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PANCE/EOC > Infectious Diseases Part 3 > Flashcards

Infectious Diseases Part 3 Flashcards

1
Q

What is Malaria?

A

Mosquito borne red blood cell disease caused by Plasmodium spp

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2
Q

What is the most dangerous type of Malaria?

A

Falciparum

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3
Q

What are two protective traits against Malaria?

A

Sickle cell trait

Thalassemia Trait

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4
Q

Transmission of Malaria

A

-Protozoa that are transmitted via female Anopheles mosquito (at dusk and dawn)

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5
Q

Symptoms of Malaria

A
  • Cyclical Fever, irregular, every 48 hours-ish
  • Cerebral Malaria (AMS, seizures, coma)
  • Blackwater Fever (renal failure + dark urine + hemolysis)
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6
Q

Diagnostics for Malaria

A
  • Giemsa-stained blood smear: thick and thin

- Leukopenia, Hemolytic anemia, thrombocytopenia

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7
Q

Treatment for Malaria

A

-Chloroquine or Hydroxychloroquine

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8
Q

Leishmaniasis is transmitted via

A

female Sand fly (in Mediterranean, Central and South America, Africa, and Asia

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9
Q

Prophylaxis for Toxoplasmosis

A

Bactrim when CD4 < 100

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10
Q

Toxoplasmosis is MC CNS infection in patients with AIDS who…

A

are not receiving appropriate prophylaxis or not on HAART

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11
Q

How else is Toxoplasmosis transmitted?

A

Soil or cat litter contaminated with feline feces or undercooked meat from infected animal

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12
Q

Symptoms of Toxoplasmosis

A
  • Encephalitis: headache, neuro symptoms, fever, AMS

- Chorioretinitis: posterior uveitis, eye pain, decreased visual acuity

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13
Q

Serologies for Toxoplasmosis show

A

Anti-toxoplasma IgG antibodies

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14
Q

On neuroimaging (MRI) for Toxoplasmosis, what is seen?

A

Multiple ring-enhancing lesions

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15
Q

Treatment for Toxoplasmosis

A
  • Sulfadiazine + Pyrimethamine

- Spiramycin if pregnant

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16
Q

Trichomonas Vaginalis is what type of bacteria?

A

Flagellated protozoan that is transmitted sexually

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17
Q

Symptoms of Trichomoniasis

A
  • Copious frothy yellow-green vaginal discharge

- Cervical petechiae (strawberry cervix)

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18
Q

Treatment for Trichomoniasis

A

-Metronidazole 2g oral dose x 1 days

Partners must be treated too!

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19
Q

What is seen on a saline wet mount for trichomoniasis?

A

Mobile protozoan trophozoites

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20
Q

Congenital Varicella syndrome develops if a mother develops Varicella (Chickenpox) between ____ and ____ weeks gestation

A

8 and 20

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21
Q

What reduces the severity of infection after exposure to Varicella virus in patients with high risk if pregnant?

A

Varicella immune globulin VZIG

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22
Q

What groups are at high risk and get the VZIG?

A
  • Newborns of mothers with Varicella 5 days before to 2 days after delivery
  • Premature infants at or greater than 28 weeks who are exposed
  • Pregnant women who lack immunity to VZV
23
Q

Management for Perinatally-acquired infection of Herpes Simplex Virus

A

IV Acyclovir x 14 days then oral Acyclovir for 6 months

24
Q

Zika Virus is transmitted from the Aedes mosquito. What are other transmission routes?

A
  • Infected mosquito
  • Sex
  • Maternal-fetal
  • Organ transplantation
25
Q

Although most people with Zika Virus are asymptomatic, what are some symptoms they can have?

A

-Congenital Zika Syndrome: microcephaly, intracranial cerebral malformation, ocular lesions, hypertonia

26
Q

What is the initial test of choice for Zika Virus?

A

-Serum or urine Zika virus IgM

27
Q

For prevention of Zika Virus, what are the recommendations for Men Vs Women?

A

Men: wait at least 3 months before having unprotected sex
Women: wait at least 8 weeks before having unprotected sex

Pregnant women should avoid travel to areas below 6,500 feet where transmission is ongoing.

28
Q

Lyme Disease is spread through Borrelia Burgdorferi, which is a

A

gram-negative spirochete spread by the Deer Tick

29
Q

Clinical Manifestations of Lyme Disease (3 stages)

A
  • Early: Erythema Migrans: expanding, warm, annular, erythematous rash that may develop central clearing (Bullseye rash)
  • Disseminated: neurologic, CNVII facial nerve palsy, AV block, headache, weakness
  • Late disease: intermittent or persistent arthritis of the knee
30
Q

Serologic testing for Lyme Disease

A

-ELISA followed by Western Blot if ELISA is positive or equivocal

31
Q

What condition can cause a false positive for Lyme?

