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Clin Med > Infectious dz > Flashcards

Infectious dz Flashcards

1
Q

dx? Difficulty swallowing and breathing. Double vision, drooping eyelids, blurry vision, difficulty moving the eyes. Slurred speech. Symmetrical weakness of both arms – proximally and distally. Descending paralysis that always includes cranial nerves. NO sensory component, only motor.

A

botulism

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2
Q

MC bac cause of diarrheal illness in US

A

Campylobacter jejuni

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3
Q

is Campylobacter jejuni
diarrhea bloody?

A

yes, usually

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4
Q

Campylobacter jejuni
complications (4)

A

dehydration, electrolyte imbalances, reactive arthritis, GBS

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5
Q

tx for chlamydia in preg

A

Pregnant: azithromycin 1g PO X 1 dose.

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6
Q

f/u for chlamydia

A

Screen all F 3 months s/p infx bc reinfection rates are high

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7
Q

dx? Fever, malaise, severe sore throat. Neck swelling, gray-white membrance covering tonsils, palate, uvula, and post pharynx.

A

diptheria

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8
Q

gonorrhea tx for pt >150kg

A

Single dose Ceftriaxone 1g IM

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9
Q

PSGN happens _____ after pharyngitis;_____ after impetigo

A

1-2 wks, 3-6 wks

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10
Q

topical, PO, and IV tx for MRSA

A

Topical mupirocin 2%. PO bactrim, doxy, clinda. IV vanc, linezolid, daptomycin

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11
Q

ped autoimmune neuropsychiatric disorder ASW strep infx

A

PANDAS

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12
Q

consider what dx in peds w/ abrupt onset of OCD or tics

A

PANDAS

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13
Q

tx for pertussis W/in 3 wks of cough onset or up to 6 wks in pregnancy, >65 y/o, chronic respiratory dz, or immunocompromised

A

Azithromycin or clarithromycin

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14
Q

MC finding on exam of acute rheumatic fever

A

mitral regurg

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15
Q

ask about what 3 sx in suspected ARF?

A

joint pain (polyarthritis in large joints), rash (erythema marginatum), bumps (subcutaneous nodules)

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16
Q

classic triad of tetanus

A

rigidity, muscle spasm, and autonomic dysfunction

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17
Q

most common mold to cause invasive fungal infx

A

aspergillosis

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18
Q

CT showing cresent sign in lungs. dx?

A

aspergillosis

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19
Q

Free-living fungal species distributed in soil of large section of midwest and SE US. Inhaled spores covert to yeasts and multiply in lungs

A

Blastomycosis (blastomyces dermatitidis)

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20
Q

tx for OP candidiasis

A

PO fluconazole

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21
Q

fungus dz from inhaling spores from soil of SW US , parts of Mexico, Central and S. America

A

Coccidioidomycosis (aka Valley Fever)

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22
Q

elderly pt in MS river valley develops fever and cough after visiting bat cave. dx?

A

Histoplasmosis

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23
Q

2nd most common opportunistic infx in HIV/AIDS

A

pneumocystis PJP

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24
Q

most common opportunistic infx in HIV/AIDS

A

oral thrush

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25
Q

MC atypical mycobacterial dz

A

most common is Mycobacterium Avium Complex (MAC) closely related species of M. avium and M. intracellulare

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26
Q

pt w/ Fever, night sweats, weight loss and anorexia, cough, hemoptysis, CP. order what tests?

A

CXR, PPD

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27
Q

how to test for TB if pt had BCG

A

quantiferon

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28
Q

tx for active TB + timeframe

A

Rifampin, Isoniazid, Pyrazinomide, Ethambutol X 2 mo, then rifampin + isoniazid X 4 mo.

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29
Q

3 tx options for latent TB + timeframe

A

INH + rifapentine weekly X 3 mo (3HP). OR rifampin QD X 4 mo (4R). OR INH + rifampin QD X 3 mo (3HR)

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30
Q

for pt on RIPE, have them take what supplement?

A

vitamin B6 pyridoxine

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31
Q

rifamipin SE

A

red/orange body fluids

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32
Q

PZA SE

A

hyperuricemia

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33
Q

ethambutol SE

A

optic neuritis

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34
Q

baseline test to order before starting RIPE

A

LFTs

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35
Q

tx for most roundworms

A

mebendazole

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36
Q

tx for pinworms

A

mebendazole

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37
Q

pt w/ f/c every other day, recent travel

A

malaria

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38
Q

gold standard for dx of malaria

A

blood smear (Giemsa stain)

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39
Q

which malaria tx worsens psoriasis

A

chloroquine

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40
Q

which malaria med is ok in preg?

