Infectious Disease

Question 1

What type of LAD is associated with Mono?

Answer 1

Posterior Cervical LAD

Question 2

How is Mono diagnosed?

Answer 2

1. Mono spot (Heterophile)
2. Peripheral smear with >10% atypical lymphs
   * Increased LFTs

Question 3

When are corticosteroids indicated for mono?

Answer 3

ONLY if airway obstruction due to LAD present

Question 4

Erythema Migrans is found in 90% of cases of _____.

Answer 4

Lyme Disease

*Tick bite!

Question 5

What is Erythema Migrans?

Answer 5

Expanding, warm, annular, erythematous rash (“bulls-eye”)

*May be accompanied w/ viral-like syndrome

Question 6

What are some other S&S of Lymes?

Answer 6

Arthritis, HA, meningitis, weakness, cardiac probs

Question 7

How is Lyme Disease diagnosed?

Answer 7

Clinical AND

-ELISA w/ Western Blot if ELISA is positive or equivocal

Question 8

How is Lyme Disease treated?

Answer 8

Early= Doxy bid 10-21 days

Amoxicillin is DOC in kids < 8y, and pregnant pts

Late/Severe= IV Ceftriaxone

Prophylaxis= Doxy 200mg x 1 dose w/in 72hr of tick removal

Question 9

AIDS is defined as CD4 count < ____.

Answer 9

200

Question 10

How is HIV diagnosed?

Answer 10

• ELISA, if reactive then confirmed by Western Blot (usually reactive w/in 3-6 months of infection)
• Rapid testing= blood or saliva
• HIV VIRAL LOAD can be positive in the window period. Also used to monitor infectivity and tx effectiveness in pts diagnosed w/ HIV

Question 11

Emtricitabine + Tenofovir= _____

Answer 11

Truvada :)

Question 12

What are the HAART regimens?

Answer 12

• NNRTI + 2 NRTIs
• PI + 2 NRTIs
• INSTI + 2 NRTIs

*See p. 141-142

Question 13

Oseltamivir and Zanamivir (inhaler) are medications used to treat what?

Answer 13

Influenza

*In patients w/ high risk of complications or if hospitalized

Question 14

Bacterial v. Aseptic Meningitis:

Answer 14

Bacterial:
Protein- HIGH (>200)
Glucose- LOW (<40)
WBC- >80% neutrophils

Viral:
Protein- <100
Glucose- Normal
WBC- Lymphocytes

*DO NOT WAIT FOR LP TO START EMPIRIC ABX

Question 15

If glucose is normal then it is most likely VIRAL meningitis

If WBC count shows neutrophils it is most likely BACTERIAL meningitis

Answer 15

fyi

Question 16

Pathogens and associated treatment for Bacterial Meningitis

Answer 16

< 1 month= Group B Strep= Ampicillin + Cefotaxime

1mos-18y= N. meningitidis= Rocephin + Vanc

18y-50y= S pneumo= Rocephin + Vanc

> 50y= S pneumo, Listeria= Ampicillin + Rocephin +/- Vanc

*Dexamethasone recommended if known or suspected Strep

**Post-exposure prophylaxis= Ciprofloxacin 500mg PO x 1 dose; Rifampin 600mg PO bid x 12 days

Question 17

____ is MC cause of Encephalitis while ____ is MC cause of Viral Meningitis.

Answer 17

Encephalitis- HSV-1

Meningitis- Enterovirus family

Question 18

Viral meningitis has ____ (normal/abnormal) cerebral function while encephalitis has ______ (normal/abnormal) cerebral function.

Answer 18

Meningitis- NORMAL

Encephalitis- ABNORMAL (profound lethargy and seizures), temporal lobe MC involved

*Tx- give Valacyclovir if HSV or no identifiable cause

Question 19

How is viral meningitis treated?

Answer 19

Usually self-limited (7-10 days)