Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infectious Disease and HEENT > Infectious Disease Exam 2 Cards > Flashcards

Infectious Disease Exam 2 Cards Flashcards

1
Q

Herpes Virus

A

DNA virus
Eight types
Don’t survive long outside of the host

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

2 HSV viruses and their GENERAL locations

A

HSV-1 Oral
HSV-2 Genital

First you kiss, then you have sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of Oral HSV and genital HSV

A

Vesicles and crusts around the mouth and nose, may also appear digitally

Genital HSV has a similar presentation but around the genitals

Herpes is ALWAYS painful!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

4 Associated symptoms with HSV 1 (besides the vescicles)

A

Burning skin, Pain with eating, swollen lymph nodes, low grade fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

6 associated symptoms of a genital infection with herpes

A

Skin pain, Dysuria, Cervicitis, Urinary retention, Swollen lymph nodes, Fever and aches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How often is herpes painful

A

ALWAYS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens after the initial herpes infection

A

It remains dormant in the basal ganglia and can flare up in response to stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Progression of HSV keratoconjunctivitis

A

Starts with blepharitis and can lead to impaired visual acuity and blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Transmission of HSV keratoconjunctivitis

A

Direct inoculation or trigeminal nerve spread - take precautions if cysts are anywhere near the eyes!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 diagnostic ways to identify HSV

A

Appearance
Cultures
PCR (used for HSV enchaphalitis)
Tzanck smear (also positive for Varicella)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tzank smear

A

Looks for multinucleated giant cells as seen in HSV or Varicella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnostic for HSV conjunctivitis

A

Appearance of dendritic lesions on fluorescein stain and slit lamp examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Screening recommendation for HSV

A

Screening NOT recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Usual healing time for HSV - initial outbreak and recurrence

A

Initial 10-20 days
Recurrence 5-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 treatment options for HSV

A

Antivirals (oral or topical)
Anesthetics for symptom relief
Antibiotics for secondary bacterial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 antivirals for treating HSV

A

Acyclovir - $4 at kroger and comes in more forms than just oral
Famciclovir
Valacyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Drug for ophthalmic HSV

A

Trifluridine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PK of Valaciclovir and Famciclovir

A

Renal primarily, no CYP450 interaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3 most common adverse reactions to herpes antivirals and pregnancy category

A

Pregnancy category B
GI symptoms, HA, Arthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

2 Drugs for CMV infections in immune compromised HIV patients

A

Ganciclovir and Valganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Drug used for Acyclovir resistant HSV

A

Foscarnet (can also be used in CMV in AIDS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How soon should HSV treatment begin?

A

48-72 hours after onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Recipe for Herpes magic mouthwash

A

1/3 Licocaine or Zilocaine
1/3 Maalox
1/3 Benadryl
2 3oz refills and may make the patient numb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Etiology and progression of Varicella virus

A

Initial infection results in chicken pox, later recurrence results in shingles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Shingles lesion presentation

A

Lesion on erythematous base - due drop on a rose petal

Pain precedes the rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

4 potential complications from Herpes Zoster

A

Post herpatic neuralgia
Secondary skin infections
Vision loss
Bell’s palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatments for:
Shingles
Herpes Zoster Opthalmicus
Post hepatic neuralgia

A

Shingles - Acyclovir, Valacyclovir, Famciclovir started within 72 hours
HZO - Admit for IV acyclovir, topical steroids
Post-Hepatic Neuralgia - Opioids, TCAs, Gabapentin for pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Dosing and age recommendation for shingrix/RZV

A

Same vaccine

Offer to those of 50 years of age
2 vaccines 2-6 months apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Etiology and transmission of Mononucleosis

A

Caused by Epstein-Barr Virus (Human herpesvirus 4)
Transmitted via saliva and blood products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

5 signs of mononucleosis

A

Posterior Cervical Lymphadenopathy
Pharyngeal irritation
Splenomegaly
Palatal petechiae
Maculopapular rash

(Classic triad if Fever, Pharyngitis, and Lymphadenopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What happens if you give a person with mono ampicillin?

A

Rash is seen in over 90% of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Serology, Blood Smear, CBC, and EBV antibody findings for Mono

A

Serology - Mono spot test showing heterophile agglutination
Blood smear - Atypical large lymphocytes
CBC - Leukopenia and Lymphocytosis
EBV antibodies - IgM for acute, IgG for non-acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

3 potential complications from mono

A

Splenomegaly/Rupture - avoid contact sports
Hepatitis - Watch for jaundice
CNS involvement - Infrequent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Drug interaction with Mono - What’s the drug, What’s the interaction

A

Rash with PCN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

3 treatments for Epstein-Barr Virus

A

Fluids, Antipyretics, Antibiotics and Antivirals NOT indicated

Hospitalize if necessary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Prognosis for Mono

A

Fever/sore throat resolves in 10 days
LAN, splenomegaly resolves in 4 weeks
Fatigue can linger for months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

3 transmission routes for CMV

A

Blood, body fluids, transplacentally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

CMV inclusion disease in newborns 3 things

A

Hepatitis, retardation, hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

3 symptoms of CMV active viral syndrome

A

Fever, Malaise, Neuralgia
Mono-like minus pharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Strains of HPV (4)

A

6 and 11 - genital warts (condyloma acuminatum)
16 and 18 - 18-70% of cervical cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

HPV demographics and spread

A

Only spread via sexual contact
More common in women with a 3 week to 8 month incubation period
Asymptomatic people can still transmit the virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

HPV clinical presentation

A

Fleshy lesions with a pedunculated stem that can be in the genital, perianal or anal region may interfere with intercourse or defacation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

4 ways to treat HPV warts

A

Chemical destruction with Podophylin/Podofilox or Imiquimod
Cryotherapy
Systemic Interferon
Laser of Excisive surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Aplication for cream for HPV lesions

A

Put around the base of the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Do you need a biopsy to diagnose HPV warts?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Prevention of HPV