A

mefloquine

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41
Q

pathognomonic finding on Ct of brain for toxoplasmosis

A

ring enhancing lesions

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42
Q

how soon does lyme rash appear after tick bite?

A

avg 7-14 days (can be 3-30)

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43
Q

pt has rash suspicious for lyme. ask about what AS? (4)

A

f/c, weakness, myalgias/arthralgias, HA

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44
Q

stage 2 lyme can cause what arrhythmia

A

complete heart block

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45
Q

tx for lyme

A

1) doxy for age 8+ for 10-14 days, 2) amoxicillin / 2nd-3rd gen cephalosporins (cefuroxime) X 14 days (NOT cephalexin!)

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46
Q

when to give lyme prophylaxis after tick bite and dose

A

doxy 200mg PO X 1 dose (if >36 hrs attached)

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47
Q

which tick dz is not treateed w/ doxy, and what is the tx?

A

babesiosis, azith + atovaquone X 7-10d

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48
Q

for pt w/ f/c, myalgias, malaise, HA, consider what group of dz?

A

tick borne

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49
Q

which tick borne dz causes hemolysis?

A

babesiosis

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50
Q

RMSF is caused by what pathogen?

A

Rickettsia rickettsii

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51
Q

pt had flu like sx and now has blanchable 2-6mm macular or papular rash on ankles/wrists, palms, soles. dx?

A

RMSF

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52
Q

tx for RMSF in 5 y/o

A

doxy

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53
Q

what does the secondary syphillis rash look like

A

Diffuse rash of erythematous papules, typically including palms and soles

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54
Q

eye finding in tertiary syphillis

A

Argyll Robertson pupil (b/l small pupils that do NOT constrict when exposed to bright light, but DO constrict for near focus)

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55
Q

congenital syphillis finding

A

hutchinson teeth (scalloped edges)

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56
Q

tx for syphilis

A

Benzathine penicillin G 2.4 million units IM single dose (no alt for pregnancy / allergic)

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57
Q

MC dz cause of sepsis

A

PNA

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58
Q

MC sx of sepsis

A

fever

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59
Q

outpatient tx for high RF for COVID and timeframe

A

Paxlovid if high risk if w/in 5 days of onset (Check meds for interactions w/ Paxlovid (esp statins))

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60
Q

tx for inpatient COVID w/ no O2 req

A

Veklury/remdesivir - 200 mg IV on day one, followed by 100 mg IV x 5-10 days.

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61
Q

tx for inpatient COVID w/ O2 req

A

Remdesivir + dexamethasone 6mg QD X 10 days.

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62
Q

pharyngitis and LAD in CMV vs EBV

A

both less severe in CMV than EBV. EBV also generalisted as well as cervical LAD

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63
Q

tissue bx finding for CMV

A

Owl-eye basophilic inclusion bodies

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64
Q

MC viral infx in transplant pts

A

CMV

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65
Q

MC congenital infx

A

CMV

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66
Q

what will happen if pt w/ CMV or EBV is treated w/ amox or ampicillin

A

generalised rash

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67
Q

CBC-D finding in EBV

A

Atypical lymphocytosis on white blood cell differential

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68
Q

classic triad of EBV

A

Classic triad: severe sore throat, fever, lymphadenopathy.

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69
Q

besides constitutional and ENT AS, ask about what for EBV?

A

abd pain

70
Q

counseling for pt w/ EBV

A

Avoid heavy lifting and contact sports for 4+ weeks after mono to prevent spleen rupture

71
Q

pt w/ fever, fatigue, lymphadenopathy, sore throat, rash, myalgia/ arthralgia, HA, mucocutaneous ulcers, n/v/d, anorexia, weight loss. consider what do not miss dx?

A

HIV

72
Q

AIDS = when CD4 count is <____

A

200

73
Q

MC STI

A

HPV

74
Q

fever timeline in flu

A

sudden onset; fever (38-40C) that peaks w/in 12-24 hours of onset, lasts 1-5 days

75
Q

annual flu vax in all pts ____ or older if no CI

A

6 mo

76
Q

antivirals for flu most effective if started <_____ of onset

A

48 hrs

77
Q

measles pt should take vitamin ___

A

A

78
Q

does the monkeypox rash involve palms/soles

A

yes

79
Q

unvaxed kid w/ fever, swollen cheeks, swollen scrotum

A

mumps

80
Q

1 infectious common cause of acquired sensorineural deafness.

