INFECTIOUS DISEASE

Question 1

HIV attacks what type of cells?

Answer 1

CD4

Question 2

How do we workup HIV/AIDS?

Answer 2

ELISA, if positive get a western blot
 
HIV antigen/antibody testing
 
Check viral load (early on it will be high)

Question 3

How do we treat HIV/AIDS?

Answer 3

NRTI’s and antiretroviral drug

Question 4

If the CD4 count gets below 100, what should we worry about and what do we treat with?

Answer 4

Toxoplasmosis

PPX treat with trimethoprim/sulfamethoxazole

Question 5

If the CD4 count gets below 50, what should we worry about and what do we treat with?

Answer 5

MAC (also at risk for CMV)

Ppx treat with azith or clarithro

Question 6

If the CD4 count gets below 200, what should we worry about? Especially if our HIV/AIDS pt has a fever, cough, and dyspnea?

Answer 6

Pneumocystis (caused by pneumocystis jirovecii – fungal infection)

Question 7

How do we workup pneumocystis?

Answer 7

CXR for bilateral intersitial infiltrates

Sputum stains

Question 8

How do we treat pneumocystis?

Answer 8

Trimethoprim/sulfamethoxazole

Question 9

What are the main types that cause HPV to become cancerous?

Answer 9

strains 16 & 18

Question 10

How would a pt with mono present?

Answer 10

Fever, malaise, pharyngitis, and tender POSTERIOR cervical nodes

Diffuse morbilliform rash (after amox or ampicillin is given)

Splenomegaly

Palatal petechiae

Question 11

How do we confirm diagnosis of EBV?

Answer 11

+ heterophil test

Question 12

What should we remember about the treatment for EBV?

Answer 12

Athletes should wait 4 weeks to return to activity due to splenomegaly

Question 13

What fungus can be lethal to HIV/AIDS pts that grows in the soil contaminated with bird/bat droppings?

Answer 13

Histoplasmosis

Question 14

What is budding yeast found in dried pigeon poop?

Answer 14

Cryptococcus

Question 15

India ink staining can be used to identify what type of fungus?

Answer 15

Cryptococcosis

Question 16

How do we treat cryptococcosis?

Answer 16

Fluconazole

Question 17

What can clostridium tetani lead to?

Answer 17

Tetanus and trismus (lock jaw)

Question 18

How do we treat acute tetanus?

Answer 18

Tetanus IG and immunization
 
(IG with wound if less than 3 vaccinations; vaccination indicated if last vaccine over 5 years ago)

 *Unless it’s a clean wound only give vaccine if it was more than 10 years ago
 
Metronidazole
 
Benzos

Question 19

How do we prophylactically treat for tetanus?

Answer 19

Less than 7 give DTap
 
Over 7 give TDap
 
Td given if recently received TDap

Question 20

Pea soup diarrhea is associated with what?

Answer 20

Salmonella

Question 21

How many days can Salmonella last for?

Answer 21

7-10

Question 22

How do you treat Salmonella?

Answer 22

Ampicillin, TMP-SMX (increasing resitance to these)

Ceftriaxone x 2 weeks

Question 23

What’s the MC form of a salmonella infection?

Answer 23

Gastroenteritis

Incubation period is 8-48 hours, can last up to 3-5 days

Question 24

If a pt has abrupt onset of diarrhea, cramping, fevers, and stools with blood and mucous – what do you think of?

Answer 24

Shigellosis

Question 25

How do you diagnose shigellosis?

Answer 25

Stool positive for leukocytes and RBC’s – culture*

Question 26

How do you treat shigellosis?

Answer 26

TMP-SMX; replace fluids

Question 27

What type of HPV causes warts?

Answer 27

6 and 11

Question 28

Who is the HPV vaccine recommended for?

Answer 28

Men and Women ages 11 and 12; up to 26

Question 29

How do we treat histoplasmosis?

Answer 29

Itrocanozole

Question 30

What’s the first immunization a child gets?

Answer 30

Hep B at birth

Question 31

If you suspect a pt has cellulitis but there is also drainage, how should you treat and what are you covering for?

Answer 31

Cover for MRSA with clinda, TMP-SMX, or doxy
 
If resistence in the area do Vancomycin
 
Duration = 7 days (up to 14 days)

Question 32

how do you treat cellulitis without drainage?

Answer 32

clinda, cephalexin, or dicloxacillin