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PANCE/EOC > Infectious Diseases Part 2 > Flashcards

Infectious Diseases Part 2 Flashcards

1
Q

Regarding Candidiasis, what is shown on a Potassium Hydroxide (KOH) Smear

A

Budding yeast and pseudohyphae

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2
Q

Symptoms of Candidiasis in the oropharyngeal cavity (Thrush)

A

-friable, white plaques that leave erythema if scraped

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3
Q

Treatment for Thrush

A
  • Nystatin swish and swallow

- Clotrimazole troches

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4
Q

Intertrigo is a cutaneous infection that is most common in moist, macerated areas. The rash appears beefy, red and distinct scalloped orders and satellite lesions. What is the treatment

A

Clotrimazole topical, keep area dry

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5
Q

How is Cryptococcis transmitted?

A

Pigeon and bird droppings inhalation

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6
Q

Risk factors for Cryptococcosis

A

-Most common in immunocompromised (CD4 < 100)

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7
Q

Symptoms of Cryptococcosis

A
  • Meningoencephalitis: headache and meningeal signs (stiff neck, nausea, vomiting, photophobia)
  • Pulmonary: pneumonia
  • Skin lesions if disseminated
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8
Q

Diagnostics for Cryptococcosis

A
  • Lumbar puncture: Fungal CSF pattern (increased WBC, decreased glucose, increased protein)
  • Cryptococcal antigen in CSF on visualization with encapsulated yeast on India Ink Stain
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9
Q

Treatment for Cryptococcosis

A
  • Amphotericin B + Flucytosine x 2 weeks followed by Oral Fluconazole x 10 weeks
  • Fluconazole if prophylaxis needed and if CD4 < 100
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10
Q

What is the biggest risk factor for Histoplasmosis?

A

Immunocompromised states and people with CD4 < 150

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11
Q

Transmission of Histoplasmosis

A
  • Inhalation of soil containing bat and bird feces in Mississippi and Ohio River Valleys
  • Demolition, Spelunkers, Excavators
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12
Q

Symptoms of Histoplasmosis

A
  • Asymptomatic (Most patients)

- PNA (Can Mimic TB)

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13
Q

Diagnostics for Histoplasmosis

A
  • CXR: Pulmonary infiltrates, hilar or mediastinal LAD
  • Antigen testing: via sputum (PCR) or urine highly specific
  • Cultures: Most specific test
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14
Q

Treatment for Histoplasmosis

A
  • Asymptomatic: No treatment needed
  • Mild: Itraconazole
  • Severe: Amphotericin B
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15
Q

Risk Factor for Pneumocystis Pneumonia (PCP)

A

CD4 < 200

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16
Q

Symptoms of PCP

A
  • Classic Triad: progressive dyspnea on exertion, fever, nonproductive cough
  • Oxygen desaturation with ambulation
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17
Q

Diagnostics for PCP

A
  • CXR: diffuse bilateral interstitial infiltrates
  • Labs: Increased LDH
  • Lung Biopsy: Definitive
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18
Q

Treatment for PCP

A
  • Bactrim drug of choice x 21 days

- If HIV +, add Prednisone if hypoxic

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19
Q

If the chest xray is positive with PCP PNA, what will it show?

A

Bilateral diffuse symmetric finely granular opacities/reticular interstitial airspace disease

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20
Q

PCP Prophylaxis in HIV

A

CD4 < 200: Bactrim

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21
Q

Risk factor for MAC

A

CD4 < 50

-Underlying pulmonary disease

22
Q

Transmission of MAC

A

-Present in soil and water (not person to person)

23
Q

Treatment for MAC

A

-Clarithromycin + Ethambutol + Rifampin

24
Q

Prophylaxis for HIV patients against MAC

A

-Clarithromycin or Azithromycin if CD4 < 50

25
Q

Pathophysiology of TB

A

After inhalation, Mycobacterium Tuberculosis goes to alveoli, gets incorporated into macrophages, and can disseminate from there

26
Q

In chronic/latent infection, what three things do you need to show the person is not infectious with TB?