A

mumps

81
Q

give MMR to preg?

A

no

82
Q

classic sx in rabies

A

hydrophobia

83
Q

rabies postmorten: __________ in brain cells are pathognomonic

A

Negri bodies

84
Q

pt got bit by racoon. no preimmunisation. next steps (4)

A

clean wound, tetanus booster. HRIG – half at site and half in buttock, then vaccinate day 0,3,7,14

85
Q

Where does roseola start?

A

Trunk and neck

86
Q

viral exanthem that starts w/ abrupt high fever, then rash when fever goes away

A

roseola

87
Q

differences between Rubella (German Measles) and measles rubeola in terms of severity, rash, and AS

A

Measles (worse, more dangerous, lasts for wks, darker rash, cough, coryza, conjunctivitis)
Rubella: low grade fever, sore throat, smaller and lighter rash that disappears in 3 days, post LAD.

88
Q

viral exanthem w/ Forchheimer spots on soft palate (petechiae)

A

Rubella (German Measles)

89
Q

rubella is

A

german measles

90
Q

rubeola is

A

measles

91
Q

cause of roseola

A

human herpesvirus 6 and 7

92
Q

which can involve palms and soles: measles, german measles, or roseola

A

german measles / rubella

93
Q

Where does rubella start?

A

Face

94
Q

is dicloxacillin active against gram - ?

A

no

95
Q

is amoxicillin active against gram - ?

A

yes

96
Q

3 bac groups that augmentin covers

A

gram +, gram -, anaerobes

97
Q

MC SE of penicillins

A

diarrhea

98
Q

potential SE of penicillins at high doses

A

neurotoxicity: hyperreflexia, myoclonus, seizures

99
Q

are cephalosporins effective against beta lactamase producing bacteria

A

yes

100
Q

keflex covers what 3 bac groups? Gram + what? Gram - what?

A

gram + cocci, gram - rods, anaerobes

101
Q

go-to cephalosporin for strep and staph infx

A

keflex

102
Q

3 types of infx covered by 2nd generation cephalosporins

A

skin, ENT/resp, UTI

103
Q

cephalosporin gen to use for bacterial meningitis and why

A

3rd,, good CNS penetration

104
Q

3rd generation cephalosprin that covers pseudomonas

A

ceftazidime

105
Q

3rd gen cephalosprin preferred in neonates

A

cefotaxime

106
Q

MC SE of cephalosprins

A

GI upset: n/v, abd pain, lack of appetite

107
Q

which abx class has broadest spectrum of coverage?

A

carbapenems

108
Q

serious SE of imipenem to consider. what makes the SE worse?

A

CNS toxicity. renal insufficiency

109
Q

coverage of monobactam aztreonam

A

gram - aerobes only

110
Q

does aztreonam cover pseudomonas?

A

yes

111
Q

polymyxin spectrum of activity (1)

A

gram -

112
Q

does polymyxin cover psuedomonas?

A

yes

113
Q

does ceftaroline cover pseudomonas?

A

no

114
Q

vanc spectrum of coverage

A

gram + only

115
Q

vanc has synergistic coverage with what class?

A

aminoglycosides

116
Q

2 methods to prevent vanc flushing syndrom

A

slow infusion over 1-2 hrs, prophylactic antihistamines

117
Q

vanc is toxic to…. (2)

A

ears, kidneys

118
Q

tetracyclines: broad or narrow coverage?

A

broad

119
Q

abx of choice for mycoplasma PNA

A

doxy

120
Q

abx for vibrio

A

doxy

121
Q

tetracyclines have impaired absorption if taken w/ ______ (5)

A

dairy, Al, Ca, Mg, Fe

122
Q

which tetracycline is NOT CI in renal impairment?

A

doxy

123
Q

macrolides: broad or narrow?

A

broad

124
Q

best macrolide for atypical coverage

A

azith

125
Q

macrolide ok in preg

A

erythromycin

126
Q

macrolides CI in pts taking what 2 medications

A

niacin, statins

127
Q

3 macrolide SE

A

GI upset from increased peristalsis, ototoxicity, prolonged QT

128
Q

bacitracin spectrum of coverage

A

gram + only

129
Q

is clindamycin broad or narrow coverage?

