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
2
Q
What infectious should you think of if a patient has been on broadspectrum antibiotic therapy and is a female?
A
Candida albicans
3
Q
Involvement of what tissue is most significant in the development of mucosal candidiasis?
A
esophagus
4
Q
Mucosal candidiasis treatment
A
- Oral fluconazole
- IV voriconazole
5
Q
Patient presents with pruritis in genital area, white-curdy discharge, and complaints of dyspareunia. Diagnosis?
A
vulvovaginal candidiasis
6
Q
vulvovaginal candidiasis treatment
A
- Topical clotrimazole vaginal table
- Miconazole suppository
- fluconazole
7
Q
Most common cause of fungal meningitis
A
cryptococcosis
8
Q
Tools used for diagnosing cryptococcosis
A
- india ink
- serum antigen
9
Q
Patient presents with severe headache, stiff neck, and altered mental status. History reveals the pt was taking prednisone. Diagnosis?
A
Fungal meningitis
10
Q
Patient presents with stiff neck and severe headache after working in the garden all day. Diagnosis?
A
Meningitis from cryptococcus neoformans
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
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
13
Q
Cryptococcosis meningitis tx
A
- Amphotericin B x 14 days
- Then fluconazole x 8 weeks
14
Q
Patient presents with URI after cave spelunking along the Ohio River. Likely infecting organism?
A
Histoplasmosis (Histoplasma capsulatum)
15
Q
Primary problem with histoplasmosis infection
A
Respiratory illness
16
Q
Presentation of histoplasmosis infection
A
- mild flu-like illness
- if severe: fever, cough, mild chest pain
17
Q
Tx for progressive localized histoplasmosis infection
A
-itraconazole
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
19
Q
At what point would you decide to prophylactically treat against pneumocystosis in an AIDS patient?
A
When CD4 cells drop <200
20
Q
Most common opportunistic infection in an AIDS patient
A
Pneumocystosis (pneumocystis jiroveci)
21
Q
Patient presents with nonproductive cough and fever. You find an isolated increased in LDH on their lab results. Diagnosis?
A
Pneumocystosis
22
Q
Pneumocystosis treatment
A
- Trimethoprim0sulfamethoxazole x 14-21 days
- Clindamycin + Primaquine
- Prednisone if PaO2 < 70mmHg
23
Q
Acute rheumatic fever can follow an infection of what pathogen?
A
S. pyogenes (GAS)
24
Q
In what patient population is acute rheumatic fever most common?
A
Children 5-15 years
25
What tissues does acute rheumatic fever affect?
- heart
- joints
- skin
- brain
26
Describe the pathophysiology of acute rheumatic fever
- the body is infected with some GAS organism
- we produce antibodies in response to the infection
- then the antibodies react to our own tissues
27
Acute rheumatic fever treatment
- ASA
- steroids (only if the heart is involved)
- penicillin
- erythromycin
28
Patient presents with diplopia, dry mouth, dysphonia, dysphagia, and muscle weakness. What relevant history would you ask about?
- if the patient had recently ingested home-canned or smoked foods
- or about injection drug use
29
If untreated, what can botulism progress to?
Respiratory paralysis
30
What nerves does Clostridium botulinum affect?
The cranial nerves
31
What does Clostridium botulinum's toxin do in the body?
Blocks acetylcholine release
32
Three types of botulism
- food-borne from canned, smoked, or vacuum-packed food
- infant < 1 year from honey
- wound from injection drug use
33
How would you differentiate between botulism and Guillain-Barre syndrome?
Guillain-Barre' syndrome involves peripheral neuropathy, while botulism involves palsy of cranial nerves (dysphagia, diplopia, dysphonia, etc.)
34
How do you treat botulism?
