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PANCE/EOC > Infectious Diseases Part 1 > Flashcards

Infectious Diseases Part 1 Flashcards

1
Q

What type of bacteria is Clostridium Botulinum?

A

Anaerobic, gram-positive spore forming rod (Bacillus)

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2
Q

What is the pathophysiology of the botulism neurotoxin?

A

Neurotoxin inhibits acetylcholine release at the neuromuscular junction, leading to weakness, flaccid paralysis and respiratory arrest

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3
Q

What are the two most common transmission routes for Botulism?

A
  • Adults: ingestion of toxin in canned, smoke, and vacuum-packed foods
  • Infants: ingestion of honey before age 1
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4
Q

Symptoms of Botulism occur how long after ingestion of toxin

A

12-36 hours

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5
Q

Symptoms of Botulism

A
  • Prodromal GI symptoms
  • 8 D’s: Diplopia, Dysphagia, Dilated/Fixed Pupils, Dysarthria, Dysphonia, Descending Decreased muscle strength, Decreased DTRs
  • Floppy Baby Syndrome: flaccid paralysis, weak cry, poor feeding
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6
Q

Diagnostics for Botulism

A
  • Clinical

- Can be confirmed via toxin assay from stool, wound, or serum

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7
Q

Treatment of Foodborne Botulism

A

If > 1 year old: Equine-derived heptavalent antitoxin
If < 1 year old: human-derived botulism immune globulin

NO ABX IF FOOD DERIVED OR INFANTILE it may lyse the bacteria

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8
Q

If Botulism comes from a wound, what is the treatment?

A

Antitoxin + Penicillin G (Metronidazole if PCN allergy)

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9
Q

True or False: Campylobacter Jejuni is the MCC of bacterial enteritis in the US

A

True

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10
Q

What is the main source of Campylobacter Jejuni?

A

Contaminated food (raw or undercooked poultry), raw milk, contaminated water, dairy cattle. Puppies are an important source in children.

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11
Q

Symptoms of Campylobacter Jejuni

A
  • Fever, crampy peri umbilical abdominal pain (may mimic appendicitis)
  • Diarrhea that begins as watery and progresses to bloody
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12
Q

What shape bacteria is Campylobacter Jejuni?

A

S, comma, or “seagull shaped” gram-negative organisms

-Vibrio

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13
Q

What is the diagnostic of choice for Campylobacter Jejuni

A

Stool culture

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14
Q

Treatment for Campylobacter Jejuni

A
  • Fluid and electrolyte replacement is mainstay of treatment

- In severe or high risk patients, Macrolides (Azithromycin) when needed

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15
Q

MC overall bacterial cause of STI’s in the US

A

Chlamydia

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16
Q

Symptoms of Chlamydia (remember associated with different conditions)

A
  • Urethritis: purulent or mucopurulent discharge, pruritus, dysuria, hematuria
  • PID: Cervical motion tenderness
  • Reactive arthritis: urethritis, uveitis, arthritis
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17
Q

What is the diagnostic of choice for Chlamydia?

A

NAAT (vaginal swab or first catch urine)

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18
Q

Treatment for Chlamydia?

A

Azithromycin or Doxycycline

-Also treat for Gonorrhea with Ceftriaxone

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19
Q

Vibrio Cholerae (Cholera) is what shape bacteria?

A

Gram-negative comma-shaped rod

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20
Q

How is Cholera transmitted

A

Contaminated food and water

-Outbreaks occur during poor sanitation and overcrowding situations (abroad)

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21
Q

Symptoms of Cholera

A

-Copious watery diarrhea = rice water stools (gray with flecks of mucus and may have a fishy odor but no blood or pus)

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22
Q

Treatment of Vibrio Cholera

A
  • Oral rehydration therapy and electrolyte replacement

- Tetracyclines

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23
Q

Symptoms of Diphtheria

A
  • Tonsillopharyngitis or Laryngitis
  • Myocarditis
  • Pseudomembrane (friable gray white membrane on pharynx) that bleeds if scraped
  • Cervical LAD with bull neck
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24
Q

Treatment for Diphtheria

A
  • Diphtheria Antitoxin (horse serum) + Erythromycin or Penicillin x 2 weeks
  • Place respiratory droplet isolation
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25
Q

Prophylaxis for Close Contacts of Diphtheria

A

-Erythromycin x 7-10 days or Penicillin G x 1 dose

26
Q

Gonorrhea is what shape?

A

Gram-negative diplococci

27
Q

Most sensitive diagnostic for gonorrhea

A

NAAT

28
Q

Symptoms of Gonorrhea

A

-Urethritis: discharge, PID, prostatitis

29
Q

-If the gonorrhea is disseminated, what are the symptoms?

A

-Triad of dermatitis, polyarthralgias, and tenosynovitis (tenderness along tendon sheath)

30
Q

Purulent gonococcal septic arthritis occurs in which joint most frequently

A

The knee

Especially in women during menses

31
Q

Treatment for Gonococcal arthritis

A

-IV Ceftriaxone

32
Q

Treatment for Urethritis and cervicitis associated with gonorrhea

A

-Ceftriaxone 250 IM + Doxy or Azithromycin

33
Q

What four medications are usually used Orally for treatment of MRSA

A
  • Clindamycin
  • Doxycycline
  • Trimethoprim-Sulfamethazole
  • Linezolid

IV: Vancomycin, Linezolid

34
Q

Rheumatic Fever generally occurs in what age range?

