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PEM Lectures dirigées > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What bacteria can cause toxic shock syndrome?

A

staph aureus
GAS

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2
Q

what is the presentation of Toxic shock syndrome?

A

sudden onset:
high fever (39+)
vomiting
watery diarrhea
diffuse, erythematous maculopapular rash
hyperemia of mucous membranes
+/-
pharyngitis
headache
myalgias
oliguria

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3
Q

Lab findings in toxic shock syndrome

A

leukocytosis with left shift
thrombocytopenia
transaminitis
elevated creatinine
elevated CK
Myoglobinuria
coagulopathy

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4
Q

Complications fo toxic shock

A

ARDS
AKI
DIC

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5
Q

What antibiotic should be added when toxic shock syndrome is suspected?

A

clindamycin

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6
Q

What GI pathogen is associated with Guillain-Barré?

A

Campylobacter jejuni

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7
Q

What GI pathogen can have CNS effects such as seizure?

A

Shigella

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8
Q

Where does campylobacter come from?

A

contaminated poultry
unpasteurized milk/dairy

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9
Q

Where does yersinia come from?

A

contaminated pork

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10
Q

What enteric pathogen can mimic appendicitis?

A

Yersinia

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11
Q

Where does E.Coli come from?

A

undercooked beef
unpasteurized fruit + vegetable juice

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12
Q

Where does norwalk virus come from?

A

raw seafood + cntaminated water

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13
Q

Where does salmonella come from?

A

contaminated poultry
unpasteurized dairy
raw or undercooked eggs

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14
Q

Where does cryptosporidium come from?

A

fresh fruits + vegetables

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15
Q

What is the treatment of choice for scalp ringworm?

A

Griseofulvin 20mg/kg/day x 6-8 weeks

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16
Q

What are the most common pathogens in necrotizing fasciitis?

A

GAS
Staph Aureus

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17
Q

What is the antibiotic treatment of necrotizing fasciitis?

A

penicilin + clinda +/- vancomycin

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18
Q

What is the most common causative organism of travelers diarrhea?

A

ENTEROTOXIGENIC E. Coli

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19
Q

What does Dukoral cover?

A

Enterotoxigenic E. Coli
Cholera

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20
Q

What viruses can cause parotitis?

A

**mumps
parainfluenza types 1 and 3, influenza, Coxsackie virus, and rarely, human immunodeficiency virus

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21
Q

What bacteria most causes parotitis?

A

S. Aureus

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22
Q

What investigations should be done for recurrent parotitis?

A

sialography/ultrasound and r/o HIV vs r/o sjorgen’s syndrome with anti-SSa, antiSSb and RF

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23
Q

What are possible neurologic complications of varicella zoster?

A

acute cerebellar ataxia, encephalitis, Reye syndrome, transient focal deficitis, aseptic meningitis, tranverse myelitis, postherpetic neuralgia, guillan barre, stroke syndrome (secondary to infection of cerebral arteries)

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24
Q

What are possible ophthalmologic complications of varicella zoster?

A

herpes zoster ophthalmicus (HZO) (reactivation of VZV in the ophthalmic division of the trigeminal nerve V1)

severe chronic pain, vision loss, corneal ulceration, bacterial superinfection, uveitis, keratitis, acute retinal necrosis, hutchinson’s sign (herpes zoster vesicle present on the tip or side of the nose - reflects zoster involvement of the 1st branch of the trigeminal nerve, and is concerning for herpes zoster ophthalmicus.)

