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PGY-4 Board Prep > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Bacterial Meningitis Causes less than 1 month

A

GBS, E coli, Listeria

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2
Q

Bacterial Meningitis Causes 3m-10 years

A

S pneumo

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3
Q

Bacterial Meningitis Causes 10-19 years

A

Neiserra Meningitis

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4
Q

Bacterial Meningitis Causes Adults

A

S pneumo > Neiserria > Strep agalactiate

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5
Q

Vancomycin use in Meningitis Treatment

A

resistant S pneumo

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6
Q

TB Meningitis Presentation

A

CN 6 palsy

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7
Q

Lyme Meningitis Presentation

A

CN 7 (facial) palsy

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8
Q

WBC in Bacterial Meningitis

A

> 1,000

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9
Q

CT Prior to LP if . . .

A

focal neuro findings, seizure
papilledema
hx CNS disease (include shunt)
immunocompromised

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10
Q

D-test

A

for S aureus

if erythromycin resistance, than clindamycin resistance for S aureus

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11
Q

Bullous Impetigo

A

S aureus!, MSSA or MRSA

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12
Q

Most Common Cause of Breast Infections

A

S aureus

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13
Q

Staphylococcal Scalded Skin Syndrome - symptoms

A

extensive skin sloughing

+ Nikolsky sign

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14
Q

Pneumonia after Measles

A

S aureus

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15
Q

Brain Abscess in cyanotic congenital heart disease

A

S aureus

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16
Q

Staphylococcal Toxic Shock Syndrome - symptoms

A

generalized erythredema

desquamation 1-2 weeks later, esp palms and soles

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17
Q

Early onset GBS

A

Birth- 7 days

Sepsis, Pneumonia, Meningitis

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18
Q

Late onset GBS

A

7d-3 months

Bacteremia, Meningitis

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19
Q

Late, late onset GBS

A

> 3 onths

usually extremely premature infants w/ bacteremia

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20
Q

Cellulitis-Adenitis Syndrome

A

late onset GBS

often w/ bacteremia

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21
Q

Cryptosporidum Exposure with Diarrhea Illnesses

A

contaminated water, livestock, animals in petting zoos

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22
Q

Cause of Liver Abscess in Pediatrics

A

Entamoeba histolytica

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23
Q

Non nitrite producing UTI organisms

A

Enterococcus, Staphylococcus, or Streptococcus

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24
Q

First Line Uncomplicated UTI/Cysitis treatment

A

nitrofurantoin (5 days)
trimethoprim-sulfamethoxazole (3 days)
fosfomycin for 1 dose

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25
Q

UTI/Cysitis Second Line Treatments

A

beta lactams, cephalosporins > fluroquinolone

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26
Q

First Line Outpatient Pyelonephritis Treatment

A

fluroquinolones

  • 5-7 d uncomplicated
  • 10-14 complicated
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27
Q

Who to Treat with Augmentin for Animal Bite Wounds

A

immunosuppressed including cirrhosis and asplenia

high risk features

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28
Q

Human Bites Management

A

Augmentin for all bites regardless of other factors

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29
Q

Diabetic Foot Infection Diagnosis

A

pus + two inflammatory signs (warmth, erythema, induration, pain, tenderness)

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30
Q

Malaria symptoms

A

fever, myalgias headache, GI symptoms

fever q48-72 hours

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31
Q

Malaria Diagnosis

A

peripheral blood smears with malarian parasites

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32
Q

Typhoid fever

A

causes by salmonella
fever, headache, arthralgia, myalgia, pharyngitis, anorexia, abdominal pain with early-onset diarrhea, pulse-temperature dissociation (relative bradycardia), and prostration.
rose spots
secondary infections from bacteremia

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33
Q

Typhoid fever treatment

A

ceftriaxone, azithromycin, fluroquinolones

dexamethasone in severe disease

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34
Q

Travelers Diarrhea Organism

A

enterotoxigenic E coli

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35
Q

Travelers Diarrhea Treatment

A

azithromycin, rifaximin, fluroquinolone

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36
Q

Dengue Fever symptoms

A

“break bone fever: fever, headache, eye pain, lumbosacral pain

spontaneous bleeding

scalartin rash that develops into petechiae

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37
Q

Finding of Zika virus separating it from dengue and chikunguya

A

conjunctivitis

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38
Q

chikungunya symptoms

A

Symptoms of chikungunya resemble dengue fever, including abrupt onset of fever (≥39.0 °C [102.2 °F]) and severe bilateral and symmetrical polyarthralgia, often involving the hands and feet; a maculopapular rash on the limbs and trunk is common.

