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PANCE-Flashcards > Infectious Dz > Flashcards

Infectious Dz Flashcards

1
Q

What is the most common fungal meningitis? Where is this organism found? How is it diagnosed?

A

Cryptococcosis

found in contaminatd soild with dried pigeon dung

Dx: CXR, CSF

Culture-Budding, encapsulated fungus

Indian ink stain with agglutination assay

Tx: Fluconazole for pulmonary infxn

Amphotericin B for severe infx x 2 weeks, followed by fluconazole

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2
Q

What is the gold standard for diagnosiing Histoplasmosis? where is it found? How do you treat it?

A
  • Found in soil infested with bird droppings in ohio river valley
  • Culture-gold standard–can take 6 weeks to grow
    • urine antigen assay-confirms

Tx: Itraconazole

Amphotericin B-in severe dz

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3
Q

What is the gold standard for diagnosing Pneumocystis Jiroveci Pneumonia (PCP)? What is the tx?

A

Dx: Bronchoscopy

Tx: TMP/SMX (prophylaxis if CD4 <200)

Dapson if allergic to Sulfa

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4
Q

What causes “floppy baby syndrome”

A

Infant botulism: secondary to production of neurotoxin in GI tract after colonization of C. botulinum from soil or honey

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5
Q

What are the sxs of Botulism? tx?

A
  • Cholinergic sxs: decreased salivation, ileus, and urinarty retention
  • Ptosis, impaired EOM, diplopia and loss of accomodation, fixed dilated pupils
  • Tx: Botulinum antitoxin
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6
Q

How do you treat Diphtheria?

A

Horse serum antitoxin

Laryngoscopy–remove membrane if airway obstruction

PCN or erythromycin

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7
Q

What causes Typhoid fever? what are the sxs?

A
  • Salmonellosis
  • “pea soup” diarrhea; malaise, HA, cough, sore throat
  • 2nd week: pink papular rash primarily on trunk
  • fever peaks on days 7-10
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8
Q

How do you dx typhoid fever? How do you tx?

A
  • Blood culture! (stool culture not reliable!)
  • Tx: Ceftriaxone and fluoroquinolones x 2 weeks
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9
Q

Which type of diarrhea can cause seizures? tx?

A

Shigella

tx: TMP/SMX

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10
Q

DTAP vs. Tdap vs. TIG

A
  • DTAP (active immunization)-immunization given to kids <7 y/o
  • Tdap–>11 y/o. given as a booster every 10 years
  • TIG: Tetanus immune globulin 500 IM given with puncture wounds when tetanus status is unknown
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11
Q

What is the common atypical mycobacterial infection in AIDs patients? At what CD4 count is it found?

A

Mycobacterium avium complex (MAC)

CD4 <50

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12
Q

How do you treat atypical mycobacterial infection (such as MAC)?

A

Clarithromycin plus ethambutol

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13
Q

Tuberculosis: classic PE finding? Gold standard of diagnostics? What do you see on biopsy?

A
  • PE: posttussive rales–classic PE finding
  • Culture: gold standard; Acid fast stain-more rapid but not specific
  • Bx: caseating granulomas–histological hallmark
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14
Q

TB skin test >/ = 5 mm

A

Positive if HIV +, Recent active TB contact, evidence of TB on CXR, immunosuppressed patients on steroids

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15
Q

TB skin test >/=10 mm

A

Positive if Recent immigrant from high TB area, Healthcare worker/Lab personell, DM, CRF, Children exposed to high risk adults

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16
Q

TB skin test >/= 15 mm

A

Everybody else

17
Q

Treatment for Active TB

A
  • First 2 months: RIPE=Rifampin, INH, Pyrazinamide, and Ethambutol
  • After 2 months: discontinue Ethambutol and Pyrazinamide; Continue INH + Rifampin x 4 more months
  • Total tx duration=6 months
18
Q

Latent TB tx

A

INH x 9 months; Rifampin x 4 months

19
Q

What are common SE of INH, Rifampin, and Ethambutol?