- Antitoxin (BIG)
| - Intubation if patient is in respiratory failure
35
Three disease states that Chlamydia trachomatis can cause
- Lymphogranuloma venereum
- Chlamydial urethritis
- Chlamydial cervicitis
36
Presentation of lymphogranuloma venereum
- evanescent primary genital lesion
- lymphadenopathy
- proctitis (rectal inflammation)
- rectal stricture
37
Chlamydia trachomatis incubation period
5-21 days
38
Female patient presents with proctitis, tenesmus, and bloody discharge. Diagnosis?
Chlamydia lymphogranuloma venerum
39
Chlamydia lymphogranuloma venerum tx options
-Doxycycline x 21 days
-Erythromycin x 21 days
Azithromycin x 3 weeks
40
How would you expect a patient with chlamydia urethritis or cervicitis to present?
- possibly burning with urination
- nonpurulent and non-painful discharge
- possible S&S of cervicitis, salpingitis, or PID
41
Clamydia urethritis/cervicitis treatment
- Single dose of Azithromycin
- Doxycycline x 7days
- Levofloxacin x 7 days
42
How long should a patient being treated for chlamydial urethritis/cervicitis wait to have intercourse?
5 days
43
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?
Cholera
44
If you suspect a diagnosis of cholera, what relevant history should you ask about?
History of travel or contact with an infected individual
45
What disease may occur in times of overcrowding or war when sanitation is inadequate?
Cholera
46
Cholera treatment
- replace fluids
| - tetracycline, ampicillin, bactrim, chloramphenicol, fluoroquinolones, azithromycin antibiotics
47
Patient presents with a sore throat, hoarseness, and a gray color on the back of the throat. Diagnosis?
Diptheria
48
What is an essential finding when considering a diagnosis of Diptheria?
Tenacious gray membrane at the portal of entry in the pharynx
49
What part of the body does Corynebacterium diptheria attack?
The respiratory tract
50
In addition to the respiratory tract, what other parts of the body can be affected by diptheria?
The exotoxin causes myocarditis and neuropathy
51
What nerves does diptheria's exotoxin "hit" first?
The cranial nerves (diplopia, slurred speech, dysphagia)
52
Diptheria treatment
- Antitoxin
- membrane removal
- Penicillin or Erythromycin x 14 days
53
Patient presents with a white discharge that turns yellow and dysuria. On a smear, you see gram (-) intracellular diplococci. Diagnosis?
Gonococcal urethritis or cervicitis
54
Incubation period for Neisseria gonorrhea
2-8 days
55
What can a gonococcal infection cause?
- urethritis
- cervicitis
- disseminated disease
- conjunctivitis
56
What is the discharge like that's associated with gonococcal urethritis?
- serious and milky
| - progresses to yellow and creamy
57
How may a female with gonococcal cervicitis present?
- dysuria
- increased frequency and urgency
- purulent discharge
58
Patient presents with arthralgia, fever, and a red rash on the extremities. Beginning to display signs of tenosynovitis. Diagnosis?
Disseminated Gonoccal Disease
59
Common complications of disseminated gonococcal disease
- arthritis
| - tenosynovitis
60
Gonococcal conjunctivitis treatment
Ceftriaxone 1g treatment
61
Treatment options for gonococcal urethritis or cervicitis
- 1 treatment of:
- Ceftriaxone
- Cefixime, or
- Spectinomycin
62
Pharyngeal gonococcal treatment
- IM ceftriaxone x 1 day
| - Bactrim x 5 day
63
Treatment options for gonococcal infection with coexisting chlamydia
- Doxycycline x 7 days
| - Azithromycin x 1 day
64
Three types of salmonella
- enteric (Typhoid) fever
- gastroenteritis
- bactermeia
65
Patient presents with headache, N/V, and abdominal pain. You discover rose spots, splenomegaly, and bradycardia. Diagnosis?
-Enteric (Typhoid) fever from salmonella
66
Characteristic diagnostic finding for enteric (typhoid) fever?
Bradycardia
67
Salmonella incubation period
5-14 days
68
How does salmonella travel into the bloodstream?
- 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
69
What effects does enteric (typhoid) fever have on the bowels?
-initially the patient is constipated, but this develops into "pea-soup" diarrhea
70
"Pea soup" diarrhea is characteristic of what?
