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First Aid Step 2 > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Gram stain : positive vs negative

A

Positive: blue purple
Negative: red

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2
Q

Chains

A

Strepotococci

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3
Q

Clusters

A

Staphylococci

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4
Q

Gram + Diplococci example

A

Strep pneumo

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5
Q

Gram - coccobacilli example

A

Haemophilus

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6
Q

Gram - diplococci

A

Neisseria

Morazella

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7
Q

Gram - rod, plump, thick mucoid capsule

A

Klebseilla

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8
Q

Gram + rods that forms spores

A

Clostridium

Bacillus

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9
Q

Pseudophyphae

A

Candida

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10
Q

Acid fast

A

Mycobacterium tuberculosis

Nocardia

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11
Q

Gram + sulfur granules

A

Actinomyces (PID w/ IUD, neck mass, cervical adenitits)

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12
Q

Silver stain

A

PCP and cat scratch

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13
Q

Positive India ink - think capsule

A

Cryptococcus

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14
Q

Spirochete

A

Treponema - dark field
Leptospira - dark field
Borrelia- light microscope

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15
Q

Catalase positive

A

Staph aureus
Serratia
Klebsiella
Aspergillus

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16
Q

Pt stuck with thorn:
Bug
Tx

A

Sporothrix schenckii

Tx: Itraconaozle, fluconazole, oral potassium iodine

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17
Q

Aplastic crisis in sickle cell or other hemoglobinopathy

A

Parvovirus B19

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18
Q

Sepsis after splenectomy or autosplenectomy in sickle cell

A

S pneumo
H flu
N meningitidis
ENCAPSULATED!!

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19
Q

Pneumo in SW

Bug and Tx

A

Cocci

Tx: itraconazole, fluconazole, amphotericin B if severe

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20
Q

Pneumo after cave exploring or bat droppings in Ohio and Mississippi River

Tx

A

Histoplasma capsulatum - acute pulm Sx

Tx: IV amphotericin B, lifelong itraconazole if HIV positiive

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21
Q

Pneumo after bird

A

Chlamydia psittaci

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22
Q

Fungus ball or hemoptysis after TB induced cavitary disease

Tx

A

Aspergillus - halo sign on CT

Tx: voriconazole

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23
Q

Pneumo with silicosis

A

Tb

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24
Q

Diarrhea after hiking or drinking from stream
Bug
Dx
Tx

A

Giardia lamblia

Dx: cyst in stool

Tx: metronidazole

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25
Q

Pregnant woman with cats

Bug Tx

A

Toxoplasmosis gondii

Tx: spiramycin

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26
Q

Vit B 12 def and ABD sx

A

Diphyllobothrium latum

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27
Q

Seizures with ring enhancing lesions on CT

Tx

A

Taenia solium - cysticercosis OR Toxoplasmosis

Tx: albendazole or praziquantel, steroids, consider anticonvulsants

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28
Q

Bladder cancer squamous cell in MIddle East and Africa

A

Schistosoma haematobium

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29
Q

Worm infection kids

Tx

A

Enterobius - positive tape test, perianal itching worse at night

Tx: mebendazole, albendazole

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30
Q

Fever, mm pain, eosinophilia, periorbital edema after eating raw meat

A

Trichinella spiralis - trichinosis

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31
Q

Food poisoning after creams or dairy

A

S aureus from preformed toxin

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32
Q

Gastroenteritis in young kids

A

Rotavirus

Norwalk

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33
Q

Food poisoning after reheated rice

A

Bacillus cereus by preformed toxin- no help with abx

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34
Q

Food poisoning seagood

A

Virbio parahaemolytcius

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35
Q

Diarrhea after Mexico

Tx

A

E coli

Tx: ciprofloxacin

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36
Q

Diarrhea after abc

Tx

A

C diff

Oral metronidaozole or vancomycin

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37
Q

Infant paralyzed after honey

A

C botulinum - toxin bloch Ach release = hypotnia, poor feeding, neurogenic bladder, constipation

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38
Q

Genital lesions kids without sexual abuse

A

Molluscum contagiosum

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39
Q

Cellulitis after cat or dog bite

Tx

A

Pasteurella multocida- amoxicillin clauvulanate

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40
Q

Slaugterhouse worker with fever

A

Brucella

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41
Q

Empiric abx and bugs: bronchitis

A

No abx shown to be good

Virus, H flu, Moraxella

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42
Q

Empiric abx and bugs: Cellulitis

A

Cephalexin or dicloxacillin, Clindamycin or TMP-SMX if suspect MRSA
Staph/strep

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43
Q

Empiric abx and bugs: Endocarditis

A

Antisaph pen or vanc + aminoglycoside

Staph/strep

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44
Q

Empiric abx and bugs:meningitis - kid or adulte

A

Cefotaxime or ceftriaxone + vanc

Strep pneumo, N meningitidis

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45
Q

Empiric abx and bugs: ostemyelitis

A

Oxacilli, cefazolin, vanc

Staph aureus, Salmonella

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46
Q

Empiric abx and bugs: atypical pneumo

A

Macrolide, doxy

Mycoplasma, Chlamydia

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47
Q

Empiric abx and bugs: classic pneumo

A

3rd ceph, azithromycin

S pneumo, H flu

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48
Q

Empiric abx and bugs: Septic arthritis

A

Antistaph pen, vanc = S aureus
Ceftazidine or ceftriazone or cefotaxime = Gram N bacilli
3rd pen or ceph + aminoglycoside, imipenem = Gram N bugs, strep, staph

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49
Q

Empiric abx and bugs: UTI

A

TMP-SMX, nitrofurantoin, amoxicilli, quinolones

E coli

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50
Q

DOC bacteroidies

A

Metronidazole

Alt: clindamycin

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51
Q

DOC Borrelia

A

Doxy (not < 8 yrs or pregnant or lactating), amox, cefuroxime
Alt: Erythromycin

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52
Q

DOC chlamydia

A

Azithromycin, doxy

Alt: erythromycin, oflaxacin, levafloxacin

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53
Q

DOC E coli

A

3rd gen ceph, fluoroquinolones

Alt: Aminoglycoside

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54
Q

DOC Enterococci

A

Pen or amp + amino glycoside

Alt: Vanc + aminoglycoside

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55
Q

DOC GC

A

Ceftriaxone plus doxy or azithromycin

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56
Q

DOC haeomophilus

A

2/3 ceph

Alt: ampicillin

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57
Q

DOC Klebsiella

A

3rd ceph, fluoroquinolone

Alt: 3rd pen + aminoglycoside

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58
Q

DOC meningococcus

A

Cefotaxime or ceftriaxone

Alt: Pen G if susceptible

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59
Q

DOC TB

A

RIPE

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60
Q

DOC mycoplasma

A

Macrolide

Alt: doxy, fluoroquinolone

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61
Q

DOC Pseudomonas

A

Ticardcillin or piperacillin + aminoglycoside

Alt: Ceftazidine, cefepime, aztreonam, imipenem, cipro

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62
Q

DOC strep A or B

A

Pen or cephazolin

Alt: eryhtromycin

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63
Q

DOC Treponema

A

Pen

Alt: doxy

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64
Q

DOC strep pneumo

A

3rd ceph

Alt: fluoroquinolone

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65
Q

DOC staph

A

Antisraph pen

Alt: Vanc if MRSA

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66
Q

Pneumo hotel, air conditioner, water tower

Bug and Tx

A

Legionella
HA, GI Sx
Tx: azithromycin or levofloxacin

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67
Q

BUrn wound infection with blue green color

A

Pseudomonas

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68
Q

Gold standard to dx pneumo

A

sputum culture

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69
Q

Common causes pneumo

A 
Strep pneumo
H flu
Staph aureus
Gram N - Pseudomonas, Klebsiella, E coli
Mycoplasma
Chlam pneumo
Viral
PCP
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70
Q

Most common cause pneumo

A

Strep pneumo

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71
Q

Uncommon due to vaccination

A

H flu

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72
Q

Hospital acquired pneumo

A

Staph aureus

73
Q

CF, IVDU, chonic granulomatous disease pneumo cause

Tx

A

Pseudomonas

Ticarcillin or pipercillin

74
Q

alcoholics and homeless pneumo, currant jelly sputum

A

Klebsiella

75
Q

Enteric gram N, aspiration pneumo, neutropenia, hospital acquired, abscesses common, high mortality

76
Q

Rapid onset shaking chills after URI, fever, pleurisy, productive cough, lobar consildation on CXR, leukocytosis, neutrophilia,

A

Strep pneumo

77
Q

Tx h flu

A

Ampicillin or amoxicillin or 2/3 ceph

GRAM - Coccobacilli

78
Q

Empyema and lung abscesses common

A

Staph aureus

79
Q

When to give vaccine for strep penumo

A 
older than 65
Splenectomy
Sickel cell
All kids
Chronic disease - DM, cardiac, pulm, renal, liver
Immunocompromised
80
Q

Tx strep pneumo

A

Macrolide, doxy, 3 ceph with macrolide or doxy, fluoroquinolone (levofloxacin or moxifloxacin)

81
Q

College student who lives in dorm and has sick contacts

A

Mycoplasma pneumo

82
Q

Negative cold agglutinin Ab titer

Tx

A

Chlam pneumo

Tx: macrolide or broad fluoro

83
Q

Viral causes pneumo

A

RSV
influenza
Parainfluenza
Adenovirus

84
Q

Silver stain

85
Q

TPositive vold agglutinin Ab

Tx

A

Mycoplasma pneumo

Macrolide or broad fluoro

86
Q

If + RPR or VDRL, what to confirm

A

FTA-ABS or MHA-TPA

can see on dark field and not light microscope

87
Q

Tx syphilis

A

Pen or doxy if allergic

88
Q

Primary vs secondary vs tertiary

A

Primary: painless chancre resolve 8 wks
Secondary: condyloma lata 6- 18 wks after infection, maculopapular rash (palms and soles), lymphadenopathy
Tertiary: after latent phase, gummas (granulomas in different organs), neuro (Argyll Robertson pupil, dementia, paresis, tabes dorsalis, Charcot joints), thoracic aortic aneurysm

89
Q

False positive RPR or VDRL

90
Q

Congential syphilis presentation

A

ASx–> cutaneous lesion palm and soles, anemia, rhinorrhea –> frontal bossing, Hutchinson teeth, saddle nose

91
Q

2 types endocarditisi

A

Acute (S aureus)

Subacute (Strep viridians)

92
Q

Presentation endocarditis

A

Signs of infection + new heart murmur, emboli (stroke or infarct) ,Osler nodes (painful tip of finger), Roth spot (retinal hemorrhages), splinter hemorrhages, septic shock

93
Q

Tx endocarditis

A

Empiric: 3rd pen or ceph + aminoglycoside

94
Q

Right sided lesions more common

A

IVDU, left most common in gen population

95
Q

Most common sequelae meningitis

A

Hearing loss

96
Q

Common causes menignitis

A

S pneumo, Ne menigitidis

97
Q

Asepetic meningitis causes

A

Mumps and measles

98
Q

Temporal lobe abnormalities

Tx

A

HSV meningitis

Acyclovir

99
Q

Contacts Tx if Neisseria meningitis

A

Rifampin, cipro, ceftriaxone, or azithromycin

100
Q

Incubation period rabies

A

1-2 months

101
Q

Classic Sx rabies

A

Hydrophobia- painful swallowing

CNS - paralysis

102
Q

Tx after bite for rabies

A
  1. local wound - amoxicillin clauvulante for prophy cellulitis
  2. Observe animal
  3. Prophy rabies Ig and vaccine (US - only give Tx if animal attaclkd unprovoked or if acting weird)
103
Q

Normal bowel flora that can cause endocarditis, UTI, sepsis
Tx endocarditis
Tx VRE

A

Enterococcus faecalis

Endocarditis - cell wall actie agent like amp or vanc and amino glycoside like gentamicin

VRE: linezolid

104
Q

Most common cause neonatal meningitis and sepsis
Acquired birth canal - normal vag flora
Prophy for mom

A

Strep agalactiae - GBS

Pen or ampicilliin

105
Q

Most common cause pneumo, otitis media, meningitis, sinusitis, sepsis

A

Strep pneumo

106
Q

FEVER, PHARYNGEAL EDEMA, TONSILLAR EXUDATE, LACK OF COUGH, Sore throat, ,enlarged tender cervical LN, leukocytosis
Tx, what to avoid

A

Strep pyogenes pharyngitis - GAS

Tx pen to avoid rheumatic fever and scarlet fever

107
Q

Jones criteria for rheumatic fever

A 
Joints- migratory polyarthritis
O- carditis
N- nodules
E- erythema marginatum
S- sydenham chorea
Minor CRiteria
Inflammatory cells (leukocytosis)
Temperature (fever)
ESR/CRP elevated
Raised PR interval
Itself (previous Hx of Rheumatic fever)
Arthralgia

Need hx strep pharyngitis + at elast 1 major

108
Q

Tx rheumatic fever

A

ASA, steroids if severe carditis

109
Q

Cause of scarlet fever

A

STrep produces erythrogenic toxin

110
Q

Classic skin presentation scarlet fever

A

Red flush in skin usually perioral that blances with pressure, truncal rash, strawberry tongue and late desquamation

KAWASAKI CAN ALSO CAUSE THESE SX

111
Q

Abrupt onset hematuria, proteinuria, RBC casts, HTN, edema (periorbital), elevated BUN and Cr

A

PSGN

Cannot prevent with abx!!!!!

112
Q

Strep pyogenes causes

A

Pharyngitis- rheumatic fever, scarlet fever, PSGN

Impetigo, erysipelas, cellulitis, necrotizing fascitis, endomtritis or puerperal fever

113
Q

Honey colored crusted lesions

A

Impetigo - staph&raquo_space;> strep
Staph if furuncle or carbuncle
Strep if glomerulonephritis

114
Q

Superficial cellulitis

A

Erysipelas

115
Q

Most common cause cellulitis

116
Q

Cellulitis in fisherman

A

Vibrio vulnificus - tetracycline

117
Q

Cellulitis progresses to necrosis and gangrene with crepitus and systemic toxicity

A

Necrotizing fascitis

118
Q

Endometritis Tx

A

Clindamycin + gentamicin after culturing

119
Q

Subacute endocarditis and dental caries

A

Strep viridans (caries - Stre mutans)

120
Q

S aureus commonly causes….

A 
Abscess - furuncle or breastfeeding
Cellultis
Endocarditis esp drug user
Food poisoning 2/2 preformed toxin
Furuncle or carbuncle
Impetigo
Osteomyelitis - most common except in sickle cell
Pneumo- form abscess or empyema
Scalded skin syndrome- preformed toxin-->impetigo then desquamates
Septic arthritis
TSS- preformed toxin, hypotension, fever, rash that desquamates
Wound infection
Stap epidermidis: IV cath, proesthetics
Staph saprophyticus: UTI
121
Q

Exposed adult with neg PPD -Tx or no

122
Q

Exposed child < 5 yrs with - PPD - Tx or no

A

Tx with INH for 3 months then repeat

123
Q

Prophy for PPD conversion from neg to positive

A

INH 9 months and repeat PPD

124
Q

Active disease or positive culture TX

A

RIPE 2 months then INH and rifampin 4 months

125
Q

What to give with INH to prevent neuropathy, confusion, angular cheilitis, seborrheic dermatitis

A

B6/ pyridoxine

126
Q

3 most common causes fever of unknown origin

A

Infection
Cancer
AI disease

127
Q

Most common predisposing factor acute sinusitis

128
Q

Asplenic pts predisposed to infections by

A

Encapsulated- pneumococcus, meningococcus, H flu, Kleb

129
Q

Number bacteria in urine to Dx UTI

130
Q

Healthy population susceptible to UTI

131
Q

Tx cocci

A

Amphotericin B

132
Q

Blueberry muffin rash - congenital infection

133
Q

Meningitis neonates
Causes
Tx

A

GBS, E coli, Listeria,

Tx: gentamicin and ampicillin

134
Q

Meningitis in infants
Causes
Tx

A

Pneumococcus
Meningococcus
H flu
Tx: cefotaxime and vanc

135
Q

CSF: low glc and PMN

A

bacterial meningitis

136
Q

CSF: normal glc w/ lymphs

A

Viral meningitis

137
Q

Numerous RBC in CSF samples

138
Q

Inc gamma globulins in CSF

139
Q

Pruritic papule with regional LNopathy–>blak eschar after 7-10 d
Tx

A

Cutanoues anthrax

Tx Pen G or ciprfloxacin

140
Q

2nd lyme findings

A

Arthralgias, migratory polyarthropathies, Bell’s palsy, myocarditis

141
Q

+ cold agglutinins

A

Mycoplasma

142
Q

Neutropenic nadir postchemo

143
Q

Findings endocarditis

A

Fever, heart murmur, osler’s nodes, splinter hemorrhages, Janeway lesions, Roth’s spots

144
Q

Branching rods oral infection

A

actinomyces israelii

145
Q

Weakly gram + partially acid fast in lung infection

A

Nocardia asteroides

146
Q

Painful chancroid

A

Haemophilus ducreyi

147
Q

Dog or cat bite

A

Pasteurella multocida

148
Q

Gardner

A

sporothric schenckii

149
Q

Raw pork and skeletal mm cysts

A

Trichinella spiralis

150
Q

Speepherders with liver cysts

A

Echinococcus granulosus

151
Q

Perianal ithcing

A

Enterobius vermicularis

152
Q

pregnant women with pets

A

Toxoplasma gondii

153
Q

Meningitis adults

A

N meningitidis

154
Q

Meningitis elderly

A

Strep pneumo

155
Q

Meningoencephalitis AIDS

A

Crypto neoformans

156
Q

Malignant otitis externa

A

Pseudomonas

157
Q

Burn infections

A

Pseudomonas

158
Q

Oteomyelitis foot puncture

A

Pseduomonas

159
Q

Osteomyelitis sickel cell

A

Salmonella

160
Q

45 yo heavy smoker and drinker wihth new cough and flulike Sx, Gram stain shows no bugs, silver stain gram - rods

A

Legionella pneumo

161
Q

middle aged man acute onset monoarticular oint pain and bilat Bells palsy
Tx

A

Lyme -Ixodes

Doxy

162
Q

Endocarditis 3 wks after prosthetic valves

A

S aureus or S epidermidis

163
Q

Endocarditis in native valve after dental cleaning

A

Strep viridans

164
Q

Turns body fluids orange - Rx

165
Q

Antigenic drift vs antigenic shift

A

Drift: small, gradual changes in surface proteins through point mutations, virus can escape immune recognition, why can be infected with flu multiple times
Shift: acute, major change in the influenza A subtype (genetic reassortment) circulating among humans, leads to pandemics

166
Q

Common causes encephalitis

A

HSV and arbovirus

167
Q

India ink stain

A

Cryptococcus

168
Q

Temporal lobe + encephalitis

A

HSV

Tx acyclovir

CMV - ganciclovir +/- foscarnet

169
Q

HA, fever, focal neuro deficit

A

Brain abscess

170
Q

Complications of CMV

A

Retinitis: retinal detachment, floaters and changes in visual field
GI and hepatobiliary: nonspecific
Pneumonitis: cough fever, sparse sputum
CNS: polyradiculopathy, transverse myelinitis, encephalitis

171
Q

Complications chlamydia

A

Arthritis, neonatal conjuctivits, pneumo, urethritis / PID, lymphogranuloma venereum

172
Q

HIV, CD4<25, anemia, hypoalbuminemia, inc ALP

A

MAC

Tx - prophy azithromycin

173
Q

Tx syphilis can result in

A

Jarisch Herxheimer rxn - acute flulike illness

174
Q

Common UTI causes

A 
SEEKS PP
Serratia
E coli
Enterobacter
Klebsiella pneumo
Staph saprophyticus
Pseudomonas
Proteus mirabilis
175
Q

Tick RMSF

A

Dermacentor variabilis

176
Q

Bacterial conjuctivitis that is an emergency

177
Q

Conjunctivitis - recurrent epithelial keratitis in childhood, leading cuase of preventable blindness worldwide

A

C trachomatis A-C

178
Q

Watery discharge conjuctivitis

A

Viral - usu adenovirus

179
Q

FB sensation w/ purulent discharge

A

Staph, strep Haemophilus, Pseudomonas, Moraxella

First Aid Step 2 (22 decks)

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