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25
What is Ramsay Hunt Syndrome?
Herpes zoster oticus – triad of ipsilateral facial paralysis + ear pain + vesicles in the auditory canal and auricle Reactivation of VZV in geniculate ganglion
26
27
Signs of neonatal/congenital syphilis
Condylomata Osteoxhondritis/perichondritjs Snuffles Lip fissures Cutaneous lesions Mucous patches Hepatosplenomegaly Lymphadenopathy Hemolytic anemia
28
What tooth findings are related to congenital syphilis?
Hutchinson teeth Mulberry molars
29
What syphilis tests are non treponemal?
RPR (rapid plasma reagin) VDRL (Venereal disease research laboratory)
30
What tests for syphilis are treponemal?
FTA-ABS (fluorescent treponemal antibody absorption) Treponema pallidum particle agglutination Enzyme immunoassay Line blot immunoassay
31
Who should receive clindamycin vs TMP/SMX + keflex for suspected MRSA skin infection?
Clinda: 3 months of age or older - low-grade fever (<38.0°C) or no fever - no other systemic signs of illness TMP/SMX+keflex: 3 months of age or older - significant surrounding cellulitis - low-grade fever (<38.0°C) or no fever - no other systemic signs of illness
32
What are the criteria for watchful waiting for AOM?
>6mo Not perforated Otalgia mild Temp <39 <48h illness No rigors Responding to antipyretics No MEE
33
What are the stages of pertussis and how long do they last?
Incubation 3-12 days Catarrhal stage (1-2 weeks) - URTI sx with low grade fever Paroxysmal stage (2-6 weeks) - paroxysms of extreme cough with whoop at end Convalescent stage (> 2 week) - slow return to normal (<3mo old may not have catarrhal phase)
34
Treatment of pertussis
Azithromycin 10mg/kg/day in a single dose x 5 days (up to 5 months) > 6 mo + kidx = 10mg/kg x 1 on day 1 then 5mg/kg/day x 4 days
35
Who should receive pertussis prophylaxis and what should they receive?
Azithromycin to all household and close contacts (Eg. daycare) regardless of immunization status and symptoms don't visit until abx given x 5 days finish vaccination series for those not fully vaccinated if > 9 years old give Tdap
36
Potential complications of pertussis
apnea secondary inections (AOM, Pneumonia) seizure encephalopathy death
37
Risk factors for fatal pertussis
< 4 mo preterm birth young maternal age
38
What pathogens cause hemolytic uremic syndrome?
Shiga toxin-producing E. Coli Shigella Salmonella Yersinia
39
What are the hallmark characteristics of HUS?/ Diagnostic triad of HUS
Coombs-negative hemolytic anemia Thrombocytopenia AKI (normal coagulation studies)
40
Complications of HUS
hemorrhagic colitis bowel wall necrosis, toxic megacolon, peritonitis, intussusception, rectal prolapse pancreatic failure - permanent diabetes mellitus Microangiopathic injury of other organs Encephalopathy - irritability and/or somnolence
41
Signs of epiglottitis on xray
o Enlargement of epiglottis “Larger than your thumb” o Thickening of aryepiglottic folds o Circumferential narrowing of subglottic portion of trachea during inspiration o Ballooning of hypopharynx and pyriform sinuses o Reversal of the normal lordotic curve of the cervical spine
42
Treatment of hot-tub folliculitis
- silver sulfadiazine, bacitracin/polymyxin B, gentamicin, or neomycin topical - widespread or symptomatic infections or those in immunocompromised hosts - ciprofloxacin
43
Most common location of peeling in staph scalded skin
around mouth, nose and eyes followed by neck, axillary and inguinal folds
44
Cause of staph scalded skin
dissemination of the exfoliative toxin produced by staph aureus
45
What is the Nikolsky sign?
if red skin is rubbed, blister is induced
46
What antibiotic is usually added to treatment of staph scalded skin and why?
clindamycin - inhibits toxin formation
47
What is Ecthyma
skin infection with loss of top layers of skin caused by necrosis
48
what is the most common cause of ecthyma in children?
GAS
49
What is erysipelas?
type of cellulitis that presesnts with swollen, red, painful edematous plaques - infection of superficial dermal lymphatics
50
How to tell the difference between cellulitis vs erysipelas
erysipelas = step-off from affected edematous to normal skin
51
What is the only bug that causes erysipelas
GAS
52
What is intertrigo?
inflamed, red skin folds that are the result of chronic irritation, yeast or bacteria - often areas of chronic irritation get superinfected with GAS or SA
53
What bug causes Rocky Mountain spotted fever and what is the transmission vector?
Rickettsia Rickettsii transmitted by tick bite
54
What is the antibiotic of choice against Rocky mountain spotted fever?
doxycycline
55
Describe the rash of Rocky mountain spotted fever
begins on day 3-4 of fever as macular or papular eruption on extremities (wrists + ankles) x 2 days - spreads to palms + soles, back. chest, abdo (predominant arms, legs, palms, soles) becomes more confluent and purpuric
56
Systemic signs and symptoms of rocky mountain spotted fever
fever headache myalgia conjunctivitis vomiting seizures myocarditis heart failure shock periorbital/facial/peripheral edema DIC purpura fulminans
57
Describe the rash of secondary syphilis
6-8 weeks after primary lesion generalized eruption of brownish, dull-red macules or papules discrete and symmetrically distributed particularly over the trunk INCLUDES papules on the palms and soles
58
Systemic symptoms of secondary syphilis
malaise fever headache sore throat rhinorrhea lacrimation generalized lymphadenopathy
59
What medications are used to treat TB?
- Isoniazid - Rifampin - Pyrazinamide - ethambutol
60
What investigations are needed in children in whom TB infection is suspected?
newborn - LP for routine studies, acid-fast culture, and M. tuberculosis PCR. (CSF profiles show a lymphocytic pleocytosis, high CSF protein, and low CSF glucose0 While TSTs and IGRAs are helpful when positive, negative tests do not rule out TB. All children in whom TB disease is suspected should be screened for HIV and have a baseline CBC and hepatic transaminases performed.
61
How to diagnose TB
TST or IGRA + CXR + known or suspected exposure
62
Factors that determine risk of infection from exposure to blood by needle stick injury
size of the needle depth of penetration whether blood was injected
63
Bloodwork to do for accidental needle stick injury
HBs-Ag Anti-Hbs Anti-HCV HIV
64
Treatment for Hep B from needlestick injury if fully. vaccinated and known to be anti-HBsAg antibody or HBsAg positive
no action
65
Treatment for Hep B from needlestick injury if not fully vaccinated
test anti-HBsAg antibody and HBsAg if negative: give HBIG immediately and HBV vaccine If anti-HBsAg positive - just complete HBV vaccine
66
When is HIV prophylaxis indicated in needle stick injury
if incident involved a needle and syringe with fresh blood and some blood was injected into the child
67
HIV post-exposure prophylaxis (needle stick injury)
Zidovudine + ART therapy
68
Indications for prophylactic antibiotics in dog bites
- Bite > 8hrs old with significant crush injury or edema - Bites to hands/feet - Potential damage to bones, joints tendons - Patient with increased risk of infection (immunocompromised) - Bite closed prematurely
69
Diagnostic criteria for acute bacterial sinusitis
Persistent nasal drainage and/or daytime cough lasting more than 10 days without improvement or Worsening clinical course (nasal drainage, daytime cough, or fever) after initial clinical improvement or Purulent nasal drainage for at least 3 consecutive days and fever ≥102.2°F (39°C)

PEM Lectures dirigées (28 decks)

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