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39
Q

Meditarrean spotted fever/rickesettal disease

A

often black eschar at site of tick bite

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40
Q

CAP Outpatient Treatment

A

doxy or macro or amox

if S pneumo resistance, b-lactam + macro or fluroquinolone

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41
Q

CAP Outpatient Treatment if Cormorbidities

A

b-lactam (HD amox, 2nd gen cephalosporin) + macrolide

Fluoroquinolone

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42
Q

Repeat CXR In Pneumonia

A

in 2-3 months for those at high risk

>50 y, smoking history

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43
Q

Clindamycin and Flagyl in Anerobic Infections

A

Clindamycin- covers GP aneraobes, but limited GN coverage

Flagyl- covers GN anaerobes, but limited against GP

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44
Q

Coxiella Burnetti

A

zoonooses associated with livestock

Q fever PNA

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45
Q

Treatment duration for uncomplicated PNA in adults

A

5-7 days

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46
Q

IgA Defieceny

A 
IgA is mucosal barrier- so sinus, pulmonary, GI tract infection
class is sinopulmonary tract w/ encapsulated organisms
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47
Q

CVID

A
  • increased risk of infections (resp, GI)
  • can have chronic diarrhea 2/2 chronic noro or Giardia
  • increased risk of autoimmune disorders
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48
Q

Early Complement Deficiency Immunodeficiencies

A

C2-C4 deficiencies
increased SLE
increased infection w/ encapsulated organisms

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49
Q

Late Complement Deficiency Immunodeficiency

A

C5-C9

Recurrent Neisseria Infections

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50
Q

Congenital Infections and Intracranial Calcifications

A

CMV- periventricular

Toxo- diffuse

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51
Q

Blueberry Rash w/ Congenital Infections

A

Classic is Rubella, but can be seen with toxo and CMV

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52
Q

Fifth Disease

A

Parvo, Erythema Infectiosum
Slapped cheeks
arthritis, aplastic anemia

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53
Q

Sixth Disease

A

HHV-6 Roseola

fever that rashes, fever 3-5 days followed by M to MP rash

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54
Q

Human Bites organism

A

Eikenella, S aureus

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55
Q

Most common infections w/ GBS by early/late

A

Early - Sepsis > Pneumonia

Late - Pneumonia > Meningitis

56
Q

Granulomatosis infantisepticum

A

Listeria, neonate with erythematous rash w/ papules

brown amniotic fluid

57
Q

Classic Anthrax Lesion

A

Painless pruritic papule –> ulcer –> black eschar

58
Q

Cause of Buccal Cellulitis

A

H Flu bacteremia

59
Q

Treatment of Plague

A

streptomycin or gentamicin

60
Q

Pseudoappendicitis Syndrome

A

Yersinia

61
Q

Yersinia infections more common in …

A

those with transfusion overload (beta thal, SCD)

62
Q

Citrobacter bacteremia associated with

A

brain abscesses!

63
Q

Tb TST Testing, differences for children

A

less than 4 = 10mm instead of 15mm

64
Q

Malassezia infections in pediatrics

A

1) tinea versicolor

2) catheter associated infections in NICU infants

65
Q

Spaghetti and Meatballs on slide

A

Malassezia

66
Q

Non-TB acid fast organism

A

Cryptosporidium (oocytes stain acid fast)

67
Q

Sulfur Belching

A

Giardia

68
Q

Congenital Varicella, timeframe for risk

A

5 days before to 2 days after

69
Q

Congenital Infection with PDA

A

Rubella

70
Q

Influenza Vaccination, two doses needed until

A

less than age 9

71
Q

Treatment for Bat Exposure

A

Rabies Ig + Vaccine

72
Q

Kaposi Sarcoma

A

HHV8

painless violet nodules

73
Q

Letptospiral Meningitis

A

uveitis, conjunctivitis

severe muscle pains esp in calves

74
Q

Brain Abscess treatment

A

focus on causes

Flagyl + 3rd generation cephaloporin or PCN

75
Q

Subdural Empyema

A

rapidly progression, NS emergency

treat w/ vanc, flagyl, ceftriaxone

76
Q

VZV Encephalitis, frequent presentation

A

Stroke/infarct cerebral arteries

77
Q

WNV Encephalitis classic presentation

A

thalamus/basal ganglia - tremors, myoclonus, parksonism

acute flaccid paralysis

78
Q

variant CJD image findings

A

hockey stick sign

79
Q

variant CJD diagnosis

A

tonsil biopsy

80
Q

Capnocytophaga carnimorsus

A

contact w/ dogs

sepsis & cellulitis in asplenic patients

81
Q

Vibrio vulnificus

A

cirrhosis or shelling oysters

Rx with ceftriaxone + doxy

82
Q

Streptococcal Toxic Shock Rx

A

PCN + clindamycin

83
Q

Staphylococcal Toxic Shock Rx

A

naf + clinda
OR
vanc + clinda or linezolid

84
Q

Lyme Disease stages

A

1) Early Localized Disease - EM +/- systemic
2) Early Disseminated - Febrile Illness (Cardiac, Neuro)
3) Late Disseminated - Arthritis

85
Q

Lyme Disease Treatment

A

Doxy

except Meningitis, Carditis: Ceftriaxone

86
Q

Ixodes ticks & what illnesses

A

Lyme, Anaplasma, Babeoiosis

87
Q

Babesiosis - biggest clinical clues

A

hemolysis!

