Infectious Disease Qs Flashcards
Necessary adjunctive Therapy for bacterial meningitis?
Steroids
CD4 count necessary to develop Primary CNS lymphoma?
<50
ethambutol side effect?
retrobulbar neuritis manifesting as decreased green-red color discrimination
TB drug that can cause gout?
Pyrazinamide
Continuation treatment for TB after initial 2 month, 4 drug treatment? When should the continuation length increase?
4 months of isoniazid and rifampin
If not given pyrazimnamide;
OR sputum cultures are still positive OR drug resistance
Patients with late (terminal) complement component deficiencies (C5, C6, C7, C8, C9) may present with?
recurrent, invasive meningococcal or gonococcal infections.
Common variable immunodeficiency (CVID) involves which cell lines? Lab findings? Types of infections?
B- and T-cell abnormalities;
hypogammaglobulinemia.
Bacterial infections, often of the sinus tract and lungs, are common
Selective IgA deficiency presents as?
sinopulmonary infections or gastrointestinal involvement with inflammatory bowel disease, sprue-like illness, or celiac disease
Classical complement pathway (C1, C4, C2) deficiencies are associated with?
Rheumatologic disorders (SLE, vasculitis, scleroderma)
Patients suspected of having brain abscess from a likely odontogenic source should begin empiric antibiotic therapy wit?
intravenous penicillin and metronidazole.
Uncomplicated cutaneous anthrax should be treated with?
ciprofloxacin, levofloxacin, moxifloxacin, or doxycycline
UTI drug to avoid in last 30 days of pregnancy? Why?
UTI in pregnanct patients the last 30 days should be treated with?
Nitrofurantoin; higher rates of neonatal jaundice;
Amoxicillin
How does West Nile Neuroinvasive disease present?
Fever, headache, and focal limb weakness following outdoor activities
When are transplant patients at highest risk for CMV?
in the first few months after transplantation when (immunosuppression is typically highest, and patients who have just finished prophylaxis against cytomegalovirus)
disseminated zoster infection - contact precautions?
Airborne and contact
Who gets prophylactic antibiotics to reduce the risk of travelers diarrhea?
IBD, immunosuppressive illnesses, or chronic diseases that could become more severe or be exacerbated by dehydration
When is an active TB patient considered non-contagious?
adequate tuberculosis treatment for at least 2 weeks, demonstrate improvement of symptoms, and have three consecutive negative sputum smears
Disseminated candidemia - treatment?
echinocandins such as caspofungin, anidulafungin, and micafungin
Disseminated fungal infections that manifest as skin lesions?
blastomycosis and coccidiomycosis
Hep A ppx for travel given to? What exactly is given?
any person planning travel to developing parts of South Asia, Africa, and South and Central America
Hepatitis A virus vaccine AND if leaving within 2 weeks: a dose of intramuscular immune globulin
Posttransplant lymphoproliferative disease is caused by? presents when? Lab suggestive? Confirm with/? Management?
EBV; 1 year after transplant;
EBV PCR; biopsy
Reduce immunosupression and maybe chemo/rituximab
When to give antibiotic ppx for a dog bite? what is the med/duration?
- immunosuppressed (including those with asplenia or significant liver disease);
- have moderate to severe wounds (particularly on the face or hand);
- have wounds near a joint or bone;
- or have wounds associated with significant crush injury or edema.
3- to 5-day with amoxicillin-clavulanate
Sacral infection that may cause episodes if aseptic meningitis?
HSV
live-attenuated influenza vaccine given by nasal mist is approved only for?
age 2 to 49 years
Med can inhibit tubular secretion of creatinine but does not actually affect glomerular filtration rate? Drug treats?
Cobicistat (pharmacokinetic enhancer.for HIV)
Smallpox presentation?
Pt contagious until?
begins as small red dots on the pharyngeal and buccal mucosa
spread in centripetal fashion to the hands and face, followed by the arms, legs, and feet.
from macules to papules to vesicles and pustules before crusting over.
Patients remain contagious until all crusts are shed.
Lyme arthritis is excluded if
symptoms have been present for longer than 1 month and Western blot IgG result is negative
Treatment for selective IgA deficiency?
no treatment
Autoimmune that causes psychiatric symptoms, seizures, autonomic instability, and choreoathetoid movements? Associated with?
anti-NMDAR receptor encephalitis; Ovarian teratomas
Treatment for disseminated Mycobacterium avium complex infection in patients with HIV/AIDS whose CD4 cell counts are less than 50/µL?
clarithromycin, ethambutol, and rifabutin
Immunocompromised patients, particularly those with liver disease are at increased risk for this infection?
Vibrio vulnificus
Empiric therapy for Patients admitted to the hospital with community-acquired pneumonia thought be caused by Pseudomonas aeruginosa?
antipseudomonal β-lactam, an aminoglycoside, and a respiratory fluoroquinolone,
Likely CXR finding in a patient with Staphylococcus aureus postinfluenza community-acquired pneumonia?
Cavitary lesions
Chikungunya v dengue? (Main v 3 other)?
severe joint pain and stiffness.
Other distinguishing features include
- high fever, which often recurs after a brief afebrile period (“saddle-back fever”);
- more significant polyarticular and migratory joint pains involving the small joints of the hands, wrists, and ankles; and
- much less thrombocytopenia.
Treatment for PID?
cefoxitin or cefotetan plus doxycycline.
