Infectious Dz Flashcards
What could cause a false positive reading on the TB PPD test?
- recent BCG vaccination
2. Anergy (sarcoid, HIV)
Reactivation TB typically occurs in which lobes
upper
What type of cough is found in pertussis ?
Whooping cough
Treatment of choice for pertussis
Macrolides, Erythromycin
Phases of pertussis
1) catarrhal phase: 1-2 weeks of URI like symptoms, this is when you are contagious and when ABX are effective
2) paroxysmal phase: whooping cough
3) convalescent
What abx fall into the penicillin class
penicillins, MSSA drugs, unasyn, zosyn
- penicillins have good gram positive coverage
- amoxicillin and ampicillin have gram positive AND gram negative
**unasyn and zosyn add on anaerobes
what class of antibiotic is the broadest
carbapenem
Types of candidiasis and their treatments
- esophagitis (MC) fluconazole
- thrush; nystatin
- vaginal; white curd-like discharge . miconazole, clotrimazole
- Intertrigo; diaper rash, topical clotrimazole
- Endocarditis; IV amphotercin B
What is the most common cause of fungal encephalitis?
cryptococcous
Treatment of cryptococcus
amphotercin B and flucytosine
Treatment of histoplasmosis
Itraconazole
Clinical distinguishing feature of pneumocystis
oxygen desaturation when ambulating, associated with high LDH levels
What organism is most likely to cause septic arthritis?
Gonorrhea
What organism is most likely to cause reactive arthritis
Chlamydia
Treatment differences in chlamydia and ghonarrhea?
Chlamydia= azithromycin+doxy
Gonorrhea=ceftriaxone + doxy
Presentation of diphtheria
friable grey/white pharynx that bleeds when scraped
*Bull neck
Diptheria treatment
antitoxin (horse serum)
+
Erythromycin / Penicillin
What is truisms?
Lock jaw that occurs with tetanus
treatment for tetanus
antitoxin
+
metronidazole
8 D’s of botulism
Diplopia, Dilated fixed pupils, dry mouth, dysphagia, dysarthria, dysphonia, descending decreased muscle strength
3 stages of syphilis presentation
1) primary: painless chancre
2) secondary; (weeks to months later); macularpapular rash on palms and soles
3) tertiary; up to 20 years later
- GUMMA: noncancerous granulomas
- Neurosyphilis
- Argyl-Robertson pupil; small pupil that does not react to light
- Cardiovascular: Aortitis
Screening tests for syphillis
RPR, VDRL
Treatment for syphilis
Pen G
Jarisch-Herxheimer reaction
Reaction to penicillin treatment.
Acute fever, myalgia, headaches due to rapid lysis of spirochetes
How to diagnose Lyme dz
ELISA testing followed Western Blott
PE of herpes
prodromal burning 24 hrs prior then painful vesicles on an erythematous base
HSV treatment
Acyclovir
Appearance of CMV on bx
Owls eye
CMV treatment
Ganciclovir
Manifestations of HSV
- chicken pox
- zoster
- Herpes Opthalmicus; trigeminal nerve (V), hutchington’s sign
- Herpes Oticus; Ramsey hunt syndrome, CN VII, otalgia, lesions on ear and TM
- Post herpetic neuralgia
Presentation of rabies
prodromal burning and itching, CNS manifestations, respiratory muscle paralysis
What is the treatment of choice for meningococcal meningitis?
Penicillin G
Clinical manifestations of Lyme dz
- erythema migrans, expanding warm bulls eye lesions
- Crainal nerve VII palsy
- AV block
- rheumatologic arthritis
Treatment for lyme disease
Doxycycline if over 8 years old
-amoxicillin if under 8 years old or pregnant
What is the epstein-barr virus also known as?
Infectious Mononucleosis
Clinical manifestations of EBV
1) fever
2) sore throat
3) posterior cervical lyphadenopathy
* *if given penicillin 5% will break out in rash!!!!
A CD4 count below what number defines AIDS?
Below 200, or an AIDS defining illness present
opportunistic infection when CD4 count reaches <200
PCP
opportunistic infection when CD4 count reaches <150
Histoplasmosis
opportunistic infection when CD4 count reaches <100
Toxoplasmosis
Cryptococcus
opportunistic infection when CD4 count reaches <50
MAC
CMV retinitis
HIV treatment options
- NNRTI + 2 NRTIs
- PI + 2 NRTIs
- INSTI + 2 NRTIs
- NNRTI= non-nucleoside reverse transcriptase inhibitor
- NRTI= nucleoside reverse transcriptase inhibitor
- PI= protease inhibitor
- INSTI= integrase strand transfer inhibitor
What is HIV?
Retrovirus that changes viral RNA to DNA via reverse transcriptase
Shigella presentation
Explosive watery, mucoid, bloody diarrhea with punctate areas of ulceration on sigmoidoscopy
Treatment of shigella
Fluids, Bactrim if severe
Salmonella sources
Poultry (dairy, meat, eggs) exotic pets
*High risk in patients with sickle cell disease
Presentation of salmonella gastroenteritis
abdominal pain, fever, mucus + bloody diarrhea
Presentation of typhoid (enteric) fever
- Salmonella typhi infection
- headache, pharengytis, cough (cephalic phase)
- Crampy abdominal pain with PEA SOUP STOOLS, intractable fever, bradycardia, ROSE SPOTS
Salmonella treatment
fluids and floroquinolones if severe
