infectious dz Flashcards
candida
skin, mm, disseminated, GI, vulva, vagina, dentures, balanitis
tx: clinical or biopsy
KOH-pseudo
cutaneous: warm, moist, dark
chronic infections: defect in Tcell response
-possible endocrinopathies
contiguous spread: trauma, burns, surgery
disseminated- on blood culture, high morality rate
endocarditis- infectious drug users, prosthetic valves
chronic disseminated- leukemia
tx:
azoles, capsofungin, amphotericin B( amyphy terrible- a lot of side effects, terbinaine
cyrptococosis
-budding yeast in soil, pigeon feces, inhalation
pull infection: fever, though
dx: cx
tx: difulcan X 10 weeks
meningitis:
s/s: HA, N/V, confusion, lethargy, visual changes
dx: CSF ( inc protein, inc WBC, dec glucose)
CT/MRI-punched out lesions
tx: mild dz: diflucan,
severe dz: induction ( amphotericin B)
maintenance- diflucan- life long
histoplasmosis
social, bird, bat droppings
3 types:
chronic progressive pul dx- apical cavities
progressive disseminated dz- ( HIV CD$
histoplasmosis work up
labs: anemia of chronic dz
diagnostic: bronchoalveolar lavage
- blood cx
tx: mild dz: itraconazole
severe dz: amphotericin witch to itraconable for life
PCP
airborne, premature babies, immunodeficiency states
s//s: abrupt, fever, tachypnea, dyspnea, cough dx: CXR: diffuse infiltrates cysts, nodules, cavities PFTS: dec VC, dec TLC labs: sputum stains
tx: Bactrim, steroids
prophylaxis( CD4
botulism
- gram positive rod, seen in soil
- toxin A and B
transmitted food borne ( canned or smoked), infant botulisms ( honey)
s/s: 12-26–> eyes ( double vision, dry mouth, n/v, dying of respirator paralysis)
tx: report to CDC with botulinum antitoxin
manage respiratory failure
cholera
seen after earthquakes, breaks in sewage
- hypersecretion of watery diarrhea ( rice water)
- pt dye of dehydration
- soil cultures
- diangosed clinical
tx: fluids, abx ( tetracycline, ampicillin, bacterium)
prevention: vaccine, short lived, limited
diphtheria
respiratory droplets
- s/s: nasal d/d
laryngitis
pharyngeal- thick gray membrane
tx: reportable dz
anti-toxicin
remove membrane
abx: pen, erythromycin, zithromax
case: till 3 neg BC
prevention: Dtap, Tdap, Td
pertussis
- respiratory droplets s/s: catarrhal- coryza, cold-like sxs, hacking cough paroxysmal- burts of coughing convalescent- 4 weeks after set
tx: erythromycin X 7d yas
prevention: Dtap, infants
Trap: adolscents
tetanus
soil, local
elderly, migrant workers, IV drug users
s/s: pain and tingling at site, stiffness of jaw/neck, irritability, painful tonic convulsions
-remains conscious
tx: tetanus immun globulin and start immunizations
- sedation, induced paralysis
PCN- eradicate any left o
wound management for tetanus
clean wound
unknown vaccine hx:
dirt wound
- 1 vaccine and immune globulin
clean wound- vaccine and no immune globulin
salmonella
-gram negative
Gastro enteriis s/s: crampy abd pain, diarrhea
tx: fluids
bacteremia: prolonged fever, bacteria go to distant areas
tx: fluids, cipo
enteric fever: malaise, fever, sore throat, pea soup diarrhea,
tx: fluids, cipro
vaccine: poorly effective
shigella
fecal -oral route
diarrhea with blood
tenesmus
30% - reactive arthritis
dx: stool cx ( WBC and RBC) and BC
tx: hydration, bactrim, cipro
lyme
borellia burgdorferi
most common tick born illness
must feed 24-36 hours
drops off in 2-4 hours
stage 1: erythema migrant, flue-like sxs
stage 2: fatigue, malaise, small, multiple, h/a neck pain, migratory arthritis
cardiac: pericarditis
focal : aseptic meningitis
stage 3: months–> years
MSK- variable arthritis synovitis
- encephalopathy
dx: early- should not get lyme titers ( testing wrong)
- diagnosed clinically
tx: doxy 2-3 weeks
peds/pregnancy- amor