A

Gardasil vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

HPV vaccine reccomendations

A

Males and Females 11-12, catch up recommended in females up to 26 and males up to 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Antigenic drift

A

Slow gradual change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Antigenic shift

A

Sudden change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

3 clinical presentation elements of Influenza

A

Sudden onset fever, chills, headache, myalgia and malasie
Non-productive cough, sore throat, nasal discharge
Unremarkable PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

4 complications in influenza

A

Secondary Bacterial infection
Rhabdomyolysis
Aseptic meningitis
Cardiac complications

SCAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

2 Diagnostic tests for Influenza

A

Rapid Diagnostic Test - More false negatives
Viral culture - conduct in all hospitalized patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

2 types of antivirals for influenza

A

Neuraminidase inhibitors
NMDA receptor agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

3 neuriminidase inhibitors with routes for flu

A

Oseltamivir (Tamiflu) - PO
Zanamivir (Relenza) - Inhaled
Peramivir (Rapivab) - IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

2 NMDA receptor antagonists for influenza and what they cover

A

Amantadine
Rimantadine

ONLY for Influenza A!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Dosage for Oseltamivir (Tamiflu)

A

75 mg PO BID for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How soon do neuraminidase inhibitors need to be started for influenza

A

Within 48 hours of sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are anti-flu treatments intended to do for the patient?

A

Prevent their symptoms from getting worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Adverse effects of neuraminidase inhibitors

Which one causes bronchospasms?

Which needs renal dosing?

A

Side effects may be worse than the flu - use judgement
N/V/D, HA - Are most common
Bronchospasms with Zanamivir

Renal dosing with Oseltamivir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Flu vaccination - when and who

A

In october for anyone 6 months or older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

2 main types of flu vaccines

A

Inactivated shot
Live attenuated - IN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

5 causative agents of viral pneumonia

A

Influenza
RSV
Parainfluenza
Adenovirus
Coronavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

4 clinical presentation hallmarks of viral pneumonia

A

Fever, chills, myalgias
Nonproductive cough
May have rhonchi on PE
Non diagnostic CXR

“Lung gunk goes away when the patient coughs”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What does an adenovirus affect and what is one key sign of one

A

EVERY mucous membrane in your body

Look for STERILE pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Rotavirus

A

Fecal oral non inflammatory gastroenteritis most often seen in children - now has a vaccine available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Norovirus

A

Gastroenteritis in older children and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

4 vector viruses
Which one is a rhabdovirus

A

Arbovuruses
West Nile
La Crosse encephalitis
Zika

Rhabdovirus
Rabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Spinal tap for viral meningitis should be _________________?

A

Clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

West nile vector

A

Mosquito

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Clinical presentation of West Nile Virus

A

Often mild with aches, GI issues and a rash

Can have serious symptoms such as seizures, stiff neck, or paralysis - serious sx can linger for months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Diagnosis treatment and prevention for West Nile

A

Diagnose via lumbar puncture - only in SEVERE cases
Supportive treatment and mosquito control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

LaCrosse Virus transmission

A

Mosquito

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

4 aspects of La Crosse clinical presentation

A

Can be asymptomatic
Febrile illness
Encephalitis
Most severe in patients under 16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Most common mosquito born virus in WV

A

La Crosse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

General information about Rabies

A

From the bite of an infected mammal, sometimes a pet
Causes encaphalitis and leads to death if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Initial rabies presentation

A

Flu like symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

When does acute neurologic disease set in with rabies

A

after 2-10 days
Delerium, abnormal behavior, hallucinations, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Post exposure prophylaxis for rabies

A

Wash wound immediately
Give doses of rabies vaccine on days 1,3,7,14 -double and add one…kinda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Target of most antifungals

A

Fungal cell membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Two types of Azoles and what they are used for

A

Triazoles - Systemic w/ fewer side effects, usually oral or IV

Flu and Itra are topical, Itra is not IV

Imidazoles - Usually topical because they have more side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

MOA of Azoles

A

Inhibit synthesis of ergosterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Fluconazole

A

Covers candida albicans and cryptococcus used for superficial and uncomplicated systemic infections
CSF penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

FIVE Systemic Azoles from least to most effective

A

Fluconazole
Itraconazole
Voriconazole
(E)Posaconazole/Isavuconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Itraconazole

A

Drug of choice against Histoplasmosis, Sporotrichosis, and Blastomycosis
Variable bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Voriconazole

A

Drug for invasive aspergillosis
CSF penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Posaconazole and Isavuconazole

A

BIG GUNS
Invasive fungal infections in IC patients OR resistant infections
Posa=CSF
Isavu=No CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

2 cheap, topical azoles

A

Clotrimazole and Miconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

3 effective topical azoles

A

Econazole, Ketoconazole, Sulconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

2 Daily topical Azoles

A

Econazole, Ketoconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Usual dosing for most Azoles

A

BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

MOA of polyenes

A

Bind to ergosterol in fungal cell membrane creating pores that cause cell leakage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Absorption and toxicity of Polyenes

A

Generally not absorbed well via the GI tract
Have major side effects - Nystatin is TOO TOXIC for systemic use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Amphotericin B

A

Polyene for severe disseminated mycotic infection
Given IV
Nephrotoxic, Causes hypokalemia, hypercholemic acidosis, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Nystatin

A

Topical and Oral Polyene - too toxic for systemic use
Non-invasive candidal infections
Can cause irritation and allergic reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

3 echinocandins

A

caspofungin, anidulafungin, micafungin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

MOA of echinocandins

A

Inhibit fungal cell wall synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Route of echinocandins

A

Administered IV only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

2 indications for echinocandins

A

Disseminated candidiasis
Aspergillosis infection in HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Drug interactions of echinocandins

A

Fewer than azoles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

2 adverse effects of echinocandins

A

Insomnia and hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Drug class of griseofulvin

A

Mitotic inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Route of Griseofulvin

