INfx Dz Need To Know Block II Flashcards
What are of the country is high index of suspicion for blastomycosis
Along the Mississippi River
Coccidioidomycosis is prevalnet in what area
ARIZONA!
60% of coccidiomycosis cases occur in what state
Arizona
A pt presents with a cough, pluertic pain, fatigue, Headache, Fever, chills, and night sweats.
On CXR; Hilar/ medialstinal adenopathy
+erythema nodosum + erythema multiforme
And the pt recent Hx or location is in Arizona
Think..
Coccidioidomycosis
What is the Tx approach to coccidioimycosis
Most cases asympotomatic/ mild or self limiting.
Flucanazole is the DOC
A pt that is spulunking, cave diving, SocHx of smoking, around bats/ bat feces, (Missippi river, Oio river)
Presents with Pneumonia like S/s with pulm infiltrates/ hilar or medistinal lympadenopthy
Think..>?
Histoplasmosis
A pt that is luekopenic, or anemic, that was hanging out in caves, near the mississippi or ohio river valley…
Think?
Histoplasmosis
What is the Tx of choice for Histoplasmosis
Itraconazole is the first line Tx ( life long suppression for those with Active AIDs)
Amphotericin B for disseminated/ severe
A pt presents with a Hx of AIDS, a CD4 count below 200, and has come into contact with pigeon droppings
What organism are they at risk of contracting
Cryptococcosis
What is the most common cause of fungal meningioencephalitis
Cryptococcosis
What is the most common oppurtunistic infection
Candida
Thush in a young adult… always think… ?
HIV (candida oppurtunistic infection)
A pt presents with diabeties, pregnancy, or a recent use of ABX, has a thick white vaginal DC.
Think?
Vaginal Candidiasis
What is the Tx of choice for vaginal candidiasis
Oral Fluconazole (single dose is usually effective)
Individuals that are either hospitilized or on extended ABX Tx, presents with diarhhea…
Think?
C. Diff
A pt presents with noninvasive diarrhea and vomitting that recently went on a cruise ship…
Think ?
Norovirus
A pt presents with invasive diarrhea after eating raw or uncooked pork, +ABD pain in the RLQ. +Poly arthritis
Think?
Yersinia entericolitica
What is the Tx of choice for diarrhea caused by yersinia entericolitica
Ciprofloxacin
A pt presents with diarrhea after eating rice or pasta, (fried rice syndrome)
Think?
Spore ingenstion of bacillus cereus
What is the Tx of choice for bacillus cereus
MOSTLY supportive care
Fluoroquinolones can be used
A pt presents with watery (possibly bloody) diarrhea after ingesting undercooked of raw chicken
PE: Severe ill, R/L LQ pain, psuedoappendicitis
10+ watery/ bloody BM a day
Think..?
Campylobacter Jejuni
A pt presents with abdominal cramping and diarrhea, after contact with snakes or reptiles, poultry or eggs
Think?
Salmonella
What is the Tx of choice for non typhoid salmonella
Flourinquinolones (Cipro)
Rose spots are a sign of…
Typhoid fever
A pt presents with ACUTE bloody diarrhea, tenesmus, with mucus like stools, +fever + Lower ABD pain w/ increased bowel sounds
Think ?
Shigellosis
What is the Tx of choice for shigelleosis
Ciprofloxacin
What is the Tx of choice for travelers diarrhea
Ciprofloxacin
A pt presents with painless, rice watery diarrhea, that has a fishy odor
Think?
Cholera
What is the Tx of choice for Cholera
Aggresive fluid rehydration
25 % of pregnant pts with listeria monocytogenes have what outcome
Death in the infant ( 24x more likely for hispanic women)
Raw fruits and vegetables consumption , dairy, and poor infant outcomes
Think>?
Listeria monocytogenes
A pt presents with descending flaccid paralysis, after eating canned foods/ canned preserves or raw unpasteurized honey
Think?
Botulism
Where do the majority of cases of lassa fever come from
Nigeria
A pt presents with facial or neck edema, from nigeria, with fever, and deafness..
Think?
Lassa fever
In Lassa fever what are the LFT levels
AST levels substantially greater than AFTs
What is the most common complication of Lassa fever
Deafness
What is the resevoir for hantavirus
Rodent resevoir
What is the triad of S/s for Hantavirus
Fever, Renal Insufficieny, Hemmoraghe
What is the Tx of Choice for Crimean-Congo Hemm Fever
Ribavirin
How is TB transmitted/ presents
Close contacts with TB infected persons ( central and south america, foreign born persons)
With fever, cough, night sweats
People who share needles/ recreational drug use
What are the three criteria to R/o TB infections
- PPD
- No S/s of infection
- CXR
Someone that comes in the HIV and cough, fever, dyspnea, or any lung d/o
The first thought should be…
TB
What are the S/s of TB
Productive cough Fever Hemoptysis Wt loss chest pain Night sweats (very specific to active TB) Anorexia Fatigue
Where is the most common body part for skeletal TB infections
Spine
What is the next step to a postive TB PPD test
CXR!