prevention: avoid ticks
chemoprevention tx: doxy 200 mg once
rockey mountain spotted fever
wood tick and dog tick
- prevention: avoid ticks
- no chemoprophylaxis
- 1 week ; f/c/n/myalagia
pneumonitis cough
delirium, lethary
rash over ankles and spread to center
labs: low plts and low salt
tx: doxy- all ages
pregnancy- cholaremphenicol
syphili
transmission only by sexual contact
testing:
non-treponema tests- regular screening
high risk: treponemal tests
primary: painless shanker, adenopathy
secondary: weeks to months and very infectious stage. fever, adenopathy, rash over palms and soles
tertiary:gummatous reactions
inflammation every where
eyes- blindness
prostitue pupils
tx: PCN, allergic-tetracycline
Jarish-herzheimer rx- reaction to PCN
pregnancy- screening all prenatal its
congenital syphillis- rash
isolate and tx with PCN
CMV cytomegalovirus
virus remains latent
sexual, congenital, person and person
perinatal dz: jaundice, metal retardation
immunocompetent host:
fever, malaise, mon-like
complicaitons: GI
reactive dz: CD4
Epstein Barr virus
human herpes 5
10-35
s/sx: fever, ST,
posterior chain nodes, enlarge spleen
hepatic
ampicillin - may get a rash
labs; cbc, hemolytic anemia, monspot
tx: symptomatic, supportive
acyclovir
steroids for impending airway obstruction
avoid contact sports for large spleen
rabies
raccoons, bats, coyotes
s/s: pain at site, fever, malaise n/v
CNS stage: furious encephalitis
labs: skin bx
CSF,MRI
tx: prevention: immunization for domestic animals
post exposure: rabies immune globulin IM to wound plus distant site
human diploid cell rabies vaccine 5 injections 0,3,7, and 15
pre-exposure - 0.7, 21, 28
tx: fatal
HIV/AIDS
human retrovirus
targets all cells with t4 antigen , primarily CD4 helper lymphocyte
perinatal transmission, sexual, blood born products
screening: ELISA confirmed with Western blot
viral load: actively replicating virus
CD4 count: decrease with illness progression
other labs: anemia, leukopenia, thrombocytopenia
acute syndrome: flu-like syndrome, persistent adenopathy
HIV dz- weight loss, fever,
AIDS indication conditions: have it
prevention: safer sex, universal precautions, drug rehab
secondary: screening programs
post exposure: counseling, testing now 6 wks, 3 dos, 6 month , risk 0.03%
perinatal: antiretroviral during pregnancy , L and D and to newborn, avoid breast feeding
tx: antiretroviral, HAART
goal: suppression load
combination therapy
much have an expert
categories: NRTI- SE: bone marrow problems
NNRT;s- rash and neuro issues
fusion inhibitors: pain with injections, allergic run
CCRS- cough, fatigue
protest inhibiors- lipid issues
INSTI- headache, dizziness
combination therapy:
helminths
rounds worms, flukes, tapers
intestinal infections
mild to sever
-skin signs: hook worm
renal dz, splenic infarction
tx: albendazole
deworming programs- stop transmission
malaria
- endemic to tropics
- most cases to US are imported
- mosquitos inoculare liver
- releaes into blood cels
-s/s: shaking chill, fever, diaphoreses
malaise, n/v, diarrhea
P falciparum-severe dx
labs: peripheral smear- number of parasite tells you how much disease
- check cbc, hemolytic anemias
tx: chloroquine
okay in pregnancy
add doxy with resistance
prevention: chemoprophyasis , chloroquine, malorone, eduction, mosquito control
toxoplasmosis
cats and birds
transmission: ingest cysts- raw or uncooked meat
primary infection: acute, mild, febrile
congenital: cause of stillbirth/ abortion
AIDS/chemo pt: local infections in brain
dx: histology, serology
CT scan
tx:pyrimethamins
clean litter box
pin worms
female worms come out in butt cheeks
tx: albendazole
- tx every one in the house now and in 2 weeks