A

Take orally with a fatty meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Indication of Griseofulvin

A

Dermatophyte/Tinea infections of the skin and hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

4 Drug interactions for Griseofulvin

A

Alcohol, Warfarin, Barbiturates, Contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Griseofulvin and pregnancy

A

Contrindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

3 serious side effects of griseofulvin and one lab that needs to be drawn

A

Hepatotoxicity, Teratogenicity, Neutropenia

Weekly CBCs needed during tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Drug class of terbinafine

A

Allyamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

MOA of terbinafine

A

interfere with ergosterol synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

2 routes of terbinafine

A

Oral or topical but irritating to mucous membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

2 Oral indications for terbinafine

A

onychomycosis, dermatophyte (tinea) infections of hair and skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

1 topical indication for terbinafine

A

Dermatophyte (tinea) infections of hair and skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

2 serious side effects of terbinafine

A

hepatotoxicity and neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Flucystosine MOA

A

Converted to 5FU Inhibits fungal RNA and protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Route of flucytosine

A

Oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

2 indications for flucystosine

A

Combo drug with amphotericin B, severe cryptococcal or candidal infections in the immune compromised
Only when patients REALLY need it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

3 adverse effects of flucystosine

A

Renal failure, Pancytopenia, Aplastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Class of Ibrexafungerp

A

Triterpenoid (new class)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Indication of ibrexafungerp

A

vulvovaginal candidiasis - one day tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Inbrexafungerp and pregnancy

A

contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

3 side effects of ibrexafungerp

A

Dysmenorrhea/Vaginal bleeding, Back pain, abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

3 alternative topicals indicated for tinea infections

A

Butenafine, Tolnaftate, Naftifine (Not OTC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

3 topical therapies for onychomycosis

A

Ciclopirox, Tavaborole, Efinaconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Presentation of Oral candadiasis

A

Edematous mucosa with white plaque that can be scraped off. Advance stages may result in altered taste and difficulty swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

3 ways to diagnose oral candidiasis

A

Clinical diagnosis, KOH prep, Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

3 topical, 1 systemic, and 1 alternative therapy for oral candadiasis

A

Topical/swish and spit - Nystatin, Clotrimazole, Miconazole x 7-14 days

Systemic - Fluconazole x 7-14 days

Alternative - Gentian Violet x3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Treatment for Esophageal candidiasis

A

Fluconazole PO or IV
If resistant Itraconazole PO or Voriconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Presentation of Vulvovaginal Candidiasis

A

Itching, burning and pain around the genital area with a non-malodourous cottage cheese discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Candidal intertrigo

A

Candidiasis in skin folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Presentation of candidal intertrigo

A

Well defined plaques with satelite papules and pustules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

3 treatments for intertrigo

A

Talc, Nystatin (Topical), Fluconazole (systemic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Tinea that isn’t really a tinea

A

Tinea versicolor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Tinea KOH prep finding

A

Segmented hypae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Candida KOH prep finding

A

Budding yeast and pseudohyphae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Clinical presentation of tinea capitis

A

Hairless patches on the scalp with black dots at the follicles, slowly enlarge over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Diagnosis for most tineas

A

Usually a clinical diagnosis but can use KOH prep if ambiguous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Primary spread of tinea capitis

A

child to child spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Spread of tinea corporis

A

Usually person to person, can also be spread from animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Presentation of tinea corporis

A

Circular plaque that spreads outwards and develops central clearing with a scaly, red border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Tinea cruris

A

Tinea that develops in the genital region, a result of sweating or HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Clinical presentation of tinea cruris

A

Scaly erythematous rash confined to the groin region, may have central clearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Clinical presentation of tinea pedis

A

Itching, burning or stinging with self-limiting exacerbations
Acutely presents with erythematous bullae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

One factor that can lead to a false negative KOH prep for Tinea

A

Sample taken from macerated skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Clinical presentation of tinea unguium

A

Thickened nail with yellow/brown discoloration that may separate from the nail bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Difference between diagnoses of Tinea unguium and other tineas

A

A KOH prep or culture is recommended to rule out other nail infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

One antibiotic that is NOT effective for tinea/dermatophyte infections

A

Nystatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Treatment for tinea capitis

A

Always systemic - use griseofulvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Treatment for tinea corporis and cruris

A

Topical Azole or systemic griseofulvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Treatment for tinea pedis

A

Topical azole or Systemic terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Treatment for tinea unguium

A

Topical efinaconazole
Systemic - terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Region in the US for Blastomycosis

A

East

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Region of the US for Coccidioidmycosis

A

South West

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Region of the US for Histoplasmosis

A

South East

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Region of the US for cryptococcus

A

West Coast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

2 Vectors for Histoplasmosis

A

Batman and Robin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

1 characteristic presentation of histoplasmosis

A

Calcification, including Egg-Shell lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Acute pulmonary histoplasmosis presentation

A

Mild flu like illness with fever cough and myalgias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Presentation of progressive disseminated histoplasmosis (5)

A

Seen in HIV
Fever, cough, dyspnea, prostration and septic like symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Presentation of chronic pulmonary histoplasmosis

A

Usually in patients with chronic respiratory disease - leads to lung nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Complication of histoplasmosis

A

Granulomatous mediastinitis - fibrosis of the mediastinum leads to constriction of the esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

3 diagnostic studies for histoplasmosis

A

Labs, CUltures, Bronchoscopy with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

3 Lab findings for Histoplasmosis

A

Anemia
Elevated LDH and Ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Treatment for Mild/Moderate; Severe; and Granulomatous histoplasmosis

A

Mild/Moderate - Itraconazole
Severe - Amphoterricin B
Granulomatous - Itraconazole +/- Rituximab +/- Corticosteroids; surgical intervention sometimes needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

3 Presentations of primary coccidioidmycosis

A

Flu like symptoms (HA, myalgia)
Erythematous rash
Joint swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Presentation of disseminated coccidioidmycosis