A

Children 5-15 years old

35
Q

Rheumatic Fever is due to an infection of

A

Group A Streptococcus (Strep Pyogenes)

36
Q

The Jones Criteria is associated with Rheumatic Fever. Explain what is included in the JONES criteria MAJOR criteria

A

J: Joint (migratory polyarthralgia)
O: Oh My heart (active carditis)
N: Nodules (Subcutaneous)
E: Erythema Marginatum (macular, non-pruritic rash with clear borders on trunk and extremities)
S: Sydenham’s Chorea (Sudden, involuntary jerky purposeless movements)

37
Q

What is included in the MINOR JONES Criteria?

A
  • Fever
  • Arthralgia (Joint Pain)
  • Increased ESR/CRP/Leukocytosis
  • ECG: Prolonged PR Interval
38
Q

In regards to the JONES criteria, you need major and minor, PLUS what?

A
  • Supporting evidence of a recent group A Strep infection
  • -Positive throat culture
  • -Rapid strep antigen
  • -Elevated Strep Ab titers
39
Q

Treatment for Rheumatic Fever

A
  • Aspirin

- Penicillin G (Erythromycin if PCN allergy)

40
Q

What is one major complication of Rheumatic Fever?

A

Rheumatic Heart Disease (mitral MC or aortic)

41
Q

Rocky Mountain Spotted Fever is caused by what organism?

A

Rickettsia Rickettsii

42
Q

What are two vectors of Rickettsia Rickettsii

A

Dermacentor Andersoni (Wood tick) & Variabilis (Dog Tick)

43
Q

Where is Rocky Mountain Spotted Fever MC?

A

South-central and Southeastern US

44
Q

Symptoms of RMSF

A
  • Rash, headache, fever, chills, myalgias
  • -Rash: blanching, erythematous macular rash on wrists and ankles (palms and soles) then spreads to trunk
  • Periorbital or pedal edema in kids
  • ARDS, cardiac problems, retinal abnormalities
45
Q

True or False: RMSF is a clinical diagnosis and you should not wait for serologies?

A

True!

46
Q

Treatment in a non-pregnant patient for RMSF

A

Doxycycline, even if < 8 years old

47
Q

What is the treatment of choice for a patient who is pregnant with RMSF?

A

Chloramphenicol

-All treatment for RMSF should begin within 5 days of symptom onset to reduce mortality.

48
Q

Causes of Salmonellosis

A
  • Poultry, eggs, milk products, fresh produce

- Contact with reptiles

49
Q

Symptoms of Salmonellosis

A
  • nausea, vomiting, fever, abdominal cramping
  • Pea soup diarrhea
  • May be bloody, malaise, headaches
50
Q

Treatment for Salmonellosis

A
  • Oral rehydration and electrolyte replacement therapy (usually self-limited)
  • Fluoroquinolones are first line when needed (-oxacin)
51
Q

Shigellosis is caused by Shigella Sonnei. What is the shape of this bacteria?

A

-Gram negative rod (bacillus)

52
Q

Which population is the most at risk for Shigellosis?

A

Children < 5 years in a daycare

53
Q

Shigellosis is transmitted via fecal-oral route and is highly virulent. name some symptoms of this disease

A
  • Lower abdominal pain
  • Explosive watery diarrhea that progresses to mucoid/bloody diarrhea
  • Febrile seizures
54
Q

Diagnostics for Shigellosis

A
  • Stool Cultures
  • CBC: Leukemoid Reaction ( WBC > 50,000)
  • Sigmoidoscopy: punctate areas of ulceration
55
Q

Treatment for Shigellosis

A
  • Oral rehydration and electrolyte replacement are mainstay
  • Anti-motility drugs should be avoided (can worsen disease)
  • Fluoroquinolones if severe (-oxacin)
56
Q

Transmission of Tetanus

A

-In Soil; germinates especially in puncture wounds and crush wounds

57
Q

Pathophysiology of Tetanus

A

-Neurotoxin blocks neuron inhibition by blocking release of inhibitory neurotransmitters GABA and glycine. This leads to severe muscle spasm.

58
Q

Symptoms of Tetanus

A
  • Local muscle spasms
  • Neck of jaw stiffness (trismus)
  • Risus sardonicus (facial contractions)
  • Increased DTR
59
Q

Treatment for Tetanus

A
  • Metronidazole + IM Tetanus immune globulin

- Benzodiazepines to reduce spasms or IV Mag

60
Q

Prophylaxis for patients with close contact with someone with Tetanus (both if vaccinated and if not vaccinated)

A
  • If vaccinated: Tdap or booster every 10 years

- Never vaccinated: Tetanus immune globulin + tetanus toxoid vaccine

PANCE/EOC (63 decks)

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