A

narrow

130
Q

2 bac classes that clindamycin covers

A

gram + and anaerobes above the diaphragm

131
Q

2 MC SE of clindamycin

A

diarrhea, allergic rxn

132
Q

chloramphenicol: broad or narrow

A

broad

133
Q

gentamicin class

A

aminoglycosides

134
Q

aminoglycoside coverage

A

gram - aerobic bacilli (rods) only

135
Q

do aminoglycosides cover pseudomonas?

A

yes

136
Q

2 synergistic options w/ aminoglycosides

A

beta lactams, vanc

137
Q

which 2 abx class causes increased muscular weakness in myasthenia gravis

A

macrolides, FQ

138
Q

linezolid mainly used for what type of infx

A

resistant gram +

139
Q

which abx causes a transient darkening of urine

A

metronidazole

140
Q

main SE of metronidazole (4) besides disulfiram

A

HA, n/v/d, metallitc taste, peripheral neuropathy

141
Q

daptomycin coverage

A

gram + only (alt to vanc)

142
Q

2 most important SE of daptomycin

A

muscle toxicity/rhabdomyolysis, eosinophilic PNA

143
Q

2nd best PO abx coverage of MRSA

A

bactrim (linezolid is 1st, but not commonly used)

144
Q

4 main SE of bactrim

A

rash, GI sx, photosensitivity, folate deficiency

145
Q

5 CI for bactrim

A

sulfa allergy, preg (1st trim, last month), nursing, neonate < 6 wks, G6PD

146
Q

is nitrofurantoin effective against pseudomonas?

A

no

147
Q

what to tell pt about taking macrobid

A

take w/ meals to increase absorption

148
Q

indication for macrobid

A

uncomplicated cystitis in F only

149
Q

is macrobid safe in preg?

A

yes except 38+ weeks

150
Q

2 MC SE of macrobid

A

HA, GI upset

151
Q

which FQ has the best gram - coverage?

A

cipro

152
Q

moxifloxacin has the best ____ (3) coverage of all FQ

A

gram +, anaerobic, atypical

153
Q

MC SE of FQ

A

GI upset

154
Q

4 serious effects of FQ

A

tendinitis/tendon rupture, disordered glucose regulation,, prolonged QT, CNS (seizures, peripheral neuropathy)

155
Q

2 CI for FQ

A

preg, kids <18

156
Q

quinupristin/ dalfopristin can only be given ______

A

via central line

157
Q

neurosyphillis requires what tx? what length of time?

A

penicillin G 4 million units IV Q4 hrs X 14 days. (no alternative)

158
Q

lactate > ____ = septic shock

A

18

159
Q

septic shock pt receives fluid resus but is still hypotensive. next tx?

A

NE

160
Q

septic shock pt receives fluid resus and 1st line tx but is still hypotensive. next tx?

A

vasopressin, then epinephrine

161
Q

MC PE finding in congenital syphilis

A

hepatomegaly

162
Q

how do most newborns with congenital CMV present?

A

asx

163
Q

tx for congenital CMV

A

IV ganciclovir

164
Q

MC manifestation of congenital rubella

A

SNHL

165
Q

does a woman with +HPV need to have a C section?

A

only if warts obscure birth canal

166
Q

when should a women with +HSV have a C section?

A

if active lesions

167
Q

HIV pt with chonric watery diarrhea. dx?

A

Cryptosporidium (parasite)

168
Q

HIV pt w/ retinitis: fluffy white retinal necrosis w/ overlying hemorrhages. pathogen?

A

CMV

168
Q

HIV pt w/ meningitis. CD4<100. consider what pathogen?

A

cryptococcus

169
Q

HIV tx (classes)

A

INSTI + 2 NRTI

170
Q

pt bit by rat. do they need rabies vax?

A

no

171
Q

A 23 year-old female complains of fever and genital pain. Examination reveals the presence of lymphadenopathy in the groin and the presence of vulvar vesicles surrounded by erythematous skin. The diagnosis may be confirmed by

A culture of a vesicle using blood agar medium.

The presence of similar lesions on the fingers and hands.

A Gram stain of a scraping from the base of the lesion.

The presence of giant multinucleated cells on Tzanck smear

A

The presence of giant multinucleated cells on Tzanck smear

Clin Med (14 decks)

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