A

Multiorgan involvement and worsened lung symptoms including lung abscesses; localized infiltrates also seen on CXR

165
Q

Two lab results possible with coccidioidmycosis

A

Leukocytosis and Eosinophilia

166
Q

Most reliable diagnostic method for coccidioidmycosis

A

Bronchoscopy with culture

167
Q

Treatment for Mild/Moderate and Severe Coccidioidmycosis

A

Mild/Moderate - Fluconazole or Itraconazole
Severe - Amphotericin B

168
Q

CD4 count for Coccidioidmycosis prophylaxis

A

Under 250

169
Q

Most common clinical presentation for Blastomycosis

A

Flu-like symptoms, nodular wart-like lesions, May resolve or progress to pneumonia

170
Q

Most common CXR finding for blastomycosis

A

Airspace consolidation or masses

171
Q

Disseminated blastomycosis presentation

A

Skin lesions as well as bone and GU system issues

172
Q

Treatment for Mild/Moderate and severe or CNS blastomycosis

A

Mild/Moderate - Itraconazole
Severe - Amphotericin B

173
Q

Cryptococcus

A

Spread via pigeon dung, only significant in the immune compromised

174
Q

Presentation of cryptococcus (3)

A

Pulmonary disease, Meningitis (HA, altered mental status) without meningeal signs, Nodular skin lesions

175
Q

3 diagnostic tests for cryptococcus

A

Serum or CSF antigen, Bronchoscopy with culture, Other cultures

176
Q

Treatment for cryptococcal pneumonia

A

Fluconazole for 6-12 months

177
Q

Treatment for cryptococcal meningitis

A

Amphotericin B for 2 weeks followed by 8 weeks of fluconazole
Potential CSF shunt needed

178
Q

Presentation of pneumocystis jirovecci

A

Sudden onset of fever, dyspnea, and non-productive cough

179
Q

Culture for Pneumocystis

A

Cannot be cultured

180
Q

First line treatment for pneumocystis jirovecci

A

TMP-SMZ (Bactrim)

181
Q

Historical question to ask if you suspect a parasitic infection

A

Have you traveled in the last month or two?

182
Q

Mild/Moderate presentation of amebic dyssenterry

A

Gradual onset of abdominal pain with bloating and diarrhea. Hematochezia may be present
NO fever

183
Q

Presentation of severe amebic dyssentery

A

Fever with 10-20 watery/bloody stools per day

184
Q

Complications of amebic dyssentery

A

Necrotizing colitis, Granulomatous lesions, Bowel ulcerations

185
Q

Extraintestinal complication of amebiasis

A

Amebic liver abcess - causes pain and fatal if ruptured

186
Q

2 tests for diagnosis of intestinal amebiasis

A

Stool antigen test and Stool PCR

187
Q

2 tests for diagnosis of an amebic hepatic abcess

A

Serum for anti amebic antibodies and CT of liver

188
Q

Treatment for amebiasis

A

Metronidazole for 10 days or tinidazole for 3 days followed by Paromomycin for 7 days

189
Q

2 forms of Giardia

A

Trophozooites or Cysts

190
Q

Clinical presentation of acute diarrheal syndrome from Giardia

A

Profuse watery diarrhea without fever or vomiting

191
Q

Clinical presentation of chronic diarrhea from GIardia

A

Daily or cyclical greasy diarrhea without blood or fever. May go on for months

192
Q

2 Diagnostic tests for giardia

A

Stool antigen and stool PCR

193
Q

Giardia drugs for:
Adults
1-3 yrs
Under 12 months

A

Adults - Tinidazole
1-3 - Nitazoxanide
Under 12 months - Metronidazole

194
Q

Key side effect of nitazoxamide

A

Bright yellow urine

195
Q

Most common cause of cryptosporidium outbreaks

A

Swimming pools

196
Q

Why does giardia cause greasy stools

A

It gets in the way and causes bad absorption

197
Q

Boiling water and giardia

A

might not kill giardia spores

198
Q

Form of cryptosporidium found in nature

A

Thick walled cysts - can survive for years

199
Q

Presentation of cryptosporidias acute infection

A

Watery, non-bloody diarrhea with a low grade fever

200
Q

Clinical presentation of cryptosporidias in the HIV patient

A

Foul smelling chronic diarrhea with pulmonary billiary tract problems

201
Q

2 diagnostic tests for cryptosporidium

A

Stool antigen assay and stool PCR testing

202
Q

Treatment for cryptosporidiosis

A

Acute form is self limiting - can use nitrozoxanide or paromomycin if needed

203
Q

3 endemic areas for cyclosporiasis

A

Haiti, Nepal, Peru

204
Q

Most common source of cyclosporiasis

A

Imported fresh produce

205
Q

Clinical presentation of cyclosporiasis

A

Watery diarrhea and cramping with a potentially flu-like prodrome - relapses are possible
More severe and prolonged in immune compromised patients

206
Q

Diagnostic of choice for cyclosporiasis

A

Stool microscopy O&P with acid fast stain

207
Q

Treatment for cyclosporiasis

A

Bactrim - first line
Second line - Ciprofloxacin or Nitazoxamide

208
Q

Transmission of trichomoniasis

A

Sexually transmitted - more common in women

209
Q

Clinical presentation of trichomoniasis

A

Frothy yellow/green vaginal discharge, dyspareunia, strawberry cervix

210
Q

3 diagnostic tests for trichamoniasis

A

MOTILE on wet prep microscopy
Rapid antigen testing
PCR

211
Q

Treatment for trichamoniasis

A

Tinidazole or Secnidazole - treat ALL sexual partners
May also use metronidazole

212
Q

Leading cause of foodborne illness deaths in the US

A

Toxoplasmosis

213
Q

Clinical presentation of toxoplasmosis in the immune competent

A

GI to Lymphatics to Systemic
Mono-like symptoms with malaise and sore throat
Can also present with heaptitis

