Infectious Disease Flashcards
1
Q
Bacterial Meningitis Causes less than 1 month
A
GBS, E coli, Listeria
2
Q
Bacterial Meningitis Causes 3m-10 years
A
S pneumo
3
Q
Bacterial Meningitis Causes 10-19 years
A
Neiserra Meningitis
4
Q
Bacterial Meningitis Causes Adults
A
S pneumo > Neiserria > Strep agalactiate
5
Q
Vancomycin use in Meningitis Treatment
A
resistant S pneumo
6
Q
TB Meningitis Presentation
A
CN 6 palsy
7
Q
Lyme Meningitis Presentation
A
CN 7 (facial) palsy
8
Q
WBC in Bacterial Meningitis
A
> 1,000
9
Q
CT Prior to LP if . . .
A
focal neuro findings, seizure
papilledema
hx CNS disease (include shunt)
immunocompromised
10
Q
D-test
A
for S aureus
if erythromycin resistance, than clindamycin resistance for S aureus
11
Q
Bullous Impetigo
A
S aureus!, MSSA or MRSA
12
Q
Most Common Cause of Breast Infections
A
S aureus
13
Q
Staphylococcal Scalded Skin Syndrome - symptoms
A
extensive skin sloughing
+ Nikolsky sign
14
Q
Pneumonia after Measles
A
S aureus
15
Q
Brain Abscess in cyanotic congenital heart disease
A
S aureus
16
Q
Staphylococcal Toxic Shock Syndrome - symptoms
A
generalized erythredema
desquamation 1-2 weeks later, esp palms and soles
17
Q
Early onset GBS
A
Birth- 7 days
Sepsis, Pneumonia, Meningitis
18
Q
Late onset GBS
A
7d-3 months
Bacteremia, Meningitis
19
Q
Late, late onset GBS
A
> 3 onths
usually extremely premature infants w/ bacteremia
20
Q
Cellulitis-Adenitis Syndrome
A
late onset GBS
often w/ bacteremia
21
Q
Cryptosporidum Exposure with Diarrhea Illnesses
A
contaminated water, livestock, animals in petting zoos
22
Q
Cause of Liver Abscess in Pediatrics
A
Entamoeba histolytica
23
Q
Non nitrite producing UTI organisms
A
Enterococcus, Staphylococcus, or Streptococcus
24
Q
First Line Uncomplicated UTI/Cysitis treatment
A
nitrofurantoin (5 days)
trimethoprim-sulfamethoxazole (3 days)
fosfomycin for 1 dose
25
UTI/Cysitis Second Line Treatments
beta lactams, cephalosporins > fluroquinolone
26
First Line Outpatient Pyelonephritis Treatment
fluroquinolones
- 5-7 d uncomplicated
- 10-14 complicated
27
Who to Treat with Augmentin for Animal Bite Wounds
immunosuppressed including cirrhosis and asplenia
| high risk features
28
Human Bites Management
Augmentin for all bites regardless of other factors
29
Diabetic Foot Infection Diagnosis
pus + two inflammatory signs (warmth, erythema, induration, pain, tenderness)
30
Malaria symptoms
fever, myalgias headache, GI symptoms
| fever q48-72 hours
31
Malaria Diagnosis
peripheral blood smears with malarian parasites
32
Typhoid fever
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
33
Typhoid fever treatment
ceftriaxone, azithromycin, fluroquinolones
| dexamethasone in severe disease
34
Travelers Diarrhea Organism
enterotoxigenic E coli
35
Travelers Diarrhea Treatment
azithromycin, rifaximin, fluroquinolone
36
Dengue Fever symptoms
"break bone fever: fever, headache, eye pain, lumbosacral pain
spontaneous bleeding
scalartin rash that develops into petechiae
37
Finding of Zika virus separating it from dengue and chikunguya
conjunctivitis
38
chikungunya symptoms
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.
39
Meditarrean spotted fever/rickesettal disease
often black eschar at site of tick bite
40
CAP Outpatient Treatment
doxy or macro or amox
| if S pneumo resistance, b-lactam + macro or fluroquinolone
41
CAP Outpatient Treatment if Cormorbidities
b-lactam (HD amox, 2nd gen cephalosporin) + macrolide
| Fluoroquinolone
42
Repeat CXR In Pneumonia
in 2-3 months for those at high risk
| >50 y, smoking history
43
Clindamycin and Flagyl in Anerobic Infections
Clindamycin- covers GP aneraobes, but limited GN coverage
| Flagyl- covers GN anaerobes, but limited against GP
44
Coxiella Burnetti
zoonooses associated with livestock
| Q fever PNA
45
Treatment duration for uncomplicated PNA in adults
5-7 days
46
IgA Defieceny
```
IgA is mucosal barrier- so sinus, pulmonary, GI tract infection
class is sinopulmonary tract w/ encapsulated organisms
```
47
CVID
- increased risk of infections (resp, GI)
- can have chronic diarrhea 2/2 chronic noro or Giardia
- increased risk of autoimmune disorders
48
Early Complement Deficiency Immunodeficiencies
C2-C4 deficiencies
increased SLE
increased infection w/ encapsulated organisms
49
Late Complement Deficiency Immunodeficiency
C5-C9
| Recurrent Neisseria Infections
50
Congenital Infections and Intracranial Calcifications
CMV- periventricular
| Toxo- diffuse
51
Blueberry Rash w/ Congenital Infections
Classic is Rubella, but can be seen with toxo and CMV
52
Fifth Disease
Parvo, Erythema Infectiosum
Slapped cheeks
arthritis, aplastic anemia
53
Sixth Disease
HHV-6 Roseola
| fever that rashes, fever 3-5 days followed by M to MP rash
54
Human Bites organism
Eikenella, S aureus
55
Most common infections w/ GBS by early/late
Early - Sepsis > Pneumonia
| Late - Pneumonia > Meningitis
56
Granulomatosis infantisepticum
Listeria, neonate with erythematous rash w/ papules
| brown amniotic fluid
57
Classic Anthrax Lesion
Painless pruritic papule --> ulcer --> black eschar
58
Cause of Buccal Cellulitis
H Flu bacteremia
59
Treatment of Plague
streptomycin or gentamicin
60
Pseudoappendicitis Syndrome
Yersinia
61
Yersinia infections more common in ...
those with transfusion overload (beta thal, SCD)
62
Citrobacter bacteremia associated with
brain abscesses!
63
Tb TST Testing, differences for children
less than 4 = 10mm instead of 15mm
64
Malassezia infections in pediatrics
1) tinea versicolor
| 2) catheter associated infections in NICU infants
65
Spaghetti and Meatballs on slide
Malassezia
66
Non-TB acid fast organism
Cryptosporidium (oocytes stain acid fast)
67
Sulfur Belching
Giardia
68
Congenital Varicella, timeframe for risk
5 days before to 2 days after
69
Congenital Infection with PDA
Rubella
70
Influenza Vaccination, two doses needed until
less than age 9
71
Treatment for Bat Exposure
Rabies Ig + Vaccine
72
Kaposi Sarcoma
HHV8
| painless violet nodules
73
Letptospiral Meningitis
uveitis, conjunctivitis
| severe muscle pains esp in calves
74
Brain Abscess treatment
focus on causes
| Flagyl + 3rd generation cephaloporin or PCN
75
Subdural Empyema
rapidly progression, NS emergency
| treat w/ vanc, flagyl, ceftriaxone
76
VZV Encephalitis, frequent presentation
Stroke/infarct cerebral arteries
77
WNV Encephalitis classic presentation
thalamus/basal ganglia - tremors, myoclonus, parksonism
| acute flaccid paralysis
78
variant CJD image findings
hockey stick sign
79
variant CJD diagnosis
tonsil biopsy
80
Capnocytophaga carnimorsus
contact w/ dogs
| sepsis & cellulitis in asplenic patients
81
Vibrio vulnificus
cirrhosis or shelling oysters
| Rx with ceftriaxone + doxy
82
Streptococcal Toxic Shock Rx
PCN + clindamycin
83
Staphylococcal Toxic Shock Rx
naf + clinda
OR
vanc + clinda or linezolid
84
Lyme Disease stages
1) Early Localized Disease - EM +/- systemic
2) Early Disseminated - Febrile Illness (Cardiac, Neuro)
3) Late Disseminated - Arthritis
85
Lyme Disease Treatment
Doxy
| except Meningitis, Carditis: Ceftriaxone
86
Ixodes ticks & what illnesses
Lyme, Anaplasma, Babeoiosis
87
Babesiosis - biggest clinical clues
hemolysis!
| matlese cross
88
Babesiosis - Rx
mild: atovaquone + azithromycin
severe: clinda + quinine
89
Ehrliciosis & Anaplasmosis
febrile illness
| basopihilc inclusion bodies: morulae
90
RMSF: illness script
macular --> petechial rash, ankles and wrists with central spread
purpura fulminans
91
Pyelonephritis, if sick/concerend
3rd general cephalosporin versus PCN (Zosyn) vs FQs vs carbapenem
92
Recurrent UTI Definition
3 in one year or 2 in 6 months
93
Latent TB
+ IGRA or + TST with NO clinical/radiographic evidence
94
TST >5mm
very high risk
- HIV+
- recent TB contact
- organ transplant
- immunosuppressed
95
TST>10mm
increased risk
- healthcare, prisons, health care facilities, homeless
- IVDA
- children less than 4
- recent arrival from endemic country (<5 years)
96
Izoniazid AE
hepatitis, peripheral neuropathy + DI-lupus
| B6/pyridoxine may help
97
Pyrazinamide AE
hepatitis, hyperuricemia
98
When to d/c airborne precautions in TB
3 negatives smears or 2 weeks of treatment
99
Rifampin AE
body fluids orange, hepatitis, drug interactions
100
Ethambutol AE
optic neuritis
101
TB Meningitis Treatment
4 drugs + dexamethasone
102
MAC illness script
old lady with chronic cough, weight loss, night sweats
OR
HIV CD4<50 with disseminated disease
103
MAC treatment
CLarithyomcyin + EthAmbutol + Rifampin
104
Mycobacterium Marinum
fish tank exposure/works with fishes
| nodular skin lesion + LAD
105
Mycobacterium Abscessus illness script
purple nodules + chronic abscesses in the young
106
Treatment of Candidiasis
```
Micafungin except
- UTI
- Meningitis
- Endopthalmitis
Amph B or Azole
```
107
Treatment of asymptomatic candiduria
neutropenic pts or undergoing urologic procedure
108
Forms of Aspergillus
1) Invasive Pulm Asp
2) ABPA
3) Aspergillomas
109
Invasive Pulm Aspergillosis
pulm tract --> hemat. diss
| Rx Voriconazole
110
ABPA Rx
steroids +/- azole adjunct
111
Aspergilloma Rx
asymptomatic --> none
| symptoms/hemoptysis --> embolization or surgery resection
112
Mucormycosis Rx
amphotericin
113
Cryptococcus Rx
amph + flucytosine
114
Blastomycosis Illness script
SOA, cough
joint pain
painful urination
115
Blastomycosis Rx
Ampho for severe/pulm
| itra for mild
116
Coccidiodomycosis Types of Illness scripts
1) chronic pulm infection
2) cutaneous infection
3) meningitis
4) MSK infection
117
Coccidiomycosis Rx
fluconazole
| continue for life if meningitis
118
What infections should you get blood cultures for?
Osteomyelitis
119
CVID diagnosis
low total IgG
low total IgA or IgM
abnormal Ab responses to vaccines
120
CVID treatment
IVIG
121
Anthrax - Clinical Symptoms
black eschar/cutaneous
Atypical PNA like symptoms
hemorrhagic LADitis/widened mediastinum
122
Anthrax Rx
fluroquinolone or doxy
| + vaccination
123
Small Pox Illness Script
rash on mucosa, face -> hands --> body
124
Small Pox Rx
Vaccination, supportive Care
125
Botulism Illness Script
symmetric described flaccid paralysis
| bulbar signs - diplopia, dysarthria, dysphonia, dysphagia
126
Botulism Rx
early anti-toxin + supportive care
127
Plague Illness Script
fever, cough, hemoptysis
128
Plague Rx & PEP
strept or gent
| PEP - doxy or levo
129
Tularemia illness script
highly infectious, PNA
| hunter & wild game exposure
130
Tularemia treatment & PEP
Strep or gent
| PEP: doxy or cipro
131
Brucellosis illness script
- unpast dairy or uncooked meat
- fever, myalgias, HA, fatigue
- depression
132
Brucellosis Rx
doxy, rifamp, strept
133
Leptospirosis Rx
doxy (mild) vs PCN/ceftriaxone
134
Yersinia illness script
acute appendicitis mimicker
135
EBV PTLD illness script
B-cell proliferation
fever + bulky LAD
Rx is rituximab and reduce immunosuppression