A
  • INH=Hepatitis, peripheral neuropathy=give B6
  • Rifampin=hepatitis, Flue syndrome, orange blody fluid
  • Ethambutol=optic neuritis
20
Q

How do you diagnose Malaria? How do you treat?

A
  • Giemsa or Wright stain
    • examined at 8 hour intervals for 3 days
  • Tx: Chloroquine -DOC for tx and prophylaxis
  • add doxycycline in severe illnesses
21
Q

How do you dx pinworms? How do you treat?

A
  • dx: tape over perianal skin
  • Tx: Albendazole, Mebendazole, or pyrantal–then repeat 2-4 weeks later
  • wash all linens, and treat all family members!
22
Q

What is the most common space occupying lesion in HIV? where can one be exposed?

A

Toxoplasmosis

CAT LITTER! raw/undercooked meats

23
Q

What are the sxs of toxoplasmosis? what do you see on CT/MRI? How do you treat?

A
  • sxs: Cervical LAD, fever
  • CNS abnormalities: UVeitis, pain, photophobia,
  • Immunocompromised adult: Encephalitis (most common), Choriortinitis (ocular pain),

CT/MRI: multiple ring-enhancing lesions

Tx: Pyrimethamine with leucovorin (folinic acid)-to prevent bone marrow suppression

Add second drug–Sulfadiazine, Clindamycin

24
Q

What are the stages of Lyme dz?

A
  • Tick transmits Borrelia burgdorferi
  • Stage I: Erythema Migrans-“bulls eye rash”
  • resolves in 3-4 weeks without tx
  • Flu-like illness
  • 2nd stage (days to weeks): involves skin, CNS, musculoskeletal system
  • Pericarditis, Bells’ palsy
  • 3rd stage (months to years:
  • Joint pain, synovitis, frank arthritis
  • Subacute encephalopathy, axonal polyneuropathy
25
Q

What is the DOC for Lyme dz? In children and pregnancy?

A
  • DOC Doxycycline
  • PG and kids: Amoxicillin
26
Q

Rocky Mountain spotted fever: organism, clinical presentation, Tx (DOC and PG/Kids)?

A
  • Rickettsia rickettsii
  • 2-24 days after exposure: flue sxs
  • Rash–Palms and soles–purpuric as it spread
  • Flushed face
  • Tx: Doxycycline; PG/kids: Chloamphenicol
27
Q

Most common congenital infection?

A

Cytomegalovirus infection

28
Q

How do you diagnose Cytomegalovirus infections? tx?

A
  • Tissue biopsy: Intracytoplasmic inclusions (“Owl eyes”)
  • Tx: Ganciclovir
29
Q

Which childhood exanthem has a prodromal phase that includes Koplik spots, conjunctivitis, and cough? What happens on day 3 to 7 of this dz?

A

Measles (Rubeola)

On day 3, an erythematous maculopapular rash starts on the face and then spreads down to trunk/ext. But rash remains on face

30
Q

What childhood exanthem involves a rash that starts on the face but then spreads to trunks and limbs (leaving the face)?

A

Rubella (German Measles)

31
Q

What congenital syndrome is involved with Rubella?

A

Torch infection: Cataracts, PDA, microcephally, deafness, and “blueberry muffin” baby

32
Q

What childhood exanthem involves a rash (starting days after fever) that starts on the trunk and then spreads to neck/extremities?

A

Roseola, AKA exanthem subitum

33
Q

What is the complication of erythema infectiosum?

A

Aplastic crisis–Tx with immunoglobulin

34
Q

Kawasaki’s Disease: symptoms/signs, Treatment, and complications

A
  • A systemic vasculitis
  • Common cause of acquired heart disease and arthritis
  • sxs: Acute onset fiever, bilateral conjunctivitis, truncal polymorphous rash, oropharynx mucosal changes (dry fissured lips, strawberry tongue)
  • Peripheral extremity changes: Edema, erythema, and desquamation
  • Tx: IV immunoglobulin, ASA
  • Complications: Coronary aneurysm, Coronory vasculitis
35
Q
A

PANCE-Flashcards (11 decks)

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