214
Q

Clinical presentation of toxoplasmosis in the immune compromised

A

Encephalitis with necrotizing brain lesions, can resurface in AIDS patients

215
Q

Presentation of congenital toxoplasmosis

A

Passed from infected mother to baby
Causes: Stillbirth, Seizures, Retardation, CNS or eye disease, Retinochoroiditis in teenagers

216
Q

3 diagnostic tools for toxoplasmosis

A

Serum antibodies, Tissue biopsy, Body fluid PCR

217
Q

Treatment of toxoplasmosis during pregnancy

A

Spiramycin

218
Q

Toxoplasmosis treatment for immune compromised patients or for fetal infection

A

pyrimethamine (teratogen in early pregnancy) + sulfadiazine

219
Q

Malaria vector

A

Anopheles mosquito

220
Q

Typical incubation for malaria

A

9-14 days

221
Q

When considering recent travel, when is risk of P. falciparum the greatest

A

2 months after exposure

222
Q

Simplified malaria life cycle

A

Sporozoites infect liver cells (come from mosquito)
Merozoites infect red blood cells - these cause systemic symptoms

223
Q

Clinical presentation of an acute malarial attack

A

High fever, chills, sweats
Dry cough
Myalgia
May have some anemia of jaundice
Start sporadic and become regular

224
Q

Most severe form of malaria

A

Falciparum

225
Q

5 clinical manifestations of severe malaria

A

Altered consciousness, Hemolysis, Secondary bacterial infection, Pulmonary edema, Hypotension

226
Q

Gold standard diagnostic for malaria

A

Giemsa-stained blood smear

227
Q

First line treatment for Falciparum/Resistant; Non-resistant; and Severe malaria

A

Non-resistant - Chloroquine
Resistant/Falciparum - Artemether-lumefantrine (Coartem)
Severe - Artesunate - only available from the CDC

228
Q

Antifolate drug for malaria

A

Malarone - second line after arteminisin, can cause liver enzyme elevation

229
Q

MOA of chloroquine

A

Collects in parasite food vacuole - Effective against Malaria that is in the RBC stage

230
Q

Malaria drug used to eliminate liver cysts

A

Primaquine - can cause cardiac issues and is CI in pregnancy

231
Q

Onset of Chloroquine derivatives

A

Fast - symptoms go away in 24-48 hours, parasites in 48-72

232
Q

Side effect of chloroquine

A

Pruritis

233
Q

Mefloquine

A

Used for prophylaxis of malaria - toxic when used for treatment. Avoid with seizure hx and psychiatric disorders

234
Q

Quinine
5 Side effects

A

MOA not well understood, can cause nausea, blurred vision and tinnitus as well as hemolysis and cytopenia

235
Q

Arteminisin derivatives

A

Fore resistant Malaria, encourage the formation of free radicals and have a short half life. Well tolerated but should be given in combo regimens

236
Q

2 antimalarial prophylaxis drugs safe for pregnancy

A

Chloroquine and Mefloquine - these must be taken early before travel

237
Q

3 antimalarial prophylaxis drugs NOT safe for pregnancy

A

Atovaquone-proguanil (Malarone), Doxycycline, and Primaquine - These must be taken daily for travel

238
Q

Made mode of transmission for tape worms

A

Ingestion of undercooked meat

239
Q

What happens when tapeworm eggs from himan feces are ingested?

A

Brain cysts

240
Q

Habitat of tapeworms

A

Live in the intestines and can reach several feet in length

241
Q

Common presentation of noninvasive Taeniasis (Tapewroms)

A

May have abdominal pain, with eosinophilia. Most commonly detected via proglottids in the stool

242
Q

Common presentation of invasive tapeworm infection

A

Invades the brain causing altered cognition, seizures, and deficits

243
Q

Treatment for intestinal tapeworm

A

Praziquantel 1 dose PO

244
Q

Treatment for Neurocysticercosis (Brain Tapeworm)

A

Albendazole BUT killing cysts can cause inflammation

245
Q

MOA of praziquantel

A

Paralyzes worms by causing calcium to enter cells which creates muscle spasms, causing them to detach from their host

246
Q

Side effect of praziquantel

A

Secondary inflammation following parasite death

247
Q

Transmission of hookworms

A

Transcutaneous (migrate to lungs) although some can be transmitted through contaminated food/water

248
Q

Path of hookworms in the human body

A

Foot to Lungs to Mouth to Gut

249
Q

Clinical presentation of hookworm infection

A

Serpigionous rash at site of entry
Fever, Wheezing, and Dry cough during pulmonary stage
Bloating, abdominal pain nausea and diarrhea

250
Q

2 complications of hookworms

A

Can cause iron deficiency
Can cause cognitive delay in children

251
Q

Diagnostic tool for hookworms

A

Stool microscopy for ova and parasite - Rapid PCR becoming increasingly available

252
Q

Treatment for hookworms

A

Albendazole or Mebendazole usually 1 dose
Treat for anemia or low protein as needed

253
Q

2 benzamidazoles

A

Albendazole
Mebendazole (Not common in the US)

254
Q

MOA of albendazole

A

Inhibits helminth microtubule formation and glucose uptake

255
Q

4 drug interactions of albendazole

A

Antimalarials, Grapefruit juice, cimetidine, anticonvulsants

256
Q

Transmission of Pinworms

A

Fecal-Oral can be contracted from contact with a contaminated fomite - most common in children

257
Q

Clinical presentation of enterobiasis (pinworms)

A

Perianal pruritis (often nocturnal), insomnia, and enuresis (bed wetting)

258
Q

Diagnostic test for pinworms

A

“Scotch tape test” eggs are not typically found in the feces but on the perianal skin

259
Q

Treatment for hookworms

A

Albendazole or Mebendazole - 1 dose PO and repeat in 2 weeks
Wash sheets and clothing and treat close contacts