A
  • Positive PPD
  • No symptoms of infection
  • No imaging findings of active infection
27
Q

With secondary/reactivation TB, what is seen on CXR?

A

Apex/upper lobes with cavitary lesions. These patients are contagious

28
Q

Regarding CXR and TB, explain the differences to each stage of TB

A

-Primary: middle/lower lobe
-Reactivation: apical (upper lobe)
Miliary TB: small millet-seed nodular lesions

29
Q

For sputum acid-fast staining, what must you get?

A

3 samples taken on 2 consecutive days must be negative to rule out TB

30
Q

However, for TB, what is more sensitive than sputum smears?

A

NAAT

31
Q

Management of active TB

A

Initiate 4-drug therapy: RIPE for 2 months

-Followed by 4 months of RI = 6 month total duration

32
Q

TB drugs and side effects

A
  • Rifampin: orange colored secretions
  • Isoniazid: peripheral neuropathy, hepatitis
  • Pyrazinamide: hepatitis and hyperuricemia
  • Ethambutol: Optic Neuritis, red/green color blindness
33
Q

Treatment for Latent TB infection

A 
-INH + Pyridoxine (Vitamin B6) x 9 months
OR
-RIF X 4 months
OR
-INH + Rifapentine x 3 months
OR
-INH x 6 or 9 months
34
Q

> 5 mm to be positive for TB:________
10 mm to be positive for TB: __________
15 mm to be positive for TB: ________

A

5: HIV or immunosuppressed, close contact with active TB, CXR with old TB
10: all other high-risk populations
15: everyone else, no risk factors for TB

35
Q

MC helminth infection in the US

A

Enterobiasis (Pinworm)

36
Q

Transmission of Enterobiasis Vermacularis

A

-Hand-mouth contact with contaminated fomites, fecal-oral contamination in school-aged children

37
Q

Symptoms of Enterobiasis

A
  • Perianal itching, especially nocturnal (eggs are laid at night)
  • Abdominal pain, nausea, vomiting
38
Q

Diagnostic for Enterobiasis

A

-Cellophane tape test or pinworm paddle test early in AM to look for eggs under a microscope

39
Q

Treatment for Enterobiasis

A

-Albendazole, Mebendazole, or Pyrantel (in pregnancy)

40
Q

MC intestinal helminth worldwide

A

-Ascariasis (roundworm)

41
Q

Diagnostic for Ascariasis

A

-Stool ova and parasite

42
Q

treatment for Ascariasis

A
  • Albendazole or Mebendazole

- Pyrantel if pregnant

43
Q

Trichinosis is transmitted through

A

Raw or undercooked meat (pork, boar, or bear)

44
Q

Adult Trichinosis are excreted in the stool and larva penetrate intestinal wall and go where?

A

Encapsulate in striated muscle tissue

45
Q

Symptoms of Trichinosis

A
  • GI phase: abdominal pain, nausea, vomiting
  • Muscle phase: myositis (weak or painful muscles), subungal splinter hemorrhages
  • Cardiac: Myocarditis
46
Q

What labs are shown with Trichinosis?

A
  • Eosinophilia (hallmark)

- Increased CK and LDH (due to muscle involvement)

47
Q

Treatment for Trichinosis

A

-If any CNS, cardiac, or pulmonary involvement, Albendazole or Mebendazole

48
Q

Hookworm is common in countries where

Hookworm (Ancylostoma duodenale and Necator americanus)

A

Poor access to adequate water, sanitation, and hygiene

49
Q

What three conditions must be met to transmit Hookworm? (Ancylostoma duodenale and Necator americanus)

A
  • Human fecal contamination of soil
  • Favorable soil conditions for larvae growth
  • Contact of human skin with contaminated soil
50
Q

4 phases of hookworm symptoms

A
  • Skin: pruritic erythematous dermatitis at site or entry
  • Transpulmonary: asymptomatic
  • GI: N/v, diarrhea, GI bleed rare
  • Chronic Nutritional Impairment: daily loss of blood, iron, and albumin
51
Q

Treatment for Hookworm

A
  • Albendazole or Mebendazole, Pyrantel

- Iron supplementation, multivitamins

PANCE/EOC (63 decks)

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