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HuntsClinMed1B > Key findings, exam 1 > Flashcards

Key findings, exam 1 Flashcards

1
Q

Staph skin infection

A

MC: erythema, purulent drainage,

pustules, crusting, cellulitis, abcesses, folliculitis

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2
Q

Toxic Shock Syndrome

A

diffuse erythematous rash on palms and soles that desquamates
Tampon use, nasopharynx packing, wound or abcess
Sudden high onset fever, myalgia, watery diarrhea, hypotension

Low platelets and liver damage, confusion leads to renal damage, shock, syncope

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3
Q

Scalded Skin Syndrome

A

A small child or infant with
Widespread bullae with sloughing, fever

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4
Q

Staph food poisoning, timing

A

Exotoxin or food contamination
2-8 hours after ingestion

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5
Q

Coag neg staph infections

A

post op, prosthetics, catheters

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6
Q

Strep pyogenes pharyngitis

A

scarlet fever. Scarlet fever is a strawberry tongue, sandpaper rash that is diffuse erythematous rash resembling a sunburn with superimposed fine red papules that blanches. leaves desquamation behind after 2 to 5 days. face flushes with circumferential pallor

-tonsilar hypertropy and tonsillar exudate, beefy red uvula, palatal petechiae, cervical lumphadenopathy bilaterally

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7
Q

Impetigo - strep

A

A wresterler with a:
Focal, vesicular pustular lesions w/ honey colored crust and stuck on appearance

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8
Q

Erysipelas -strep or s aureus

A

Painful superficial cellulitis with dermal lymphatic involvement covering the face

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9
Q

Strep agalactiae

A

Group B strep.
Mother to infant through birth canal. Must take prophylactic PCN
10-30% asymptomatic carriers. Mom needs pregnancy screening before going to the hospital as it can cause neonatal sepsis.

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10
Q

OM - strep pneumo

A

2-14 year old
Erythematous, bulging tympanic membrane
Absent light reflex, poor mobility
Otalgia, hearing loss, loss of balance, fever, diarrhea
Otorrhea if ruptured

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11
Q

Acute sinusitis - strep pneumo

A

MC: starts as a viral infection
purulent rhinorrhea and sinus pressure. erythematous, swollen nasal turbinates and mucosa

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12
Q

Pneumococcal pneumonia

A

Rigor, rust colored sputum, pleuritic chest pain, lobar consolidation +- effusion on CXR
bronchial breath sounds early and then crackles in the lobe

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13
Q

Bacillus anthracis skin

A

onset within 2 weeks of exposure
painless black eschar
regional adenopathy exposure
Fever, headache

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14
Q

Bacillus anthracis ingestion

A

bloody diarrhea, ulcerations on mouth, GI obstruction and perforation
inadequately cooked meat
Ingested spores cause symptoms

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15
Q

Bacillus anthracis inhalation

A

first progression of flu like symptoms,

then chest pain, severe respiratory distress, acidemia,
meningitis, mediastinitis, pleural effusion

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16
Q

Bacillus cereus

A

RICE/LEFTOVERS
1-10 hours onset
watery diarrhea self limiting

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17
Q

Listeriosis (listeria monocytogenes)

A

Bacteremia, high fever, meningitis, dermatits
oculoglandular retinitis &lymph node enlargement,

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18
Q

Pseudomonas Aeruginosa

A

MC in Corneal ulcers in contact wearers, ICU pneumonia, osteochondritis

Healthy people get OE (otitis ext) UTI dermitis on bathing suit

IC people get pneumoniae (2nd MC), UTIs (3rd MC), bacteremia, sepsis, CF, burn patients, VAP

Its water related and it causes fever and green discharge

hot tub folliculitis 7-10 d

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19
Q

Cornebacterium diplitheriae

A

GRAY membrane covering tonsils and pharynx, nasal discharge, can spread to heart CNS and kidneys.

mild sore throat that progresses to toxemia and prostration (big fatigue)

CDC must provide a Diphlitheriae equine antitoxin

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20
Q

Neisseria meningococcal meningitidis

A

stiff neck, fever, HA, maculopapular rash, petechiae, photophobia, lethargy, change in mental status (not respond to verbal), + kernig and brudinski

can progress to fatal meningococcemia, lumbar puncture. prevent with Penbraya

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21
Q

Neisseria gonorrhoeae

A

○ May be asymptomatic (most of the time)
○ Yellow-green purulent discharge
○ Erythematous cervix (friable)
○ Infants conjunctiva discharge (culture if so)
○ Skin rashes, septic arthritis, conjunctivitis in newborns, prostatitis, PID, cervixitis, urethritis

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22
Q

Whooping Cough Bordetella Pertussis

A

○ MC in unvaccinated children
○ Aerosolized droplets. Incubation 7-14 d
-** Catarrhal -**
■ Insidious onset
■ Sneezing, coryza, cough
○** Paroxysmal**
■ Can be deadly
■ Worsening cough
■ Forceful coughing fits
■ Whooping gasps for breath
○** Convalescent**
■ Symptoms diminish
■ Cough may linger for months

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23
Q

Legionnaires disease

A

○ MC: CAP, IC, smokers, chronic lung disease, CPAP users
○ Contaminated aerosolized WATER SOURCES
○ Scant sputum production
○ Pleuritic chest pain
○ High fever
○ Toxic appearance
aerosolized water sources
scant sputum production, pleuritic chest pain, high fever. CXR shows focal patchy infiltrates or consolidation

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24
Q

Klebsiella pneumoniae

A

○ MC: ALCOHOLICS, DM, HIV
○ Severe pneumonia symptoms
■ SOB, pleuritic chest pain
■ RED CURRANT-JELLY SPUTUM
■ Can progress to lung abcess
○ Can cause UTIs as well

25
Q

Travelers diarrhea

A

○ Presents during/shortly after travelling
○ Increased frequency, weight, and volume of stools
○ Urgent need to defecate (Tenesmus)
○ 4-5 water stools a day
○ Abdominal cramps/bloating
○ N/V
○ Fever
○ Main concern H20. +/- moderate-severe dehydration, persistent vomiting, or high fever

26
Q

Campylobacter jejuni

A

○ Foodborne
○ Inflammatory (sometimes bloody) diarrhea, dysentery syndrome with cramps, fever, pain

27
Q

Shigellosis

A

Inflammatory blood diarrhea
tenesmus
● Presentation:
○ Abrupt onset of diarrhea (often with blood and mucus), lower abdominal pain/cramping, tenesmus
○ Systemic: fever, chills, anorexia, malaise, HA

28
Q

Cholera

A

● Presentation:
○ Presents after travelling to endemic area/contact with infected person
○ Acquired by ingestion of contaminated food/water
○ Sudden onset severe, voluminous diarrhea (liquid, gray, turbid, WITHOUT ODOR, blood, or pus)
○ RICE WATER STOOL

29
Q

Non cholerae vibrio

A

cellulitis
○ Enteric illness: watery diarrhea, tenesmus, abdominal cramping
● V. parahaemolyticus
○ Japan/coastal US
○ Shellfish/contaminated seawater
● V. mimicus
● V. hollisae

30
Q

salmonella Enterica

A

○ Typhoid fever -
Incubation stage is 5-14 days.
○ Prodromal stage is 7-10 days :
■ ABD pain, N/V
■ Sore throat, Cough, HA
■ Worsens after 10 days
○ Becomes —> exhaustion, N/V, abdominal pain, BLOODY PEA SOUP DIARRHEA, headaches, ROSE SPOTS, fever

31
Q

Enterocolitis salmonella

A

○ Ingestion of infected eggs/poultry/chicken, raw milk, or meat
○ Direct contact with infected animals (TURTLES and REPTILES)
○ Nausea, crampy abdominal pain, inflammatory diarrhea (mucus/blood), fever
■ Sx start 12-48 hours after contact
turtles and reptiles. bloody inflammatory diarrhea and fever

32
Q

Bubonic plague

A

○ Yersinia Pestis
RODENTS/bite of FLEAS. Only HumanXHuman during epidemic.
○ 3 forms
■ Bubonic plague (skin)
■ Pneumonic (lungs)
■ Septicemia (blood)
○ Profoundly ill: sudden onset high fever, malaise, severe myalgias, prostration
○ 1st- Axillary or inguinal lymphadenitis (BUBO), may be suppurative/draining
○ 2nd- Tachypnea, productive cough, BLOOD TINGED SPUTUM, cyanosis with pneumonia
○ 3rd- Hematogenous spread: toxic, comatose, purpuric spots (BLACK PLAGUE) on skin

33
Q

Francisella Tularensis

A

most infectious bacteria known
CDC Cat A bioweapon
● Presentation: “rabbit disease”
○ RABBITS, rodents, and ticks
○ Fever, HA, nausea, prostration, regional lymphadenopathy
○ Papule progressing to ulcer at site of inoculation
○ Eschar is possible like anthrax but more localized and has different histories

34
Q

Sepsis

Labs? Presentation? Progression?

A

○ Coincides with infectious source
■ Ex: cough with dyspnea=pneumonia
○ 1. Infection 2. Moves to blood 3. BV leaks are everywhere 4. Organ system dysfunction
○ Hypotension (systolic <90)
○ Fever >100.4 or <95
○ HR >90
○ RR >20
○ Signs of end organ perfusion
■ Warm/flushed skin
● Poor cap refill, cyanosis, mottling
■ Altered mental status
■ Absent bowel sounds
● qSOFA > or = 2 associated with poor outcomes
○ RR >22
○ Altered mentation
○ Systolic BP <100

35
Q

Mycoplasma pneumoniae

A

● Presentation:
○ 2-3 week incubation
○ MC: fall, summer, young adults
○ WALKING PNEUMONIA
○ Gradual, milder
○ Scant sputum production
○ Cough
○ Often associated with pharyngitis and/or AOM
■ BULLOUS MYRINGITIS
○ Chest auscultation clear
○ CXR: nonconsolidation. nondiagnostic patchy infiltrates

36
Q

Chlamydia pneumoniae

A

Second MC of atypical pneumoniae
Sx same as Mycoplasma pneumoniae

37
Q

Chlamydia psittaci pneumoniae

A

○ 7-10 d incubation
○ BIRDS
○ “Atypical” pneumonia but more severe symptoms
○ Fever, chiIls, cough, HA
BIRDS
Atypical pneumonia but severe

38
Q

Chlamydia trachomatis & any complications

A

○ MOST COMMON STD
○ Female: mucopurulent discharge, chandelier sign, urethritis, red/inflamed/friable cervix, PID (pelvic pain, dyspareunia, cervical motion tenderness)

○ Male: mucoid/watery urethral discharge, urethritis, prostatitis, dysuria, epididymitis (testicular pain, palpable/swollen epididymis)

○ Both genders: conjunctivitis, lymphogranuloma venereum
○ 7-14 day incubation

Pregnancy complications - PROM (premature rupture of the membranes)
Infertility (from PID)
Can be transmitted to newborn
Perihepatitis (Fitz Hugh-Curtis syndrome) – Clap gone wild

39
Q

Haemophlus influenzae

A
  • -colonize the upper respiratory tract in patients with COPD and frequently cause purulent bronchitis.
  • -sinusitis, OM, respir. Tract infection
40
Q

FUO

A

● Fever >101.9F or >38.3 C
● Oral is most accurate. Axillary adjust by one F
● >3 weeks
● Failure to make diagnosis after 1 week of inpatient investigation
● After that you should do a full PE on them daily to figure out etiology
● Differentiate: classic, hospital-acquired, IC/neutropenic, HIV-related
● Presentation:
○ Varies, obtain detailed HPI/ROS
○ Shaking chills: more likely infectious

41
Q

SIRS

A

systemic inflammatory response syndrome.
Leads up to sepsis, but NOT sepsis.
● Presentation:
○ 2 or more:
■ Fever >100.4 (38C) or <96.8 (36C)
■ PaCO2 < 32 mmHg
■ HR >90
■ RR >20
■ Abnormal WBC
● >12,000
● <4,000
● >10% bands
○ Etiology: ischemia, infection, inflammation, trauma

42
Q

Bacteremia

A
  • Not fatal, means bacteria are in the blood.
  • RI: 65+ yrs old
  • During winter and spring
  • Gram pos>Gram neg>fungi
43
Q

Syphillis stages and primary presentation, and incubation, also state microorganism

A

spirochetes!
treponema pallidum
● Stages:
○ Early (primary and secondary) -> INFECTIOUS, first year
○ Latent -> symptom free (infectious within first year)
○ Tertiary (late) -> severe systemic symptoms, NON-CONTAGIOUS
○ Neurosyphilis and ocular syphilis
● Presentation:
○ 21 day incubation before symptoms
○ CHANCRE (painless ulcer) location:
■ MC: penis/labia
■ Cervix, anorectal region, oropharynx (where it can hide from plain site)
○ Nontender regional lymphadenopathy
○ Chancre has spontaneous healing

44
Q

Secondary syphillis

A

-bacteria disseminate,
● Presentation:
○ Generalized maculopapular rash
○ Mucous membrane patches and ulcers
○ Condyloma lata
○ Meningitis
○ Iritis/visual disturbances
○ Hepatitis
○ Arthritis
○ Fever/generalized lymphadenopathy (LAN)

45
Q

3rd stage of syphillis

A

Latent Stage (third stage, asymptomatic, contagious in 1st year)