260
Q

Transmission of trichinosis

A

Ingestion of larvae from undercooked pork or other meat

261
Q

Incubation of trichanosis

A

1-7 days

262
Q

Clinical presentation of trichinosis

A

Abdominal pain to eosinophilia and periorbital edema, signs of muscle involvement in severe cases

263
Q

3 diagnostic tests for trichinosis

A

Elevated serum muscle enzymes
ELISA assay 2+ weeks after infection
Muscle Biopsy

264
Q

Treatment for trichanosis

A

No specific treatment for systemic stage - supportive care
Can us albendazole early on

265
Q

Transmission of Roundworms (Ascariasis)

A

Fecal-Oral - ingestion of contaminated eggs or food

266
Q

Incubation period for round worms

A

6-8 weeks

267
Q

Clinical presentation of roundworms

A

Fever, eosnophilia, dry cough, chest pain, pancreatitis

268
Q

2 ways to diagnose roundworms

A

Stool microscopy or emergence of adult worms

269
Q

Treatment for Roundworms

A

Albendazole or Mebendazole 1 dose

270
Q

4 viral childhood exanthems

A

Rubeola (1st) Rubella (3rd) Parvovirus(5th) and Roseola ((6th)

271
Q

Cause and most common age for measles

A

Caused by the rubeola virus and mostly seen in children under 5

272
Q

Transmission of measles

A

Airborne and highly contagious, communnicable for 4 days after rash appears

273
Q

Initial Clinical presentation of measles

A

LG Fever, Dry cough, Little white “Koplicks” spots with blue centers on buccal mucosa

274
Q

Later clinical presentation of measles

A

Blotchy red rash, starts at the hairline and descends receding in the same direction it appeared with a high fever

275
Q

Treatment for measles (rubeola)

A

No established cure - supportive care but no aspirin in under 18

276
Q

6 complications from measles

A

Otitis Media - MC
Bronchitis
Pneumonia
Pregnancy complications
Encephalitis
THrombocytopenia

277
Q

Scheduling for the MMR vaccine

A

1st dose at 12-15 months 2nd dose at 4-6 years

278
Q

Cause of mumps

A

The mumps virus

279
Q

Transmission of mumps

A

Airborne, Saliva, and contaminated surfaces

280
Q

Isolation for mumps patients

A

5 days after glands begin to swell

281
Q

3 symptoms of mumps

A

Fever, Loss of appetite, Parotitis (Swollen salivary glands)

282
Q

Treatment for mumps

A

Supportive care

283
Q

4 complications of mumps

A

Orchitis, Encephalitis, Mastitis, Deafness

284
Q

Rubella

A

German measles, 3 day measles, or 3rd diease

285
Q

Transmission

A

Can be transmitted to children by pregnant women

286
Q

Communicable period of rubella

A

10 days prior and 1-2 weeks after rash appearance

287
Q

4 clinical presentations of rubella

A

Congestion and HA, Descending rash (as in measles), Symmetrical postauricular occipital tender lymphadenopathy, Arthralgia

288
Q

3 complications of Rubella

A

Arthritis, Otitis Media, Encephalitis

289
Q

Triad of congenital rubella syndrome

A

Microcephaly, Cataracts, Cardiac defects

290
Q

Diagnosis and treatment for rubella

A

IgM antibody titer - isolation and supportive care

291
Q

MMR vaccine and pregnancy

A

Cannot give while pregnant, women should make sure they are up to date on it before becoming pregnant

292
Q

Erythema Infectiosum

A

5th disease or Parvovirus-19

293
Q

Transmission, Incubationof Erythema infectiosum

A

1-2 week incubation
Transmitted via blood, respirattory secretion, springtime and pregnancy

294
Q

When is erythema infectiosum infectious

A

BEFORE the rash appears

295
Q

Clinical presentation of Erythema infectiosum

A

Usually in 5-7 year-olds
Slapped cheeks erythema
Later develop a lacy (reticular erythema on extremities - gets worse with stimuli, Polyarthropathy also possible

296
Q

Diagnosis and treatment for erythema infectiosum

A

Usually a clinical diagnosis but can also blood test for antibodies
IV immune globulin for immune compromised, or supportive

297
Q

Complications of erythema infectiosum

A

Can pass to infants - counsel patients about contacts who are pregnant
Can cause red cell aplasia

298
Q

Roseola infantum

A

6th disease caused by HHV 6&7

299
Q

Incubation and transmission of roseola infantum

A

5-15 day incubation
Airborne and most common in the spring or fall

300
Q

Epidemiology of roseola infantum

A

Usually caught around 2-4 years of age

301
Q

Clinical presentation of roseola

A

High fever for 3-5 days followed by a nonpruritic rosy pink macular rash

302
Q

Diagnosis and treatment of roseola infantum

A

Diagnosis is usually clinical with supportive care

303
Q

Rare complication of roseola

A

Febrile seizures

304
Q

What is the aspect of fever that we are most concerned about?

A

The LENGTH rather than the HEIGHT

305
Q

Why do febrile seizures occur

A

Because of how fast the fever comes on NOT because of the height of the fever

306
Q

Incubation and transmission of varicella

A

Incubation 10-21 days
Very contagious and can be spread w/o skin to skin contact

307
Q

When is varicella communicable

A

1-2 days before the rash appears until all blisters have scabbed over

308
Q

4 stages of chickenpox

A

Macule, Papule, Vesicle, Crust

309
Q

2 diagnostic tools for chickenpox

A

PCR swab of the lesion and IgM titers

310
Q

Treatment for chickenpox

A

Trim nails, lotion and oatmeal baths
Can use 10x dose acyclovir or Ig therapy for those at high risk

311
Q

If using acyclovir for varicella when must it be started

A

within 24 hours, treat for 5 days

312
Q

Recommendations for Varicella vaccine

A

12-15 months, again at 4-6 years

313
Q

Causitive agent of hand foot and mouth disease

A

Coxsackievirus

314
Q

Incubation and transmission of hand foot and mouth

A

3-7 day incubation
Highly contagious, various secretions and spread most in summer and fall