A

Syphilis

32
Q

Prophylaxis for Lyme

A

-Doxycycline x 1 dose given within 72 hours of tick removal if tick was present for at least 36 hours

33
Q

Treatment for Lyme Disease

A
  • Doxycycline first line (Amoxicillin or Cefuroxime)

- Amoxicillin is first line in pregnancy (Azithromycin or Erythromycin)

34
Q

If the Lyme disease is late or severe, what is the treatment? For example, if the patient has a 2nd/3rd heart block, syncope, dyspnea, chest pain, CNVII palsy

A

IV Ceftriaxone

35
Q

Transmission of Syphilis

A

Direct contact of mucocutaneous lesion (sexual activity) or to the fetus via the placenta

36
Q

Symptoms of Syphilis

A
  • Primary: Chancre (painless ulcer near or at inoculation site) with raised edges. Nontender LAD near site that lasts 3-4 weeks
  • Secondary: Maculopapular rash, involvement of palsy and soles. Condyloma Lata (wart like moist lesions evolving mucus membranes). Fever, LAD, headache, meningitis, alopecia
  • Tertiary: Gumma (noncancerous lesions on skin and body), Neurosyphilis (headache, Tabes dorsalis of posterior columns leading to ataxia, weakness), Argyll-Robertson Pupil: small irregular pupil that constricts with light accommodation but not reactive light. Aortitis, AR, aortic aneurysm
37
Q

Diagnostics for Syphilis

A
  • Nontreponemal Tests (nonspecific): RPR and VDRL
  • Treponemal Test (confirmatory): FTA-ABS
  • Darkfield Microscopy: direct visualization
38
Q

Treatment for Syphilis

A

-Penicilin G Benzathine

39
Q

What if the patient is allergic to PCN and needs treatment for Syphilis?

A

Doxycycline is first line

40
Q

What is a Jarisch-Herxheimer Reaction?

A

Acute, self-limited febrile reaction that occurs within first 24 hours after receiving therapy for a spirochetal infection. Fever, chills, headache, myalgias, hypotension, and worsening of rash
-Self limited and give NSAIDs or antipyretics

41
Q

Cytomegalovirus occurs primarly in patients that are immunocompromised. Symptoms are like Mononucleosis, but are…

A
  • Without sore throat or LAD

- Fever, cough, myalgia, arthralgias

42
Q

With reactivation of CMV, what are the symptoms?

A
  • Colitis: MC (bloody stools, fever, abdominal pain)
  • Retinitis: hemorrhage with yellow-white soft exudates when CD4 < 50
  • Esophagitis: large superficial ulcers on upper endoscopy
43
Q

On biopsy of tissues with CMV, what is seen?

A

Owl’s Eye appearance (epithelial cells with enlarged nuclei surrounded by clear zone and cytoplasmic inclusions)

44
Q

Treatment for reactivation CMV

A

-Gangiclovir first line

45
Q

Congenital CMV can lead to stillbirth, prematurity, and hydrops fetalis. True or False, it is the MC congenital viral infection?

A

True

46
Q

Treatment for congenital CMV

A

Ganciclovir

47
Q

What is the MC sequelae of congenital CMV?

A

Sensorineural hearing loss

Also have vision impairment, seizures

48
Q

EBV (HHV-4) is an infection due to Epstein-Barr Virus that is characterized by what things?

A

Fever, posterior cervical LAD, and tonsillar pharyngitis

  • Splenomegaly, fatigue
  • Rash if given Ampicillin
49
Q

Diagnostics for EBV Mono

A
  • Heterophile Antibody (Monospot) test of choice

- Peripheral smear: atypical lymphocytes

50
Q

Treatment for EBV Mono

A
  • Supportive is mainstay

- Avoid trauma and contacts sports for at least 3-4 weeks to prevent splenic rupture

51
Q

Erythema Infectiosum also known as _______, is most common in children aged < 10 years old.

A

Fifth Disease

52
Q

Erythema Infectiosum is caused by

A

Parovirus B19 (respiratory droplets)

53
Q

Symptoms of Erythema Infectiosum

A
  • Erythematous malar rash with a slapped cheek appearance
  • Circumoral pallor for 2-4 days
  • Lacy, reticular maculopapular rash on extremities
  • Arthropathy or arthralgia
  • Increased fetal loss during pregnancy
  • Aplastic Crisis in sickle cell patients
54
Q

What are the only two vaccines you should get when pregnant?

A

Inactivated flu

Tdap

PANCE/EOC (63 decks)

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