What is a postive PPD measurment
larger than 5 mm for HIV, close contact of TB, CXR consitent with old heald TB
Larger than 10 all other high RSk populations
Larger thaqn 15 for all other pts
What is the Tx approach to latent TB prevention
INH for 9 months + pyridoxine
Rifampin if INH resistance
What is the causitive agent of Nec Fasc
Group A sterp
S Aureus
Vibrio
What is the most common assoc dz of Nec Fasc
DM
A pt with a rapid spreading distrucion of the tissues and fat, with gangrene, severe cellulitis, erythemic areas, migratory pains, leading to eventual sepsis
Think
Nec Fasc
What is the Tx of Choice for Nec Fasc
Imipenem ( Military) (Need to know)
Penicillin G and Clindamycin can also be used
What is the Tx of choice for Strep throat
Dysphagia, lymphadenopathy, fever, tonilitis
Benzine PCN G (IM)
What is the prevention of Rheumatic Fever
Treating Strep throat with PCN!
The major and minor criteria for Rhematic Fever
JONES Joints Myocarditis Nodes Erthyma margniatm Syndham chorea
Fever
Poly arthritsi
Prolongation of the PR interval
Elevated CRP or ESR
A pt presents with flu like s/s, signs of soft tissue injury, with N/V/D, pain, Headache, dyspnea, CNS depression, HOTN, +/- pertichea, sudden onset of fever.
On CBC thrombocytopenia
Pt is a woman with a recent menstral cycle
Think… ?
Toxic Shock Syndrome (possible retained tampon)
What is the Tx approach to toxic shock syndrome
EVAC,
Aggresive ABX Tx ( Clindamycin, Vanc, Nafcillin)
What is the most common manifestation of Group B strep infection
Peripartum fever
Rupture of membrane in pregnancy without proper progression increased RSK
A pt comes in with a step on a nail or dirty knife cut, what is a serious complication of this sequela of injury
Tetanus and SZR ( treat the SZR first, diazapam)
What is the Tx for tetanus
Tenus IGM and metronidazole
If the pt is SZR then treat the SZR first, diazapam
What are the 4 critera for SIRS
Body temperature over 38 (100.4) or under 36 (96.8) degrees Celsius.
Heart rate greater than 90 beats/minute ( may be on a CCB)
Respiratory rate greater than 20 breaths/minute or partial pressure of CO2 less than 32 mmHg
Leucocyte count greater than 12000 or less than 4000 /microliters or over 10% immature forms or bands.
What is a common cause of SIRs in a “little old lady”
UTI
How does measels present
Droplet spread ( very contagious)
Cough
Koplik Spots (in the mouth)
Coryza
Fever
On the 3-7 days
Characteristic red blotchy rash
Begings on face then moves to trunk
( a pt with out proper vax)
What are the 3 cs of measels
High Fever plus cough, coryza, conjuntivitis ( plus koplik spots)
HIV oppurtunistic infection involving the eye
CMV conjunctivitis
A pt presents with fever, signifigant fatigue, chills, malaise, sever sore throat… is a younger child or pt between 15-25 yrs old
May have tonisilar pharyngitis
Strep test is negative
-/+ Jaundice and elevated LFTs (need to know)
PE: Splenomegaly
Think?
EBV/ Mono
What is the causitive agent of Burkitt lymphoma and Nasopharyngeal Cancers
EBV/ Mono
A pt presents with fever, unilateral or bilateral swelling of the parotid glands, dysphagia, malaise
-/+ orchitis or oophiritis
Think?
Mumps
A pt presents with acute onset of flaccid paralysis.. think
Acute poliomylitis
Where does the infection of polio occur and what is its s/s
Infection occurs in the GI tract,
Aseptic meningitis,
Fever, malaise, N/V
FLACCID PARALYSIS
What type of paralysis is present with Polio
Acute flaccid paralysis without senory loss
May be unilateral
A pt presents with a maculopapular rash, on the face trunk neck, that becomes vessicles, then become a granular scab. Anc collapse when punctured
Think?
Polio
A pt presents with a very high fever Headache Retro orbital pain And sever althragias Bleeding from the teeth/ gums
Abdominal pain/ blood diarrhea
Truncal rash
from a mosquito
“Saddle back fever”
Dengue Fever
What is a postive TQ test for dengue
Positve if 10 or more petechia per square inch with BP cuff inflation
A pt presents with “black water vomit” Mucosal and GI tract bleeding Nausea with billious vomitting Conjunctival injections Leukopenia/ thrombocytopenia Think?
Yellow fever
Tx: supportive care