body does Corynebacterium diptheria attack?

A

The respiratory tract

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50
Q

In addition to the respiratory tract, what other parts of the body can be affected by diptheria?

A

The exotoxin causes myocarditis and neuropathy

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51
Q

What nerves does diptheria’s exotoxin “hit” first?

A

The cranial nerves (diplopia, slurred speech, dysphagia)

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52
Q

Diptheria treatment

A
  • Antitoxin
  • membrane removal
  • Penicillin or Erythromycin x 14 days
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53
Q

Patient presents with a white discharge that turns yellow and dysuria. On a smear, you see gram (-) intracellular diplococci. Diagnosis?

A

Gonococcal urethritis or cervicitis

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54
Q

Incubation period for Neisseria gonorrhea

A

2-8 days

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55
Q

What can a gonococcal infection cause?

A
  • urethritis
  • cervicitis
  • disseminated disease
  • conjunctivitis
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56
Q

What is the discharge like that’s associated with gonococcal urethritis?

A
  • serious and milky

- progresses to yellow and creamy

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57
Q

How may a female with gonococcal cervicitis present?

A
  • dysuria
  • increased frequency and urgency
  • purulent discharge
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58
Q

Patient presents with arthralgia, fever, and a red rash on the extremities. Beginning to display signs of tenosynovitis. Diagnosis?

A

Disseminated Gonoccal Disease

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59
Q

Common complications of disseminated gonococcal disease

A
  • arthritis

- tenosynovitis

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60
Q

Gonococcal conjunctivitis treatment

A

Ceftriaxone 1g treatment

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61
Q

Treatment options for gonococcal urethritis or cervicitis

A
  • 1 treatment of:
  • Ceftriaxone
  • Cefixime, or
  • Spectinomycin
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62
Q

Pharyngeal gonococcal treatment

A
  • IM ceftriaxone x 1 day

- Bactrim x 5 day

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63
Q

Treatment options for gonococcal infection with coexisting chlamydia

A
  • Doxycycline x 7 days

- Azithromycin x 1 day

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64
Q

Three types of salmonella

A
  • enteric (Typhoid) fever
  • gastroenteritis
  • bactermeia
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65
Q

Patient presents with headache, N/V, and abdominal pain. You discover rose spots, splenomegaly, and bradycardia. Diagnosis?

A

-Enteric (Typhoid) fever from salmonella

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66
Q

Characteristic diagnostic finding for enteric (typhoid) fever?

A

Bradycardia

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67
Q

Salmonella incubation period

A

5-14 days

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68
Q

How does salmonella travel into the bloodstream?

A
  • Transcytosis
  • organism is taken up by macrophage, which is then restructured by the organism, and the organism is the deposited into the blood via exocytosis
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69
Q

What effects does enteric (typhoid) fever have on the bowels?

A

-initially the patient is constipated, but this develops into “pea-soup” diarrhea

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70
Q

“Pea soup” diarrhea is characteristic of what?

A

Enteric (Typhoid) fever

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71
Q

How long should it take for you to see improvement in a patient with Typhoid fever?

A

7-10 days

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72
Q

After the prodromal phase of typhoid fever (malaise, HA, cough, N/V), how does it progress?

A
  • “Pea soup” diarrhea
  • splenomegaly
  • abdominal distention/tenderness
  • bradycardia
  • rose spot rash on the trunk
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73
Q

What lab findings support a diagnosis of typhoid fever?

A

Blood culture positive for salmonella

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74
Q

Typhoid fever treatment

A
  • ampicillin, cipro, or levofloxacin
  • Azithromycin
  • Chloramphenicol or bactrim for resistant strains
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75
Q

What treatment would you give to a typhoid fever carrier?

A
  • Ciprofoxacin x 4 weeks

- cholesystecomy?

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76
Q

How would a patient with salmonella gastroenteritis present?

A
  • fever w/ chills
  • N/V
  • abdominal cramping
  • possibly bloody diarrhea
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77
Q

Salmonella gastroenteritis treatment

A
  • usually self-limiting

- Bactrim or Ampicillin

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78
Q

Patient presents with bloody and mucoid diarrhea and looks toxic. What would you culture the stool for?

A

Shigella and WBCs

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79
Q

Shigella treatment

A
  • Bactrim x 7-10 days
  • Ciprofloxacin x 7-10 days
  • Levofloxacin x 3 days
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80
Q

Patient presents with dysphagia, a stiff neck, and hyperreflexia with occassional painful convulsions. Diagnosis?

A

-Tetanus

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81
Q

What causes tetanus?

A

the neurotoxin from Clostridium tetani

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82
Q

Patient steps on a rusty nail. What should they look for as early signs of tetanus?

A
  • Stiff jaw and neck
  • dysphagia
  • irritability
  • spasticity of muscles near the wound site
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83
Q

How would you treat a patient with tetanus?

A
  • 500 units of TIG IM within 24 hours
  • Full course of immunizations upon recovery
  • daily dose of PCN to eradicate it
84
Q

If you suspect a patient has TB, what should you look for on a phlegm smear?

A

-Acid fast bacilli

85
Q

Does the majority of active TB come from primary response or latent/reactivation TB?

A

Latent or reactivation TB

86
Q

Describe the primary response of TB

A
  • inhalation of pathogen
  • uptake of pathogen by alveolar macrophages
  • pathogen escapes macrophage, causing infection
  • pathogen disseminates via lymphatics and bloodstream
  • granulomas (small nodular aggregation of monocytes)
87
Q

If a patient isn’t treated with Isoniazid, what’s the chance that their TB will reactivate?

A

6% chance

88
Q

When does most TB reactivation occur?

A

In the first 2 years

89
Q

Patient presents with malaise, anorexia, fever, weight loss, and night sweats. He has a chronic cough, as well. Diagnosis?

A

TB

90
Q

S & S of TB?

A
  • malaise
  • anorexia
  • weight loss
  • fever
  • night sweats
  • chronic cough
91
Q

How many sputum samples must be positive for TB in order to support the diagnosis of TB?

A

3 consecutive morning sputum samples

92
Q

Why is it difficult to rely solely on cultures to diagnose TB?

A
  • they take 12 weeks to grow

- but DNA/RNA amplification is definitive for a diagnosis

93
Q

What therapy do you start TB patients on (6 month regiment)? How long does this last?

A
  • Daily INH, RIF, PZA, and ETH x 2 months

- You give this while you’re waiting for cultures to grow

94
Q

-After determining what TB cultures are susceptible to, how do you change TB therapy? (6-month therapy)

A
  • If susceptible to INH, stop ETH
  • If susceptible to INH and RIF, stop ETH and PZA
  • Continue INH and RIF x 4 months
95
Q

How long should you treat TB?

A

3 months past TB negative documentation

96
Q

What therapy do you start TB patients on (9 month regiment)?

A

-INH, RIF, and ETH for 4-8 weeks

97
Q

Why would you treat TB with a 9-month therapy, rather than 6-month therapy?

A

If the patient cannot take PZA (like if they’re pregnant)

98
Q

After determining what TB cultures are susceptible to, how do you change TB therapy? (9-month therapy)

A
  • If susceptible to INH and RIF, ETH may be stopped

- INH and RIF are then given biweekly for 9 months

99
Q

How should you treat a patient who’s clinically positive for TB but for whom the smears and cultures are negative?

A
  • INH, RIF, and PZA for 2 months

- INH and RIF for 4 additional months

100
Q

How do you treat drug-resistant TB?

A
  • 6 months of RIF, PZA, and ETH or STM

- Or 12 months of RIF and ETH

101
Q

Treatment of latent TB

A
  • INH for 9 months
  • RIF and PZA for 2 months
  • RIF for 4 months
102
Q

Although disseminated atypical mycobacterial disease is rare in most patients, it is more common in what type of patient?

A

AIDS patients

103
Q

What might you suspect if a patient presents with a chronic cough, sputum production, and fatigue, but no weight loss? On auscultation, you hear altered breath sounds?

A

Atypical mycobacterial disease

104
Q

How do you make a definitive diagnosis of atypical mycobacterial disease?

A
  • sputum cultures

- bronchial washings

105
Q

How would you treat an atypical mycobacterial disease with M. kansasii as the infecting agent?

A
  • Daily RIF, ISN, and ETH for 18 months

- must have a minimum of 12 months of (-) cultures

106
Q

What tissues can be affected by amebiasis?

A
  • colon

- liver

107
Q

Patient presents with bloody diarrhea, fever, and severe abdominal tenderness. You discover a hemorrhage upon colonoscopy. Diagnosis?

A

Severe colitis caused by amebiasis

108
Q

Patient presents with fever and severe abdominal pain. You palpate hepatomegaly and detect a hepatic abscess on imaging. Diagnosis?

A

Hepatic involvement of an amebiasis infection

109
Q

How do you treat an asymptomatic with an amebiasis infection?

A

-Diloxanide furoate x 10 days

110
Q

How do you treat a symptomatic amebiasis infection?

A
  • Metronidazole x 10 days

- Or Tinidazole x 3 days

111
Q

What parts of the body do hookworms affect?

A
  • the skin
  • pulmonary system
  • GI system
112
Q

How do hookworms make their way to the GI tract?

A
  • eggs hatch in soil and penetrate skin
  • they migrate to the pulmonary capillaries and penetrate the alveoli
  • cilia carry the worms to the mouth, where they’re swallowed and end up in the bowel
113
Q

Patient presents with a dry cough and low fever x 1 week. Now the patient has epigastric pain, anorexia, and diarrhea. Diagnosis?

A

Hookworms

114
Q

What blood test results might point you in the direction of a hookworm diagnosis?

A
  • protein malnutrition (hypoalbuminemia)
  • microcytic anemia
  • eosinophilia
115
Q

How do you treat a patient for hookworms?

A
  • Albendazole x 1 day, or

- Mebendazole x 3 days

116
Q

Patient presents with attacks of chills, fever, and sweating. Patient also experiencing myalgia, headache, and N/V. Diagnosis suspicion?

A

-Malaria

117
Q

Where do malaria parasites live?

A

In erythrocytes

118
Q

What is the most lethal organism causing malaria?

A

P. falciparum

119
Q

What physical exam signs might point toward malaria?

A
  • anemia
  • jaundice
  • organomegaly
120
Q

What lab stain would you use to screen for and/or identify malaria?

A

Giemsa stain

121
Q

When in doubt about the specific infecting organism, what drug would be the best bet to use to treat malaria?

A

-Chloroquine

122
Q

What is the most common intestinal nematode in the US?

A

-Pinworm (Enterobiasis)

123
Q

Child presents with peri-anal itching and insomnia. You find excoriations around the anus. What diagnosis do you suspect?

A

Pinworms

124
Q

What tool might you use to diagnose pinworms?

A

adhesive tape preparations used in the morning on the perianal area

125
Q

How do you treat pinworms?

A
  • Albendazole, Mebendazole, or Pyrantel 1 time

- Repeat after 2 weeks

126
Q

Child played with an outdoor cat and presented with fever, malaise, sore throat and noted lymphadenopathy. Diagnosis?

A

Toxoplasmosis via T. gondii parasite

127
Q

Toxoplasmosis can present in what 3 circumstances?

A
  • primary infection
  • congenital
  • in immunocompromised patients
128
Q

What is the most common CNS “lesion” in AIDS?

A

Toxoplasmosis

129
Q

Why are pregnant women not supposed to change kitty litter?

A

-Because there’s a chance they can get toxoplasmosis from coming into contact with T. gondii (cats are hosts)

130
Q

What sites does toxoplasmosis most commonly affect?

A
  • brain
  • liver
  • heart
  • lungs
  • eyes
131
Q

How can you diagnose toxoplasmosis?

A
  • trophozoites in blood, fluids, or tissues
  • PCR on serum
  • Antigen in serum
  • CT brain scan with multiple contrasts will enhance peripheral lesions
132
Q

If you are presented with a multiple-contrast CT brain scan with multiple peripheral lesions and are told that the patient recently ate undercooked pork, what diagnosis would you think of?

A

toxoplasmosis

133
Q

How long do you treat an immunocompromised patient with toxoplasmosis?

A

For 4-6 weeks after symptoms have resolved

134
Q

Patient presents with a target-like rash and headache after hiking in the woods in the upper midwest. Diagnosis?

A

-Lyme disease

135
Q

How might a patient with lyme disease present?

A
  • erythema migrans (target-like lesion that gets bigger)
  • HA
  • Stiff neck
  • Arthralgias, arthritis
  • Myalgias
136
Q

What infectious agent causes lyme disease?

A

Borrelia burgdorferia via an Ixodes tick

137
Q

How long do stage 2 (musculoskeletal, neurological and cardiac) symptoms of lyme disease usually last?

A

weeks to months

138
Q

What lab results would support a diagnosis of lyme disease?

A
  • Elevated ESR
  • Abnormal LFTs
  • Mild anemia
  • Leukocytosis
139
Q

How do you treat lyme disease?

A

-Doxycycline or Amoxicillin x 2-3 weeks

140
Q

Patient presents in delerium. Family says the patient experienced flu-like symptoms, fever, and a severe HA after hiking. Diagnosis?

A

Rocky Mountain Spotted Fever

141
Q

Where would you expect to find a Rocky Mountain Spotted Fever rash on day 2 of a patient’s symptoms?

A
  • On the wrists and ankles

- It will spread centrally

142
Q

About 1 week after exposure, how would you expect a patient with Rocky Mountain Spotted Fever to present?

A
  • fever
  • chills
  • HA
  • N/V
  • myalgias
  • restlessness
  • insomnia
  • irritability
  • neurologic symptoms
143
Q

Rocky Mountain Spotted Fever treatment

A
  • Doxycycline

- Chloramphenicol for pregnant women

144
Q

At a well-woman exam, you note inguinal lymphadenopathy that’s not tender at the beginning of your exam. During the pap smear, you note an painless ulcer with a clean base. Patient has no other symptoms. Diagnosis?

A

Primary Syphilis

145
Q

Patient acquired syphilis when on an overseas trip. He was prescribed Doxycycline x 14 days, but left his pills overseas after only 2 days of tx. He now presents with a rash on his feet, fever, eye pain, light sensitivity, and dark spots in his vision. Into what stage has he progressed?

A

Secondary syphilis

146
Q

Patient presents with signs of secondary syphilis including a rash on his feet, fever, eye pain, light sensitivity, and dark spots in his vision. What else can you expect to manifest as a result of secondary syphilis if he does not receive treatment?

A

-condylomata lata
-aseptic meningitis
-cranial nerve palsies
-nephrotic syndrome
(already experiencing uveitis)

147
Q

Patient presents with bone pain, areas of soft tissue inflammation, vision changes, muscle weakness, and loss of coordination. When asked about sexual history, he reports he noticed a non-painful ulcer on his penis about 2 years ago. Diagnosis?

A

Late (tertiary) syphilis

148
Q

Patient presents with signs of bone pain, areas of soft tissue inflammation, vision changes, muscle weakness, and loss of coordination. When asked about sexual history, he reports he noticed a non-painful ulcer on his penis about 2 years ago. What else should you work him up for?

A
  • mucous membrane and respiratory tract gummatous lesions
  • gummas of liver
  • uveitis
  • CVS (aortic regurg, aneurysm)
  • neurosyphilis
  • periostitis, osteitis, arthritis
149
Q

Tests to diagnose syphilis

A
  • non-treponemal test

- treponemal test

150
Q

During a routine physical, you note a non-tender ulcer at the base of the patient’s penis. What’s the best treatment?

A

-Penicillin G x 1 IM dose

151
Q

Treatment for latent late syphilis?

A
  • Penicillin G IM weekly x 3 weeks

- Doxycycline or Tetracycline x 28 days

152
Q

Treatment for tertiary syphillis with neurosyphilis?

A

-IV Pen G every 3-4 hours x 10-14 days

153
Q

3 types of cytomegalovirus classification

A
  • perinatal disease and CMV inclusion disease
  • disease in immunocompetent hosts
  • disease in IC hosts
154
Q

If pregnant mom has primary CMV infection, how likely is it that baby will be symptomatic with CMV inclusion disease?

A

10% chance

155
Q

Baby is born and appears jaundiced with microcephaly. Upon examination, you note hepatosplenomegaly, pupuric lesions, and motor disability. Diagnosis?

A

-Cytomegalovirus inclusion disease

156
Q

Baby is born and appears jaundiced with microcephaly. Upon examination, you note hepatosplenomegaly, pupuric lesions, and motor disability. Do you expect normal mental function?

A

No, mental retardation is likely

157
Q

Baby acquires CMV through breast-feeding. Should the mother be very worried?

A

No, infection acquired this way has a benign clinical course

158
Q

Baby is born symptomatic for CMV inclusion disease. What should you watch out for as the baby gets older?

A
  • neurological deficits

- hearing loss

159
Q

IC patient is diagnosed with mono, but the infection goes on to last 8 weeks. What is it likely that patient really had?

A

CMV infection

160
Q

Patient presents 6 weeks status post kidney transplant with fever, malaise, myalgias, and arthralgias. You note splenomegaly and abnormal LFTs. Diagnosis?

A
  • CMV disease in an immunocompromised host

- (patient has been on steroids)

161
Q

AIDS patient comes in for check-up and you note a CD-4 count < 50. Patient lives with a friend who has recently been diagnosed with a cytomegalovirus infection. What should you look out for?

A
  • CMV retinitis

- Also GI CMV, pulmonary CMV, and neurologic CMV (encephalitis)

162
Q

Therapy used to prevent CMV infection in an AIDS patient

A

-HAART (Highly Active Anti-Retroviral Therapy)

163
Q

CMV treatment

A

“-vir” antiviral agent

164
Q

16-yo patient presents with fever, fatigue, sore throat, anorexia, myalgia, and a rash on her belly. You note posterior cervical lymphadenopathy and splenomegaly. Diagnosis?

A

Epstein-Barr virus (infectious mononucleosis)

165
Q

You suspect infectious mononucleosis from Epstein-Barr viral infection. What lab/test findings would support this?

A
  • granulocytopenia
  • atypical lymphocytes
  • thrombocytopenia
  • (+) to a monospot test
166
Q

EBV treatment

A
  • 95% recover without therapy

- can treat the symptoms with NSAIDs and warm salt water gargles

167
Q

Mom brings child in with complaints of malaise and headache. Yesterday, she developed red spots on her cheeks that make her daughter look like she’s been slapped. Now there’s a “lacy” rash on her belly and back. What do you suspect?

A
  • Erythema infectiosum

- AKA “Fifth disease”

168
Q

Erythema infectiosum (Fifth disease) infectious agent?

A

Parvovirus B19

169
Q

Why would you not want a child with Fifth Disease to be around an AIDS patient?

A
  • If the AIDS patient “catches” it, he can develop aplastic crisis
  • Caused by pure RBC aplasia in which the bone marrow stops producing RBCs
170
Q

Erythema infectiosum (Fifth disease) treatment

A

-Just supportive care like NSAIDs

171
Q

Dendritic ocular HSV ulcers stain with what?

A

Flourescein

172
Q

Female presents with urinary retention, dysuria, and painful ulcers on her labia. You note cervicitis on PE. Diagnosis?

A

HSV-2

173
Q

When HSV causes encephalitis, what lobes of the brain are often affected?

A

Temporal lobes

174
Q

In what circumstances would you need to treat HSV infection with IV acyclovir?

A
  • if it’s a neonatal infection

- if it’s caused encephalitis

175
Q

Treatment of Bell’s Palsy caused by HSV

A

Prednisolone

176
Q

When does an HIV-infected person have AIDS?

A

-When they’re symptomatic and have a CD-4 lymphocyte count < 200/uL

177
Q

What’s a normal CD4 count in an unaffected patient?

A

600-1200 cells/mm3

178
Q

What’s a normal CD4 count in a patient with HIV?

A

> 500 cells/mm3

179
Q

What test is used for HIV screening?

A

ELISA

180
Q

How do you confirm a diagnosis of HIV?

A

Western blot

181
Q

When do you initiate antiretroviral therapy for HIV treatment?

A

When the CD-4 count drops below 500

182
Q

HPV strains responsible for external genital warts?

A

6 and 11

183
Q

HPV strains responsible for cervical dysplasia?

A

16, 18, 31, 33, 35

184
Q

Most commonly transmitted STD in the US

A

HPV

185
Q

Patient presents with fever, chills, malaise, myalgias, and a HA that he thinks is due to his nasal stuffiness. Diagnosis?

A

Influenza

186
Q

What signs would you look for when suspecting influenza diagnosis?

A
  • mild pharyngeal injection
  • flushed face
  • conjunctival redness
  • cervical lymphadenopathy
187
Q

Influenza treatment

A
  • Amantadine/Rimantadine
  • Oral Oseltamivir (Tamiflu)
  • Inhaled Zanamivir (Relenza)
  • bed rest, fluids, NSAIDs, ribavirin
188
Q

8-yo patient presents with a “swollen cheek” and enlarged testicles. Suspicion?

A

Mumps

189
Q

How do you treat Mumps

A
  • Isolation
  • Bed rest
  • Symptomatic treatment
190
Q

Patient got bitten by a raccoon when cleaning under his house. Presents with pain at the bite site, fever, HA, and N/V. What is he experiencing?

A

Rabies prodrome

191
Q

How do you treat a person with rabies?

A
  • HDCV (human diploid cell vaccine) IM on day 0, 3, 7, and 14
  • Add an injection on day 28 for IC patients
192
Q

How long would you expect a person to live after becoming symptomatic with rabies (if not treated)?

A

7 days or so

193
Q

Most common infectious exanthem in the first 2 years of life

A

Roseola

194
Q

Roseola causative agent

A

Human Herpes Virus 6

195
Q

Mom brings infant in with c/o fever/irritability x 4 days. Fever broke this morning and baby developed a rash on his belly. The rash looks like it’s spreading outward and doesn’t seem to itch. Diagnosis?

A

Roseola

196
Q

Patient presents with a rash that started on his face and progressed to his trunk and extremities. Before the rash, he had a fever and noticed “knots” on the back his neck. Diagnosis?

A
  • the “knots” were postcervical swollen lymph nodes

- He has Rubella

197
Q

Describe the rash associated with Rubella

A
  • starts on face

- progresses to trunk and then to extremities

198
Q

German measles

A

Rubella

199
Q

Pregnant patient has been reading online about Rubella and is asking about the vaccination. She was home schooled and received no vaccinations as a child. Should you vaccinate her now?

A

No. The Rubella vaccine has a live virus. Have her be careful not to be around infected patients and to receive the vaccination after she gives birth.

200
Q

Patient presents with c/o cold-like symptoms, redness of the eyes, and a cough for the past 4 days. She felt better as of last night, but now notices a rash that started on her face and is traveling “downward and outward”. You note white lesions on the inside of her cheeks. Diagnosis? Why?

A
  • Measles
  • She has the “Three C’s” of Coryza, Conjunctivitis, and Cough”
  • White buccal lesions are Koplik spots
201
Q

What should you think if you see white buccal lesions in a patient?

A
  • Rubella

- Measles (Rubeola)

202
Q

What are the white buccal lesions called that are associated with Rubella and Measles?

A

Koplik spots

203
Q

How would you describe the initial lesions of varicella?

A

Vesicular lesions that look like “Dewdrops on rose petal”

204
Q

Virus responsible for chicken pox

A

HHV-3

205
Q

Varicella-zoster treatment

A

-Acyclovir

206
Q

Why should you be particularly concerned when a patient has herpes zoster on their face?

A

Involvement of the trigeminal nerve can lead to blindness if the opthalmic branch if affect

Clin Med II (9 decks)

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