matlese cross

88
Q

Babesiosis - Rx

A

mild: atovaquone + azithromycin
severe: clinda + quinine

89
Q

Ehrliciosis & Anaplasmosis

A

febrile illness

basopihilc inclusion bodies: morulae

90
Q

RMSF: illness script

A

macular –> petechial rash, ankles and wrists with central spread
purpura fulminans

91
Q

Pyelonephritis, if sick/concerend

A

3rd general cephalosporin versus PCN (Zosyn) vs FQs vs carbapenem

92
Q

Recurrent UTI Definition

A

3 in one year or 2 in 6 months

93
Q

Latent TB

A

+ IGRA or + TST with NO clinical/radiographic evidence

94
Q

TST >5mm

A

very high risk

  • HIV+
  • recent TB contact
  • organ transplant
  • immunosuppressed
95
Q

TST>10mm

A

increased risk

  • healthcare, prisons, health care facilities, homeless
  • IVDA
  • children less than 4
  • recent arrival from endemic country (<5 years)
96
Q

Izoniazid AE

A

hepatitis, peripheral neuropathy + DI-lupus

B6/pyridoxine may help

97
Q

Pyrazinamide AE

A

hepatitis, hyperuricemia

98
Q

When to d/c airborne precautions in TB

A

3 negatives smears or 2 weeks of treatment

99
Q

Rifampin AE

A

body fluids orange, hepatitis, drug interactions

100
Q

Ethambutol AE

A

optic neuritis

101
Q

TB Meningitis Treatment

A

4 drugs + dexamethasone

102
Q

MAC illness script

A

old lady with chronic cough, weight loss, night sweats
OR
HIV CD4<50 with disseminated disease

103
Q

MAC treatment

A

CLarithyomcyin + EthAmbutol + Rifampin

104
Q

Mycobacterium Marinum

A

fish tank exposure/works with fishes

nodular skin lesion + LAD

105
Q

Mycobacterium Abscessus illness script

A

purple nodules + chronic abscesses in the young

106
Q

Treatment of Candidiasis

A 
Micafungin except
- UTI
- Meningitis
- Endopthalmitis
Amph B or Azole
107
Q

Treatment of asymptomatic candiduria

A

neutropenic pts or undergoing urologic procedure

108
Q

Forms of Aspergillus

A

1) Invasive Pulm Asp
2) ABPA
3) Aspergillomas

109
Q

Invasive Pulm Aspergillosis

A

pulm tract –> hemat. diss

Rx Voriconazole

110
Q

ABPA Rx

A

steroids +/- azole adjunct

111
Q

Aspergilloma Rx

A

asymptomatic –> none

symptoms/hemoptysis –> embolization or surgery resection

112
Q

Mucormycosis Rx

A

amphotericin

113
Q

Cryptococcus Rx

A

amph + flucytosine

114
Q

Blastomycosis Illness script

A

SOA, cough
joint pain
painful urination

115
Q

Blastomycosis Rx

A

Ampho for severe/pulm

itra for mild

116
Q

Coccidiodomycosis Types of Illness scripts

A

1) chronic pulm infection
2) cutaneous infection
3) meningitis
4) MSK infection

117
Q

Coccidiomycosis Rx

A

fluconazole

continue for life if meningitis

118
Q

What infections should you get blood cultures for?

A

Osteomyelitis

119
Q

CVID diagnosis

A

low total IgG
low total IgA or IgM
abnormal Ab responses to vaccines

120
Q

CVID treatment

A

IVIG

121
Q

Anthrax - Clinical Symptoms

A

black eschar/cutaneous
Atypical PNA like symptoms
hemorrhagic LADitis/widened mediastinum

122
Q

Anthrax Rx

A

fluroquinolone or doxy

+ vaccination

123
Q

Small Pox Illness Script

A

rash on mucosa, face -> hands –> body

124
Q

Small Pox Rx

A

Vaccination, supportive Care

125
Q

Botulism Illness Script

A

symmetric described flaccid paralysis

bulbar signs - diplopia, dysarthria, dysphonia, dysphagia

126
Q

Botulism Rx

A

early anti-toxin + supportive care

127
Q

Plague Illness Script

A

fever, cough, hemoptysis

128
Q

Plague Rx & PEP

A

strept or gent

PEP - doxy or levo

129
Q

Tularemia illness script

A

highly infectious, PNA

hunter & wild game exposure

130
Q

Tularemia treatment & PEP

A

Strep or gent

PEP: doxy or cipro

131
Q

Brucellosis illness script

A
  • unpast dairy or uncooked meat
  • fever, myalgias, HA, fatigue
  • depression
132
Q

Brucellosis Rx

A

doxy, rifamp, strept

133
Q

Leptospirosis Rx

A

doxy (mild) vs PCN/ceftriaxone

134
Q

Yersinia illness script

A

acute appendicitis mimicker

135
Q

EBV PTLD illness script

A

B-cell proliferation
fever + bulky LAD
Rx is rituximab and reduce immunosuppression

PGY-4 Board Prep (18 decks)

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