Enteric (Typhoid) fever
71
How long should it take for you to see improvement in a patient with Typhoid fever?
7-10 days
72
After the prodromal phase of typhoid fever (malaise, HA, cough, N/V), how does it progress?
- "Pea soup" diarrhea
- splenomegaly
- abdominal distention/tenderness
- bradycardia
- rose spot rash on the trunk
73
What lab findings support a diagnosis of typhoid fever?
Blood culture positive for salmonella
74
Typhoid fever treatment
- ampicillin, cipro, or levofloxacin
- Azithromycin
- Chloramphenicol or bactrim for resistant strains
75
What treatment would you give to a typhoid fever carrier?
- Ciprofoxacin x 4 weeks
| - cholesystecomy?
76
How would a patient with salmonella gastroenteritis present?
- fever w/ chills
- N/V
- abdominal cramping
- possibly bloody diarrhea
77
Salmonella gastroenteritis treatment
- usually self-limiting
| - Bactrim or Ampicillin
78
Patient presents with bloody and mucoid diarrhea and looks toxic. What would you culture the stool for?
Shigella and WBCs
79
Shigella treatment
- Bactrim x 7-10 days
- Ciprofloxacin x 7-10 days
- Levofloxacin x 3 days
80
Patient presents with dysphagia, a stiff neck, and hyperreflexia with occassional painful convulsions. Diagnosis?
-Tetanus
81
What causes tetanus?
the neurotoxin from Clostridium tetani
82
Patient steps on a rusty nail. What should they look for as early signs of tetanus?
- Stiff jaw and neck
- dysphagia
- irritability
- spasticity of muscles near the wound site
83
How would you treat a patient with tetanus?
- 500 units of TIG IM within 24 hours
- Full course of immunizations upon recovery
- daily dose of PCN to eradicate it
84
If you suspect a patient has TB, what should you look for on a phlegm smear?
-Acid fast bacilli
85
Does the majority of active TB come from primary response or latent/reactivation TB?
Latent or reactivation TB
86
Describe the primary response of TB
- 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
If a patient isn't treated with Isoniazid, what's the chance that their TB will reactivate?
6% chance
88
When does most TB reactivation occur?
In the first 2 years
89
Patient presents with malaise, anorexia, fever, weight loss, and night sweats. He has a chronic cough, as well. Diagnosis?
TB
90
S & S of TB?
- malaise
- anorexia
- weight loss
- fever
- night sweats
- chronic cough
91
How many sputum samples must be positive for TB in order to support the diagnosis of TB?
3 consecutive morning sputum samples
92
Why is it difficult to rely solely on cultures to diagnose TB?
- they take 12 weeks to grow
| - but DNA/RNA amplification is definitive for a diagnosis
93
What therapy do you start TB patients on (6 month regiment)? How long does this last?
- Daily INH, RIF, PZA, and ETH x 2 months
| - You give this while you're waiting for cultures to grow
94
-After determining what TB cultures are susceptible to, how do you change TB therapy? (6-month therapy)
- If susceptible to INH, stop ETH
- If susceptible to INH and RIF, stop ETH and PZA
- Continue INH and RIF x 4 months
95
How long should you treat TB?
3 months past TB negative documentation
96
What therapy do you start TB patients on (9 month regiment)?
-INH, RIF, and ETH for 4-8 weeks
97
Why would you treat TB with a 9-month therapy, rather than 6-month therapy?
If the patient cannot take PZA (like if they're pregnant)
98
After determining what TB cultures are susceptible to, how do you change TB therapy? (9-month therapy)
- If susceptible to INH and RIF, ETH may be stopped
| - INH and RIF are then given biweekly for 9 months
99
How should you treat a patient who's clinically positive for TB but for whom the smears and cultures are negative?
- INH, RIF, and PZA for 2 months
| - INH and RIF for 4 additional months
100
How do you treat drug-resistant TB?
- 6 months of RIF, PZA, and ETH or STM
| - Or 12 months of RIF and ETH
101
Treatment of latent TB
- INH for 9 months
- RIF and PZA for 2 months
- RIF for 4 months
102
Although disseminated atypical mycobacterial disease is rare in most patients, it is more common in what type of patient?
AIDS patients
103
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?
Atypical mycobacterial disease
104
How do you make a definitive diagnosis of atypical mycobacterial disease?
- sputum cultures
| - bronchial washings
105
How would you treat an atypical mycobacterial disease with M. kansasii as the infecting agent?
- Daily RIF, ISN, and ETH for 18 months
| - must have a minimum of 12 months of (-) cultures
106
What tissues can be affected by amebiasis?
- colon
| - liver
107
Patient presents with bloody diarrhea, fever, and severe abdominal tenderness. You discover a hemorrhage upon colonoscopy. Diagnosis?
Severe colitis caused by amebiasis
108
Patient presents with fever and severe abdominal pain. You palpate hepatomegaly and detect a hepatic abscess on imaging. Diagnosis?
Hepatic involvement of an amebiasis infection
109
How do you treat an asymptomatic with an amebiasis infection?
-Diloxanide furoate x 10 days
110
How do you treat a symptomatic amebiasis infection?
- Metronidazole x 10 days
| - Or Tinidazole x 3 days
111
What parts of the body do hookworms affect?
- the skin
- pulmonary system
- GI system
112
How do hookworms make their way to the GI tract?
- 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
Patient presents with a dry cough and low fever x 1 week. Now the patient has epigastric pain, anorexia, and diarrhea. Diagnosis?
Hookworms
114
What blood test results might point you in the direction of a hookworm diagnosis?
- protein malnutrition (hypoalbuminemia)
- microcytic anemia
- eosinophilia
115
How do you treat a patient for hookworms?
- Albendazole x 1 day, or
| - Mebendazole x 3 days
116
Patient presents with attacks of chills, fever, and sweating. Patient also experiencing myalgia, headache, and N/V. Diagnosis suspicion?
-Malaria
117
Where do malaria parasites live?
In erythrocytes
118
What is the most lethal organism causing malaria?
P. falciparum
119
What physical exam signs might point toward malaria?
- anemia
- jaundice
- organomegaly
120
What lab stain would you use to screen for and/or identify malaria?
Giemsa stain
121
When in doubt about the specific infecting organism, what drug would be the best bet to use to treat malaria?
-Chloroquine
122
What is the most common intestinal nematode in the US?
-Pinworm (Enterobiasis)
123
Child presents with peri-anal itching and insomnia. You find excoriations around the anus. What diagnosis do you suspect?
Pinworms
124
What tool might you use to diagnose pinworms?
adhesive tape preparations used in the morning on the perianal area
125
How do you treat pinworms?
- Albendazole, Mebendazole, or Pyrantel 1 time
| - Repeat after 2 weeks
126
Child played with an outdoor cat and presented with fever, malaise, sore throat and noted lymphadenopathy. Diagnosis?
Toxoplasmosis via T. gondii parasite
127
Toxoplasmosis can present in what 3 circumstances?
- primary infection
- congenital
- in immunocompromised patients
128
What is the most common CNS "lesion" in AIDS?
Toxoplasmosis
129
Why are pregnant women not supposed to change kitty litter?
-Because there's a chance they can get toxoplasmosis from coming into contact with T. gondii (cats are hosts)
130
What sites does toxoplasmosis most commonly affect?
- brain
- liver
- heart
- lungs
- eyes
131
How can you diagnose toxoplasmosis?
- trophozoites in blood, fluids, or tissues
- PCR on serum
- Antigen in serum
- CT brain scan with multiple contrasts will enhance peripheral lesions
132
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?
toxoplasmosis
133
How long do you treat an immunocompromised patient with toxoplasmosis?
For 4-6 weeks after symptoms have resolved
134
Patient presents with a target-like rash and headache after hiking in the woods in the upper midwest. Diagnosis?
-Lyme disease
135
How might a patient with lyme disease present?
- erythema migrans (target-like lesion that gets bigger)
- HA
- Stiff neck
- Arthralgias, arthritis
- Myalgias
136
What infectious agent causes lyme disease?
Borrelia burgdorferia via an Ixodes tick
137
How long do stage 2 (musculoskeletal, neurological and cardiac) symptoms of lyme disease usually last?
weeks to months
138
What lab results would support a diagnosis of lyme disease?
- Elevated ESR
- Abnormal LFTs
- Mild anemia
- Leukocytosis
139
How do you treat lyme disease?
-Doxycycline or Amoxicillin x 2-3 weeks
140
Patient presents in delerium. Family says the patient experienced flu-like symptoms, fever, and a severe HA after hiking. Diagnosis?
Rocky Mountain Spotted Fever
141
Where would you expect to find a Rocky Mountain Spotted Fever rash on day 2 of a patient's symptoms?
- On the wrists and ankles
| - It will spread centrally
142
About 1 week after exposure, how would you expect a patient with Rocky Mountain Spotted Fever to present?
- fever
- chills
- HA
- N/V
- myalgias
- restlessness
- insomnia
- irritability
- neurologic symptoms
143
Rocky Mountain Spotted Fever treatment
- Doxycycline
| - Chloramphenicol for pregnant women
144
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?
Primary Syphilis
145
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?
Secondary syphilis
146
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?
-condylomata lata
-aseptic meningitis
-cranial nerve palsies
-nephrotic syndrome
(already experiencing uveitis)
147
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?
Late (tertiary) syphilis
148
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?
- mucous membrane and respiratory tract gummatous lesions
- gummas of liver
- uveitis
- CVS (aortic regurg, aneurysm)
- neurosyphilis
- periostitis, osteitis, arthritis
149
Tests to diagnose syphilis
- non-treponemal test
| - treponemal test
150
During a routine physical, you note a non-tender ulcer at the base of the patient's penis. What's the best treatment?
-Penicillin G x 1 IM dose
151
Treatment for latent late syphilis?
- Penicillin G IM weekly x 3 weeks
| - Doxycycline or Tetracycline x 28 days
152
Treatment for tertiary syphillis with neurosyphilis?
-IV Pen G every 3-4 hours x 10-14 days
153
3 types of cytomegalovirus classification
- perinatal disease and CMV inclusion disease
- disease in immunocompetent hosts
- disease in IC hosts
154
If pregnant mom has primary CMV infection, how likely is it that baby will be symptomatic with CMV inclusion disease?
10% chance
155
Baby is born and appears jaundiced with microcephaly. Upon examination, you note hepatosplenomegaly, pupuric lesions, and motor disability. Diagnosis?
-Cytomegalovirus inclusion disease
156
Baby is born and appears jaundiced with microcephaly. Upon examination, you note hepatosplenomegaly, pupuric lesions, and motor disability. Do you expect normal mental function?
No, mental retardation is likely
157
Baby acquires CMV through breast-feeding. Should the mother be very worried?
No, infection acquired this way has a benign clinical course
158
Baby is born symptomatic for CMV inclusion disease. What should you watch out for as the baby gets older?
- neurological deficits
| - hearing loss
159
IC patient is diagnosed with mono, but the infection goes on to last 8 weeks. What is it likely that patient really had?
CMV infection
160
Patient presents 6 weeks status post kidney transplant with fever, malaise, myalgias, and arthralgias. You note splenomegaly and abnormal LFTs. Diagnosis?
- CMV disease in an immunocompromised host
| - (patient has been on steroids)
161
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?
- CMV retinitis
| - Also GI CMV, pulmonary CMV, and neurologic CMV (encephalitis)
162
Therapy used to prevent CMV infection in an AIDS patient
-HAART (Highly Active Anti-Retroviral Therapy)
163
CMV treatment
"-vir" antiviral agent
164
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?
Epstein-Barr virus (infectious mononucleosis)
165
You suspect infectious mononucleosis from Epstein-Barr viral infection. What lab/test findings would support this?
- granulocytopenia
- atypical lymphocytes
- thrombocytopenia
- (+) to a monospot test
166
EBV treatment
- 95% recover without therapy
| - can treat the symptoms with NSAIDs and warm salt water gargles
167
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?
- Erythema infectiosum
| - AKA "Fifth disease"
168
Erythema infectiosum (Fifth disease) infectious agent?
Parvovirus B19
169
Why would you not want a child with Fifth Disease to be around an AIDS patient?
- 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
Erythema infectiosum (Fifth disease) treatment
-Just supportive care like NSAIDs
171
Dendritic ocular HSV ulcers stain with what?
Flourescein
172
Female presents with urinary retention, dysuria, and painful ulcers on her labia. You note cervicitis on PE. Diagnosis?
HSV-2
173
When HSV causes encephalitis, what lobes of the brain are often affected?
Temporal lobes
174
In what circumstances would you need to treat HSV infection with IV acyclovir?
- if it's a neonatal infection
| - if it's caused encephalitis
175
Treatment of Bell's Palsy caused by HSV
Prednisolone
176
When does an HIV-infected person have AIDS?
-When they're symptomatic and have a CD-4 lymphocyte count < 200/uL
177
What's a normal CD4 count in an unaffected patient?
600-1200 cells/mm3
178
What's a normal CD4 count in a patient with HIV?
>500 cells/mm3
179
What test is used for HIV screening?
ELISA
180
How do you confirm a diagnosis of HIV?
Western blot
181
When do you initiate antiretroviral therapy for HIV treatment?
When the CD-4 count drops below 500
182
HPV strains responsible for external genital warts?
6 and 11
183
HPV strains responsible for cervical dysplasia?
16, 18, 31, 33, 35
184
Most commonly transmitted STD in the US
HPV
185
Patient presents with fever, chills, malaise, myalgias, and a HA that he thinks is due to his nasal stuffiness. Diagnosis?
Influenza
186
What signs would you look for when suspecting influenza diagnosis?
- mild pharyngeal injection
- flushed face
- conjunctival redness
- cervical lymphadenopathy
187
Influenza treatment
- Amantadine/Rimantadine
- Oral Oseltamivir (Tamiflu)
- Inhaled Zanamivir (Relenza)
- bed rest, fluids, NSAIDs, ribavirin
188
8-yo patient presents with a "swollen cheek" and enlarged testicles. Suspicion?
Mumps
189
How do you treat Mumps
- Isolation
- Bed rest
- Symptomatic treatment
190
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?
Rabies prodrome
191
How do you treat a person with rabies?
- HDCV (human diploid cell vaccine) IM on day 0, 3, 7, and 14
- Add an injection on day 28 for IC patients
192
How long would you expect a person to live after becoming symptomatic with rabies (if not treated)?
7 days or so
193
Most common infectious exanthem in the first 2 years of life
Roseola
194
Roseola causative agent
Human Herpes Virus 6
195
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?
Roseola
196
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?
- the "knots" were postcervical swollen lymph nodes
| - He has Rubella
197
Describe the rash associated with Rubella
- starts on face
| - progresses to trunk and then to extremities
198
German measles
Rubella
199
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?
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
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?
- Measles
- She has the "Three C's" of Coryza, Conjunctivitis, and Cough"
- White buccal lesions are Koplik spots
201
What should you think if you see white buccal lesions in a patient?
- Rubella
| - Measles (Rubeola)
202
What are the white buccal lesions called that are associated with Rubella and Measles?
Koplik spots
203
How would you describe the initial lesions of varicella?
Vesicular lesions that look like "Dewdrops on rose petal"
204
Virus responsible for chicken pox
HHV-3
205
Varicella-zoster treatment
-Acyclovir
206
Why should you be particularly concerned when a patient has herpes zoster on their face?
Involvement of the trigeminal nerve can lead to blindness if the opthalmic branch if affect