46
Q

Tertiary Syphillis

A

Tertiary syphilis – (late, non-contagious)
● Presentation:
○ Ocular sx
○ GUMMAS (skin and mucous membrane lesions)
○ Infiltrative tumors in the skin, bones, internal organs, liver
○ Bone lesions (bone pain)
○ Respiratory distress (gummas in lungs)
○ Liver disease/cirrhosis
○ Cardiovascular lesions
○ Aneurysms
○ Neurosyphilis (MC but can occur at any stage)

47
Q

Neurosyphillis

A

● Asymptomatic neuroinvasion – asymptomatic CSF invasion
● Meningovascular syphilis- meningeal symptoms
● Tabes dorsalis – chronic progressive degen of posterior columns of spinal cord. Inability to walk in the dark, control bladder, parathesias, wide based gait
● General paresis – once cerebral cortex is infected
● Diagnose neurosyphilis w/ LP, tx same. RI: HIV, man 45yr old+

48
Q

Borrelia burgdorferi, primary presentation

A

○ DEER TICK (ixodes)
○ MC : spring summer fall, NE and N. central US
○ Stage 1 (early localized): 4 weeks
■ 1 week after tick bite
■ Erythema migrans (BULLS EYE)
■ Flu-like symptoms

49
Q

Borrelia Burgdorferri stage 2

A

○ Stage 2 (early disseminated):
■ Days-weeks after initial infection
■ Bacteremia
■ Secondary skin lesions/rash
■ Worsening flu-like symptoms
■ +/- cardiac involvement -arrythmia, heart block
■ +/- neuro manifestations – aseptic meningitis, facial palsy

50
Q

Borrelia Burgdorferri stage 3

A

○ Stage 3 (late persistent)
■ Months-years after initial infection. Ok if untreated
■ MSK (60%)
■ Neuro
■ Skin

51
Q

Leptospirosis

presentation, diagnosis, treatment

A

○ RAT URINE
○ Minor to fatal liver and kidney disease
● Diagnosis:
○ Serologic testing
● Treatment:
○ Doxycycline

52
Q

Rickettsia rickettsii

A

● Presentation:
○ MC: NC, TN, OK, AK, MO. 73% mortality unless tx
○ WOOD/DOG TICK (dermacentor)
○ 2-14 days after tick bite
○ Fever, chills, HA, N/V, myalgias, insomnia, RASH
■ Faint macules progressing to papules, then to petechiae
■ Appears first on wrists and ankles then spreads centrally

53
Q

Clostridial soft tissue infection

A

-gas gangrene. Lives in soil.
● Presentation:
○ Pain, edema, erythema, TISSUE CREPITUS, FOUL SMELLING

54
Q

1.

Clostridial gastroenteritis

A

○ Found in feces, soil, air, and water
○ Mild gastroenteritis (watery diarrhea). Rare sx is fever and vomit

55
Q

Clostridium Tetani

A

● Presentation:
○ Spores from C. tetani enter the body from wound, burn, IV drug use. It attaches to the peripheral nerve ending, causing muscle stimulation. Leads to tonic spasticity, and muscle rigidity. It CANNOT be neutralized once bound.
○ Incubation 5-30 d
○ Seen after injury, burn, or IV drug use
○ Jaw stiffness
○ Difficulty swallowing
○ Stiff neck, arms, or legs
○ Headache
○ Tonic muscle spasms
○ Trismus
○ Respiratory failure due to overstimulation (spasm of diaphragm/laryngeal spasm)

56
Q

Botulism

A

● Presentation:
○ Can absorb many ways. Respiratory is synthesized, all other ways are natural. 8 subtypes of bolulinum
○ MC: home canned foods, commercial food, direct injection, wound
○ 18-36 hours after ingestion
○ N/V/abdominal cramps b4 neuro involvement
○ Neuro sx
■ Dry mouth, slurred speech, dysphagia
■ Blurry vision, drooping eyelids
■ Leads to diaphragm PARALYSIS (resp fail)

57
Q

Pseudomembrane colitis

A

Overgrowth of organism because of antibiotic use. Found in soil. Water, pets, humans (asymptomatic). It produces a toxin.

● Presentation:
○ 5-10 DAYS AFTER ANTIBIOTIC USE but can take up to 2 months.
○ Diarrhea (frequent, watery, sometimes bloody)
○ Abdominal cramps, tenderness, bloating

58
Q

Gardnerella (usually)

A

○ Asymptomatic often.
○ MC cause of vaginal discharge
○ Thin, off-white to grayish discharge
○ FISHY SMELL, elevated pH

HuntsClinMed1B (19 decks)

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