315
Q

Communication of HFMD

A

Most contagious in the first week but still contagious until all blisters have resolved

316
Q

Clinical presentation of HFMD

A

Fever and malaise with a red non-pruritic rash -vesicles surrounded by a red halo on palms and soles
Painful red lesions on tongue, gums and hard palate

317
Q

3 things that help us differentiate HFMD from other infections

A

Age, Pattern of signs and symptoms, Appearance of rash

318
Q

Treatment for HFMD

A

Supportive, can use an oral rinse for discomfort

319
Q

2 complications of HFMD

A

Dehydration and encephalitis

320
Q

6 Category A bioterrorism agents

A

Anthrax, Botulism, Plague, Smallpox, Tularemia, Viral Hemorrhagic Fevers

321
Q

Anthrax
Organism
Spread
Signs/Symptoms
Management
Past Use

A

Bacillus anthracis Gram + Rod
Used before in 2001
Bioterrorism use most likely respiratory
Treat with antitoxin, or clindamycin
PEP vaccine and fluoroquinolone

322
Q

Botulism

A

C. bot toxin
Has been used at various times in the 1900s (Japanese cult)
A-G forms
Flacid paralysis
Antitoxin if caught early
Intubation and supportive care is caught late

323
Q

Plague

A

Caused by yersinia pestis
Used as an aerosol potentially
Used by Japan in WWII
Bubonic (LAD) and Pneumonic
Use gentamycin, streptomycin, doxycycline, or chloramphenicol to treat

324
Q

Smallpox

A

Eradicated in 1980 by WHO
Double stranded DNA virus
Scabbing maculopapular rash, with death usually from severe systemic illness
Strict isolation - antivirals not really studied

325
Q

Tularemia

A

Extremely infectious - can be caught from a petri dish
Aerosol or drinking water weapon
Not spread person to person
Inflammation of the airways with conjunctivitis
Streptomycin or doxycycline recommended for treatment

326
Q

Viral hemorrhagic fevers

A

Fever, myalgia, prostration, DIC
Direct contact required for spread
Single stranded RNA viruses
Temp voer 38.3 for under 3 weeks and bleeding internally from at least two sites

327
Q

Universal Precautions

A

Established in 1980s - Treat all bodily fluids as if they are infected

328
Q

Standard precautions

A

Added protection to UP, includes hand hygeine, PPE, and safe injection practices

329
Q

Contact precautions

A

Gown and gloves required for patient contact or even upon entering the room

330
Q

Droplet precautions

A

Surgical mask required within 3 feet of the patient

331
Q

Airborne infective isolation

A

Negative pressure with a respirator

332
Q

3 examples of airborne precaution pathogens

A

TB, Varicella, Measles

333
Q

3 examples of droplet precaution pathogens

A

Mycoplasma, Influenza, Meningococcal meningitis

334
Q

Active immunity

A

Induced by vaccines either derived from bacteria or their products

335
Q

Passive immunity

A

Induced by administration of preformed antibodies

336
Q

Inactivated vaccine

A

Contains dead parts and is safer but may require booster doses
Includes Flu and Polio

337
Q

Live attenuated vaccine

A

Live but weakened virus
Provides the greatest benefit and typically does not cause the disease
Includes MMR

338
Q

Subunit vaccine

A

Contain only antigens - hard to make
Include Hep B

339
Q

Toxoid vaccines

A

Inactivate bacterial toxins
Include TDaP

340
Q

Conjugate vaccine

A

Woeks against bacteria with a cell wall - synthetic product containing cell wall produces
Includes HIB type B and Pneumoccocal

341
Q

3 contraindications to vaccines

A

Anaphylaxis, Pregnancy and Immunosuppression for LIVE vaccines

Take precaution with acutely ill patients

342
Q

DTaP

A

Childhood Diptheria, Pertussis, Tetanus, Five part series given at 2,4,6,15 months and 4 years

343
Q

Tdap

A

Diptheria Tetanus Pertussis vaccine booster at 11 or 12 and every 10 years thereafter

344
Q

Td

A

No pertussis, just tetanus and diptheria - given for a dirty wound if its been over 5 years since last tetanus

345
Q

2 contraindications of Tdap

A

Hx of encephalopathy with administration
Uncontrolled seizures

346
Q

1 contraindication for MMR vaccine

A

Postpone a month if pt on steroids

347
Q

Polio vaccine dosing schedule

A

2 months, 4 months, 6 months, 4 years

348
Q

Dosing route and schedule for Hep A vaccine

A

Killed virus vaccine
Given IM
Given at 12 months and 2 years

349
Q

Dosing route and schedule for Hep B vaccine

A

Subunit vaccine
IM
1 month, 2 months, 4 months, 6 months
Combined with other vaccines

350
Q

1 contraindication to HEP B vaccine

A

Hypersensitivity to yeast

351
Q

Rotavirus vaccine

A

Live attenuated
Give PO on a 2,4 or 2,4,6 schedule
CI for those with hx of intussusception

352
Q

Flu vaccine type

A

Conjugate vaccine

353
Q

Schedule for Flu vaccination

A

2,4,6 months and then every 12-15 months thereafter

354
Q

Pneumococcal vaccine type

A

Conjugate vaccine

355
Q

4 pneumococcal vaccines

A

PCV13 - Better for children
PCV23 - Better for adults
PCV15 - Combines 13 with some 23
PCV20 - Combines 13 with all of 23 and some extra

356
Q

3 types of quadrivalent flu vaccine

A

Fluzone - Egg based and 6+ months
Flucelvax - Mammal cell based and 4+ years
Flublock - Recombinant and 18+

