Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations of Clinical Practice II > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Fever of Unknown Origin (FUO): criteria

A
  1. Fever >38.3 C (100.9 F)
  2. 3 + weeks
  3. No other diagnosis for 3 outpatient visits (or 3 days in the hospital)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

FUO: common etiologies (3)

A
  1. Infection
  2. Malignancy
  3. Connective tissue disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FUO: name 3 less common infectious reasons

A
  1. Intra-abdominal abscesses
  2. Osteomyelitis
  3. Tuberculosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

FUO: name 4 malignancies

A
  1. Hepatocellular carcinoma
  2. Leukemia
  3. Lymphoma (NHL)
  4. Renal cell carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

FUO: systemic inflamatory causes

A
  • Giant cell arteritis

- Polyarteritis nodosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FUO: management

A
  • Refer to infectious disease

- Consider admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Staphylococcal infection

A
  • Nose (main site of colonization)
  • 3 major species (Staph aureus, Staph epidermitis, Staph saprophyticus)
  • Coagulase postive (staph aureus)
  • Beta-hemolytic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Staphylococcus epidermitis

A
  • coagulase negative
  • frequent skin contaminant on blood cultures
  • LOVES to grow on catheters, IV lines, prosthetic joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Staphylococcus saprophyticus

A
  • coagulase negative
  • Leading UTI cause
  • lives in female genital tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Toxic Shock syndrome

A
  • Staph aureus
  • “super antigens”
  • abrupt high fever, vomiting, watery diarrhea, rash, conjunctivitis, desquamation of the palms and soles*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Toxic Shock syndrome: Empiric Treatment

A

Clindamycin + Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Staph Scalded Skin Syndrome (SSSS)

A
  • affects neonates 3-15 days old
  • loss of cell-to-cell adhesions leading to intra-epidermal splitting
  • erythematous patches with large superficial fragile blisters**
  • Nikolsky sign*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Staph Scalded Skin Syndrome: treatment

A

Penicillin-ase resistant beta-lactam

if no response –>Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes anthrax?

A

Bacillus anthracis

  • gram-positive rod
  • spores
  • GI tract, skin, inhalation*, direct injection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most common form of anthrax

A

cutaneous

  • small, painless, pruritic papules that turn into vesicles/bulla –>leave painless necrotic ulcer with black, depressed eschar**
  • Edema + lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anthrax inhalation clinical course

A
  • spores phagocytosed and transported to mediastinal lymph nodes
  • Spores germinate and release toxins
  • Toxins cause hemorrhagic necrosis of thoracic lymph nodes (hemoptysis)
  • Fulminant is fatal (usually)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anthrax: CXR

A

Widened mediastinum (opacity around the hilar lymph nodes)**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you test for anthrax?

A

Report to public health/Send em to CDC!

culture, immunohistochemical staining, molecular testing ex. ELISA, lumbar puncture if concerned for meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How many samples need to be taken from a cutaneous anthrax lesion?

A

2

  • Swab for gram stain
  • Swab for PCR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anthrax: cutaneous treatment

A

Ciprofloxacin/Levofloxacin

or doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment for people exposed to aerosolized Bacillus anthracis

A
  1. Ciprofloxacin
    - start within 48 hours
    - 60 days of treatment
  2. Anthrax vaccine (3 dose)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rabies: cause

A

rhabdovirus (RNA virus)

  • travels along nerves to brain
  • multiplies in brain
  • travels along efferent nerves to salivary glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Rabies: clinical presentation

A
  1. Pain/parethesias radiating proximally
  2. Percussion myoedema (mounding of the muscle at percussion site)
  3. CNS
    - “furious” - encephalitic (80%)
    - “dumb” - paralytic (20%), kinda like guillan-barre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Rabies: Treatment

A
  • Immuneglobulin

- Rabies vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Zika: cause

A

flavivirus (arthropod–borne virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Zika transmission

A
  1. Aedes mosquito
  2. Sexual transmission
  3. Vertical transmission
  4. Blood product transfusion/organ transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Zika diagnostics

A

Viral RNA or IgM

PCR blood or urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When do you test asymptomatic pregnant women for zika

A

-Look for IgM 2-12 weeks after they travel to endemic area
or
sexual contact with person with confirmed zika infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Zika virus: monitoring of pregnancy

A

US every 3-4 weeks (congenital microcephaly)

complications: meningoencephalitis!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Legionella: etiology

A

Legionella pneumophila

gram-negative bacilli

Water reservoir contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Legionella risk factors

A
  • cigarette smoking
  • chronic lung disease
  • older age
  • biologic therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Legionella: clinical presentation

A
  1. Cough (blood-streaked sputum)
  2. GI symptoms (NVD)
  3. Rales and signs of consolidation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Legionella: CXR

A

patchy unilobar infiltrate that progresses to consolidation

-pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Pontiac fever

A

mild form of legionella infection

  • no respiratory
  • self-limited
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Legionella: diagnostic

A
  1. Sputum culture (if hospitalized)

2. Urinary antigen test* (still postiive after antibiotics unlike sputum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Legionella: treatment

A

Azithromycin (or clarithromycin)

or

Fluroquinolone

x 10 -14 days! ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Botulism: cause

A

Clostridium botulinum

gram-positive +

38
Q

Botulism: pathophys

A

-blocks release of acetylcholine (esp. in excitatory synapses)

39
Q

What should infants avoid eating?

A

honey (haven’t developed gut immunity to botulism)

40
Q

Botulism: clinical presentation

A
  • Bilateral cranial neuropathies
  • DESCENDING WEAKNESS***
  • blurred vision, diplopia, nystagmus, ptosis, dysphagia, dysarthria
  • Urinary retention and constipation
41
Q

EMG: compare and contrast MG and botulism

A

Botulism: wave amplitude increases the more it is stimulated

MG: wave amplitude decreases the more it is stimulated

42
Q

Botulism: who do you call

A
  1. Health Department

2. CDC

43
Q

Botulism: treatment

A

Equine serum heptavalent botulism antitoxin (within 24 hours)

44
Q

Diphtheria: cause

A

Corynebacterium diphtheriae

gram positive bacillus

45
Q

Diphtheria: clinical presentation

A
  • Can happen anywhere in the URT

- Pharyngeal - gray membrane covering tonsils and pharynx ****

46
Q

Name the 2 scary complications of Diphtheria

A
  1. Myocarditis (arrhythmias, heart block, heart failure)

2. Neuropathy (diplopia, slurred speech, dysphagia)

47
Q

What are the non specific lab findings of diphtheria

A
  1. Elevated WBC

2. Proteinuria

48
Q

Diphtheria: treatment

A

AIRWAY MANAGEMENT!

  1. Diphtheria equine antitoxin
  2. Penicillin (or erythromycin) x 14 days
49
Q

What precautions need to be taken with Diphtheria

A

Respiratory droplet isolation until 3 negative oropharyngeal cultures

50
Q

Tetanus: cause

A

Clostridium tetani

  • Found in soil
  • rod-shaped bacterium (transforms after inoculation)
51
Q

Tetanus: patho

A

retrograde axonal transport within motor neuron

-blocks neurotransmission of inhibitory neurons

52
Q

Tetanus: clinical presentation

A

Generalized (MC and severe of the 4 clinical patterns!)

  • Trismus (lock jaw)**
  • increased muscle tone
  • painful spasms
  • widespread autonomic instability (ex. labile HTN, fever)
53
Q

Tetanus: treatment

A
  1. Metronidazole
  2. Tetanus immune globulin (neutralize toxins)

(also, benzos)

54
Q

Tetanus prevention/post puncture wound

A

Immunization!
If puncture wound….

give vaccine + immune globulin if never boosted or >5 years since last booster

55
Q

Lyme disease: etiology

A

Borrelia burgdorferi

  • mc tick-borne illness
  • white footed mouse and deer
  • Ixodes scapularis (deer tick)***
  • Spring and summer
56
Q

How long do deer ticks need to feed to transmit lyme?

A

24 -36 hours

57
Q

What is the name of the rash associated with Lyme?

A

erythemia migrans

58
Q

Lyme early clinical manifestations

A

Early disseminated:

  1. Cardiac (ex. arrhythmias)
  2. Neurological (ex. aspetic meningitis, radiculopathy)
  3. Eyes (ex.conjunctivitis, keratitis)
59
Q

Lyme late manifestions

A
  1. Musculoskeletal: arthritis esp in knee**
60
Q

Lyme: diagnostic criteria

A
  1. Exposure to tick habitiat within 30 days of developing erythema migrans
61
Q

What are the two important labs to help confirm Lyme disease

A
  1. ELISA antibody
  2. Western immunoblot assay

~elevated SED, LFTs

62
Q

Lyme disease: Treatment

A

Doxycycline (10-14 days)

63
Q

Lyme disease: pregnant lady (or kid <8 yrs)

A

Amoxicillin!

64
Q

Who gets prophylactic antibiotics?

A
  1. Tick attached for 36+ hours
  2. Treatment can be started within 72 hours or tick removal
  3. > 20% of the ticks in the area are infected
  4. No contraindications to treatment
65
Q

Rocky mountain spotted fever: cause

A

-Rickettsia rickettsii

gram-negative (obligate intracellular bacterium)
-Tick borne

66
Q

Rocky mountain spotted fever: clinical presentation

A

Rash (blanching macules that transition to petechiae)

  • ankles and wrists, spread to trunk
  • Seen on palms and soles
67
Q

Rocky mountain spotted fever: diagnostics

A
  • Normal WBC count with immature bands
  • Thrombocytopenia (prolonged PTT/PT)
  • Hyponatremia
  • Elevated LFTs
68
Q

Rocky mountain spotted fever: treatment

A

Doxycycline

Start within 5 days of symptoms!

69
Q

Epstein Barr virus: virus type

A

herpes virus

  • transmitted by intimate contact with saliva
  • associated with B cell lymphomas, Hodgkin lymphoma, nasopharyngeal carcinoma, gastric tumors)
70
Q

EBV: classic symptoms

A
  • tonsillitis/pharyngitis
  • cervical lymphadenopathy**
  • fever
71
Q

What happens if you treat EBV with ampicillin cause you thought it was strep throat?

A

morbilliform rash!!!

72
Q

What is the key finding on CBC for EBV?

A

lymphocytosis (WBC 12-18,000)

73
Q

What is the best way to diagnose EBV?

A

Heterophile antibody test (+ for 3 months after onset)

74
Q

EBV: best marker of acute infection

A

IgM and IgG antibodies against viral capsid antigen (VCA)

75
Q

EBV: best marker of latent virus (present for life)

A

Nuclear antigen

if you see this, not an acute infection

76
Q

EBV: treatment

A

Corticosteroids

-Restrict from playing sports for 4 weeks!

77
Q

Cytomegalovirus: most common presentation in healthy individual vs. HIV

A

Healthy: CMV mono (looks similar to EBV)

HIV/AIDS: retinitis

78
Q

CMV: treatment

A

Antiviral (ex. ganciclovir, valganciclovir, foscarnet, cidofovir)

79
Q

Toxoplasmosis: etiology

A

Toxoplasma gondii (intracellular protozoan)

80
Q

Toxoplasmosis: transmission

A

definitive host = cat

  • contaminated food, water, meat from infected animal
  • vertical transmission**
81
Q

Toxoplasmosis: clinical presentation

A
  • Bilateral symmetrical nontender cervical or occiptal adenopathy
  • Chorioretinitis (visual loss or floaters)**

“headlights in the fog”

82
Q

What is the scarriest thing to be concerned for if your immunocompromised patient get toxoplasmosis?

A

encephalitis with multiple necrotizing brain lesions!

83
Q

Toxoplasmosis: diagnosis

A

ELISA

84
Q

Toxoplasmosis: prophylaxis

A

TMP-SMX

treatment: pyrimethamine + sulfadiazine x 2-4 wks

85
Q

Cryptococcosis: etiology

A

Cryptococcus neoformans

-encapsulated budding yeast found in soil, dried pigeon dung**

inhaled**

86
Q

Cryptococcus treatment

A

Amphotericin B x14 days
then
fluconazole x8 weeks

87
Q

Where does varicellla zoster become latent?

A

sensory dorsal root ganglia

88
Q

VZV rash

A
  • MC thoracic or lumbar dermatomes
  • Opthalmic branch of trigeminal is SERIOUS!!!
  • rash preceded by acute neuritis prodromal pain
89
Q

VZV: treatment

A
  1. Antiviral therapy**
    - start within 72 hours
  2. Analgesia (NSAIDs or Opioids)
90
Q

What is the name for herpes zoster oticus?

A

Ramsay Hunt Syndrome

91
Q

Who gets the VZV vaccine?

A

60+ recommended

-Shingrix** (recombinant zoster vaccine)

Foundations of Clinical Practice II (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions