Infectious Disease (Alice) (12%) Flashcards

1
Q

firm inflamed swelling in the right submandibular area unresponsive to IV abx

A

atypical myobacterial dz

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2
Q

FNA findings of myobacterial dz

A

acid-fast bacilli on ziehl-neelsen staining

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3
Q

atypical myobacterial infections in children are most frequently located where

A

superior anterior cervical or submandibular nodes

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4
Q

95% of myobacterial infxns in kids present with

A

unilateral, subacute, painless, firm, progressive LAD

mc do NOT involve constitutional sx

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5
Q

mc age for pediatric myobacterium infxns

A

1-5 yo

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6
Q

3 pediatric myobacterial infxns to know

A

MAC
kanasaii
marinum

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7
Q

sx of MAC (4)

A

fever
diarrhea
wt loss
anemia

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8
Q

mode of transmission for MAC

A

soil
water

not person to person

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9
Q

MAC is mc symptomatic in what pt pop

A

HIV w. CD4 < 50

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10
Q

dx for MAC

A

AFB
culture

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11
Q

tx for MAC

A

clarithromycin
PLUS
ethambutol
x at least 12 mos
+/- rifampin

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12
Q

prophylactic tx for MAC for HIV pt

A

azithromycin OR clindamycin if CD4 < 50

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13
Q

which myobacterium infxn presents w. TB like sx

A

kanasii

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14
Q

tx for myobacterium kanasasii

A

rifampin
PLUS
ethambutol

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15
Q

where is myobacterium marinum found

A

fresh and saltwater

think aquarium/marine animals

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16
Q

tx for myobacterium marinum (4)

A

tetracyclines
fluoroquinolones
macrolides
sulfonamides

x 4-6 weeks

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17
Q

sore throat
fever
malaise
diffuse tonsillar exudate

A

EBV

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18
Q

splenomegaly
painful LAD
hepatomegaly

A

EBV

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19
Q

classic EBV triad

A

fever
LAD
pharyngitis

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20
Q

what lab trend does EBV make you think of

A

lymphocytic leukocytosis

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21
Q

what is this showing

A

atypical lymphotyctes w. enlarged nuclei and prominent nucleoli -> EBV

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22
Q

what is this rash associated w.

A

maculopapular rash w. ampicillin -> EBV

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23
Q

HSV viruses and associated symptoms/conditions

A

HSV1: oral lesions
HSV2: genital lesions
HHV3: varicella zoster - chicken pox/shingles
HHV4: EBV
HHV5: CMV
HHV6: roseolovirus (6th disease)
HHV7: similar to HHV6 - not classified
HHV8: rhadinovirus - kaposi’s sarcoma (KSHV)

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24
Q

what is this showing

A

HHV 3 - varicella zoster

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25
Q

what is this showing

A

HHV 3 - chickenpox

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26
Q

what is this showing

A

HHV4 - EBV

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27
Q

what is this showing

A

HHV5 - CMV

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28
Q

what is this showing

A

HHV 6/7 - roseola (6th dz)

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29
Q

what is this showing

A

HHV8 - kaposi sarcoma

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30
Q

what virus causes the influenza

A

orthomyxovirus

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31
Q

4 contraindications to influenza vaccine

A
  • < 6 mo old
  • severe egg allergy
  • previous rxn
  • guillain barre w.in 6 weeks of previous vaccination OR w.in past 6 weeks
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32
Q

contraindication for flumist flu vaccine

A

asthma

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33
Q

gs dx for influenza (2)

A

RT-PCR
OR
viral culture

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34
Q

CXR findings in primary influenza

A

bilateral diffuse infiltrates

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35
Q

are false positives or false negatives more common w. rapid influenza diagnostic tests (RIDT)

A

false negatives

36
Q

which antivirals treat influenza A and B

A

oseltamivir
zanamivir

best w.in 48 hr of sx onset

37
Q

5 indications for antiviral tx w. influenza

A

hospitalized
outpt w. severe/progressive sx
> 65 yo
pregnant/2 weeks postpartum
lots of comorbidities

38
Q

what virus causes measles

A

paramyxovirus

39
Q

3 phases of measles

A

prodrome: 3 c’s
enathem: koplik spots
exanthem: morbilliform, maculopapular, blanching rash

40
Q

what are the 3 c’s of measles

A

cough
coryza
conjunctivitis
PLUS
fever

41
Q

what is this showing

A

irregularly-shaped bright red spots in the mouth w. bluish white central dot -> koplik spots

42
Q

how does the measles rash spread

A

cephalocaudally

43
Q

clinical dx of measles requires (2)

A

fever x >/= 3 days
PLUS
at least one of the 3 c’s
or
koplik spots

44
Q

gs dx for measles

A

IgM abs
viral PCR

45
Q

management of measles (2)

A

isolation x 1 week after rash onset
symptomatic

46
Q

4 complications of measles

A

otitis media
PNA
diarrhea
encephalitis

47
Q

5 yo w. acute onset of painful swollen parotid glands - temp 100.8

A

mumps

48
Q

what does this make you think

A

mumps

49
Q

what virus causes mumps

A

paramyxovirus

50
Q

how is mumps transmitted

A

respiratory droplets

51
Q

3 different presentations of mumps

A

parotitis
orchitis
aseptic meningitis

52
Q

incubation period of mumps

A

12-14 days

53
Q

hallmark symptom of mumps

A

bilateral parotitis

54
Q

mcc of pancreatitis in children

A

mumps

55
Q

dx of mumps is usually made by

A

hx of exposure
PLUS
parotitis

56
Q

2 diagnostic tests for mumps

A

saliva/blood test
real-time nested PCR

57
Q

lab finding suggestive of mumps

A

elevated amylase (from parotitis)

58
Q

2 CSF findings of mumps

A

lymphocytosis
decreased glucose

59
Q

18 mo old w. increasing intermittent cough x 3 weeks that lasts 10 min at a time and causes gasping inhalations

A

whooping cough (pertussis)

60
Q

what bacteria causes pertussis

A

bordetella pertussis

61
Q

think pertussis if you see (2)

A

cough > 2 weeks
< 2 yo

62
Q

3 stages of pertussis

A

catarrhal: cold-like
paroxysmal: inspiratory whooping cough
convalescent: residual cough

63
Q

the convalescent stage of pertussis can last up to

A

100 days

64
Q

dx for pertussis

A

nasopharyngeal swab culture

65
Q

tx for pertussis

A

macrolide
supportive
SABAs/LABAs

66
Q

enterobiasis vermicularis is aka

A

pinworm (variation of roundworm)

67
Q

mc symptom of pinworm

A

perianal itching esp at night (when eggs are laid)

gross. stop it.

68
Q

transmission of pinworm (3)

A

direct contact
food
surfaces

69
Q

t/f: pinworm eggs can live for 2-3 weeks on an inanimate object

A

t!

70
Q

dx for pinworm

A

scotch tape test -> eggs under microscopy

71
Q

tx for pinworm

A

albendazole
mebendazole

72
Q

teardrop vesicles on an erythematous base/dewdrops on a rose petal

A

varicella - chickenpox

73
Q

what is this showing

A

dewdrops on a rose petal -> chicken pox

74
Q

what is this showing

A

dewdrops on a rose petal -> chicken pox

75
Q

describe the spread of chicken pox

A

cephalocaudal

76
Q

acute chickenpox becomes dormant in the

A

dorsal root ganglion

77
Q

what is this showing

A

maculopapular rash along one dermatome -> shingles

78
Q

dx for shingles

A

tzanck smear -> multinucleated giant cells

79
Q

what is this showing

A

multinucleated giant cells -> zoster

80
Q

dendritic lesions on slit lamp

A

zoster ophthalmicus -> CN V shingles

81
Q

ramsay hunt syndrome is aka _
and involves CN _

A

zoster oticus
CN VII

82
Q

3 sx of ramsay hunt syndrome

A

otalgia
lesions on ear/auditory canal/TM
facial palsy

83
Q

management of shingles

A

acyclovir
PLUS
valacyclovir
PLUS
famciclovir

w.in 72 hr to prevent post perpetic neuralgia

84
Q

definition of postherpetic neuralgia

A

pain > 3 mo
paresthesias
decreased sensation

85
Q

tx for postherpetic neuralgia (4)

A

gabapentin
TCA
topical lido
capsaicin

86
Q

zoster vaccine is recommended for

A

adults > 60 yo