357
Q

2 flu vaccines for 65+

A

Fluzone (5x standard dose) and FLUAD

358
Q

Age recommendation for intranasal flu vaccine

A

2-49 - Not pregnant or immune suppressed

359
Q

Flu vaccine number of doses

A

2 a season before 8
1 a season after 8

360
Q

Varicella vaccine type

A

Live attenuated vaccine

361
Q

Doseing route and schedule for varicella vaccine

A

12 month and 4 years
Given SQ

362
Q

2 meninggococcal vaccines and when to give them

A

IM
ACYW - give at 11 and 16
B - 16 years with 6 month booster

363
Q

Route and schedule for HPV vaccine

A

IM
Indicated 9-45 but not beneficial over 26
Only 2 doses before 15, one at 11 with a booster 6-12 months later

364
Q

Yellow fever vaccine

A

17D - Live attenuated
Given IM to those 9months to 59 travelling to Africa or South America

365
Q

2 types of typhoid vaccine

A

Oral, live attenuated and capsular polysaccharide

366
Q

Dosing route and schedule for typhoid vaccine

A

Oral - 1 capsule PO every other day (4 pills)
Good to travel 1 week later given at 6+ and good for 5 years
IM - One dose and able to travel 2 weeks later
Boost every 2 years

367
Q

Dosing for rabies immune globuline

A

Inject around the wound up to 7 days after vaccine

368
Q

Rabies vaccine dosing schedule

A

Give on days 0,3,7,14 (and 28 for immune compromised)

369
Q

Min age for botulinum antitoxin

A

For use in those under 12 months of age

370
Q

RSV vaccine - who is it for?

A

Only for high risk because it is expensive - chronic lung disease and under 6 months at start of RSV season

371
Q

When should antivenom be administered

A

ASAP - 4 hours after bite is best

372
Q

3 dosing stages for antivenom administration

A

Initial - 4-6 vials in 1 hour
Subsequent - 4-6 more vials
Maintenance dose - 2 vials every 6 hours

Control is usually achieved during initial dose

373
Q

Caution with administering antivenom

A

Test sensitivity via SQ injection first
Have epinephrine and antihistamine at bedside

374
Q

Side effects of antivenoms

A

Allergic reaction, serum sickness

375
Q

Main causitive agent of tuberculosis

A

Mycobacterium tuberculosis

376
Q

4 factors that determine likelihood of TB transmission

A

Infectiousness of TB patient
ENvironment
Frequency and duration of exposure
Immune status of exposed individual

377
Q

2 drugs that drug resistant TB is resistant to

A

Isoniazid and rifampin

378
Q

Latent TB infection

A

Occurs when TB is in the body but the immune system has it under control

379
Q

Where does a TB infection begin

A

In the alveoli

380
Q

3 differences between latent and non-latent TB

A

LTB - Cannot spread to others, Has no symptoms, has a normal CXR

381
Q

Percentage of people for whom LTBI will progress to TB

A

5% within the first 2 years 10% over a lifetime

382
Q

2 conditions that are risk factors for developing full blown TB disease

A

DM and CKD

383
Q

2 sites of extrapulmonary TB

A

Lymph nodes and brain

384
Q

5 groups who are more likely to develop active TB once infected

A

HIV+, Gastric bypass surgery, Low body weight, smokers, children under 5

385
Q

Strongest known risk factor for developing TB

A

HIV+ - TB is the leading cause of death for AIDS patients

386
Q

TST

A

Tuberculin Skin Test

387
Q

When should a TST be read

A

48-72 hours after administration

388
Q

Groups for whom a 5mm induration or less is considered positive (5)

A

HIV+, Recent TB+ contacts, Suggestive X-ray findings, Organ transplant recipients, Immune compromised

389
Q

4 groups for whom 10mm or less is a positive TB test

A

People from endemic areas, Drug abusers, Lab workers, People who live/work in high risk settings

390
Q

Induration considered positive for everyone regardless of risk factors

A

People with no known risk of infection

391
Q

3 things that can cause a false positive TST reading

A

Different mycobacterium, Administration of wrong antigen, BCG vaccination

392
Q

4 factors that can cause a false negative TST

A

Anergy, Infection too recent, under 6 months, Recent live vaccine administrtion

393
Q

How long between initial TB infection and Positive TST

A

2-8 weeks

394
Q

5 components to incorporate when evaluating for TB

A

History, Physical, TST, CXR, Bacteriological evaluation

395
Q

3 pulmonary symptoms of TB

A

Chest pain, Cough over 3 weeks, Hemoptysis

396
Q

Confirmatory test for TB

A

CULTURE

397
Q

Standard treatment for LTBI

A

9 months of isoniazid

398
Q

LTBI treatment for patients with potentially resistant TB

A

4 month daily Rifampin

399
Q

Strategy for managing close contacts of TB patients

A

Don’t treat prophylactically, test and then restest in 8-10 weeks

400
Q

Drug regimen for LTBI for HIV+ patients

A

Isoniazid and rifapentine once a week for 12 weeks

401
Q

Contacts of TB+ individuals that we want to treat even if the test is negative

A

HIV+ and under 5 years old

402
Q

4 drug regimen for the initial treatment of TB

A

Isoniazid, Rifampin, Pyrazinamide, Ethambutol

403
Q

TB drug that can cause peripheral neuropathy

A

Isoniazid

404
Q

3 TB drugs that can cause liver damage

A

Isoniazid, Pyrazinamide, RIfampin

405
Q

TB drug that causes eye damage

A

Ethambutol

406
Q

TB drug causing orange urine

A

Rifampin

407
Q

Three ways to determine whether a patient is responding to TB treatment

A

Evaluate TB symptoms
Conduct bacteriologic exam
Use chest X-ray

408
Q

3 criteria for when TB is considered infectious

A

Recieved treatment for 2+ weeks
Symptoms have improved
3 consecutive negative sputum smears ((collect at 8-24 hour intervals with at least on early morning specimen)

409
Q

Proper protection for TB

A

A fitted respirator in all TB rooms, rooms where cough inducing procedures are done, ambulances carrying infected patients, Homes of infected patients

Infectious Disease and HEENT (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions