Infectious Disease Flashcards
What is dx:
17 yr old w diffuse, erythematous, blanching, maculopapular rash on chest, abdomen, extremities. recently took amoxicillin, fever to 100.4
PE: no rhinorrhea, TM clear, tender cervical lymphadenopathy. Leukocytosis, elevated total bilirubin, AST, ALT
Infectious Mononucleosis (EBV) - fever, fatigue, exudative pharyngitis, lymphadenopathy, hepatosplenomegaly.
*Exanthematous rash most often erupts after inappropriate administration of AMOXICILLIN OR AMPICILLIN
How is molluscum contagiosum contracted?
Skin-to-skin contact caused by poxvirus
–consider HIV testing (widespread lesions or involve face)
Which close contacts require abx prophylaxis to present meningococcal meningitis
which chemoprophylaxis should be used
- Household members
- Roommates/intimate contacts
- Child care workers
- Exposed to respiratory of oral secretions
- Seated next to an affected person for >/= hours
chemoprophylaxis:
- rifampin - 4 doses
- Ceftriaxone - 1 IM, used on preg
- Ciproflox - once orally, not in children
How do you manage an HIV pt w cryptococcal meningoencephalitis with worsening nausea, vomiting, lethargy
Serial lumbar punctures- cryptococcal meningoencephalitis have dramatic cerebrospinal fluid fungal burdens (increases ICP)
–more recalcitrant cases require ventriculoperitoneal shunt
How is cryptococcal meningitis managed in HIV patients?
3 stages:
1. Induction: ampho B, flucytosine for >=2 weeks
- Consolidation - high-dose ORAL fluconazole 8 weeks
- Maintenance - lower-dose oral fluconazole for >/= 1 year
What are the two most likely ways to prevent recurrent episodes of Cdiff infections?
- minimizing abx
2. Avoidance of gastric acid suppression
What is the firstline tx of onychomycosis?
Terbinafine, Itraconazole
2nd line: griseofulvin, fluconazole, ciclopirox (long tx regimens, high relapse rates)
What is dx, tx?
26 yr old Ghana, w dysurian, increased urinary frequency, end void hematuria. Microcytic anemia, mild peripheral eosinophilia
Urinary Schistosomiasis - Praziquantel
What is the acute management of shingles
pts who present <72 hrs after rash onset - 7 days of oral valacyclovir
What is the immediate management of a Guillain-Barre syndrome patient?
What is treatment modality?
Serial Vital Capacity measurements at bedside (30% GBS pts ultimately require mechanical ventilation
-Therapeutic plasma exchange or IVIG
What is the best treatment for tinea versicolor?
Topical Ketoconazole - TV is noninvasive by malassezia species
What is the organism? how is it diagnosed?
HIV pt not on antiretrotherapy with multiple small papules with central umbilication on the face, neck, trunk, upper thighs. Some lesion have central necrosis and are covered in hemorrhagic crust
Cutaneous cryptococcus - resemble molluscum contagiosum
- -encapsulated yeast - primarily affects CD4 counts <100/m3.
- most common = meningoencephalitis
DX: Biopsy lesion
What is the dx? comorbidity risk?
15 yr old girl with chills, malaise, sorethroat, febrile
oropharyngeal exam shows grey exudate in a membrane that bleed when scraped
Corynebacterium diphteriae
-grey patch/pseudomembrane pharyngitis, myocarditis, neuritis, kidney disease
What is the dx:
43 yr old man w international travel
2 days of persistent fever, headache, malaise, intense myalgia/arthralgia. after few minutes a sphyngmomanometer cuff is on his arm he develops severe petechiae. mild cervical lymphadenopathy
liver is palpated 3 cm below costal margin
retroorbital pain
Dengue Fever - spread by aedes mosquito
- –most serious = Dengue hemorrhagic fever
- -Circulatory failure
What is the dx?
pt with joint pain with hx travel between wisconsin and caribbean 3 months ago, During trip, fever and malaise for several days, followed by severe pain in the fingers, and wrists, and ankles.
Chikungunya fever
- -Aedes mosquito
- -High fevers & severe polyarthralgias
mgmt = supportive care
