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Elaina: Infectious Disease > learning objectives we didn't learn > Flashcards

learning objectives we didn't learn Flashcards

1
Q

opportunisitic pathogen part of the normal GI and GU flora?

A

candida albicans

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2
Q

manifestations of candidiasis?

A

1) oral thrush: nystatin
2) esophagitis: think HIV
3) vaginal candidiasis: curd-like discharge
4) intertrigo: beefy red with satellite lesions
5) fungemia: BAD; usually with indwelling catheters
6) endocarditis: in patients with HIV; treat with amphotericin B

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3
Q

how to diagnose candidiasis?

A

KOH! budding yeast and branching hyphae

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4
Q

SO, what are the manifestations of candidiasis mostly seen in patients with HIV?

A

esophagitis and endocarditis!

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5
Q

when you hear pigeon/bird droppings, think…

A

cryptococcosis (YEAST)

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6
Q

what is the most common cause of fungal meningitis?

A

cryptococcosis

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7
Q

when may cryptococcosis show up in a patient with HIV/AIDS?

A

CD4

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8
Q

diagnosis and treatmente of cryptococcosis?

A

india ink stain of CSF

tx: amphotericin B

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9
Q

how do we treat cryptococcosis prophylactically in AIDS?

A

fluconazole

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10
Q

when you hear soil contaminated by bird/bat droppings, think…

A

histoplasmosis!

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11
Q

when does histoplasmosis typically present in AIDS patient?

A

CD4

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12
Q

how does histoplasmosis present in immunocompetent vs. immunosuppressed?

A

immunocompetent: asymptomatic or flu-like symptoms
immunocompromised: disseminated! OROPHARYNGEAL ULCERS, adrenal insufficiency, bloody diarrhea

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13
Q

histoplasmosis can also cause an atypical case of….

A

pneumonia!

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14
Q

how do we treat histoplasmosis in immunocompromised?

A

same as candidiasis and cryptococcosis because they are all yeasts!

amphotericin B if severe

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15
Q

what is THE most common opportunistic infection in patients with HIV?

A

pneumocystis pneumonia! caused by pneumocystis jiroveci (fungus)

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16
Q

what is interesting about the treatment of pneumocystic pneumonia?

A

it is caused by a fungus but does NOT respond to anti-fungals!

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17
Q

how do we treat and prophylax against pneumocystic pneumonia?

A

treat with bactrim!

prophylax with bactrim if CD4

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18
Q

what is key to diagnosing pneumocystic pneumonia/.

A

get chest xray!

bilateral diffuse interstitial infiltrates

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19
Q

how does one acquire acute rheumatic fever?

A

2-3 weeks post untreated strep pharyngitis (caused by group A strep AKA strep pyogenes)

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20
Q

complication of acute rheumatic fever?

A

rheumatic valve disease!

most common is mitral valve then aortic

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21
Q

what is the jones criteria associated with?

A

acute rheumatic fever

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22
Q

drug of choice for treating strep?

A

penicillin

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23
Q

patient presents with diplopia, dry mouth, dysphagia, dysarthria, dysphonia, decreased muscle strength, dilated fixed pupils…….

A

botulism!

clostridium botulinum (gram positive spore forming rods)

24
Q

pathogenesis of botulism?

A

neurotoxin inhibits acetylcholine release at neuromuscular junction causing weakness and flaccid paralysis

potential for respiratory arrest

25
Q

common causes of botulism in:

1) adult
2) baby
3) active person

A

1) ingestion of canned/smoked/vaccuum packed foods
2) ingestion of honey
3) traumatic injury

26
Q

treatment of botulism?

A

antitoxin and respiratory support if respiratory failure!

antibiotics ONLY in wound botulism

27
Q

when you hear “rice water” diarrhea, think…

A

cholera

it is grey, turbid, without odor, blood, or pus

28
Q

pathophysiology of cholera?

A

vibrio cholera; ingestion of fecally contaminated food or water.

toxin is produced that causes hypersecretion of water and chloride ion and massive diarrhea

29
Q

complications of cholera?

A

dehydration, hypotension, electrolyte imbalance, death

30
Q

diagnosis & treatment of cholera?

A

stool culture

oral or IV rehydration!

antibiotics reserved for severe cases: tetracycline, bactrim, fluoroquinolones

31
Q

will alcohol disinfect water?

A

no!

32
Q

patient presents with friable grey/white membrane on pharynx that bleeds when scraped…diagnosis?

A

diptheria

these are pseudomembranes

33
Q

how does one acquire diptheria?

A

inhalation of respiratory secretions; the exotoxin induces inflammatory response

34
Q

treatment of diptheria?

A

diptheria antitoxin (horse serum) and erythromycin x 2 weeks

35
Q

should you treat close contacts of an individual with diptheria?

A

yes! and keep them in isolation until they have 3 negative cultures

36
Q

other manifestations of diptheria

A

bull neck, fevers, nasopharyngeal symptoms, myocarditis & neuropathy

37
Q

how to prevent diptheria?

A 
vaccine given at:
2 months
4 months
6 months
15 months

booster at age 4-6

38
Q

what are the three manifestations of salmonellosis?

A

1) enteric (typhoid) fever
2) gastroenteritis: most common
3) bacteremia

39
Q

enteric (typhoid) fever is characterized by what presentation?

A

“pea soup” diarrhea

malaise, HA, fever, splenomegaly, bradycardia, abdominal distention

40
Q

how to diagnose typhoid fever due to salmonella?

A

stool is unreliable! blood culture during 1st week only

41
Q

treatment of typhoid fever?

A

ampicillin, chloramphenicol, and bactrim x 2 weeks

42
Q

what will the diarrhea of salmonellosis gastroenteritis look like?

A

bloody!

fever, nausea, vomiting, cramping as well

43
Q

how do we treat gastroenteritis due to salmonella?

A

self-limiting

ABX only for severe cases

44
Q

what is bacteremia secondary to salmonella?

A

prolonged, recurrent fevers and local infection of bone, joints, pleura, pericardium, or lungs

COMMON IN IMMUNOSUPPRESSED

45
Q

how do we treat bacteremia due to salmonella?

A

same as enteric (typhoid!) ampicillin, chloramphenicol, and bactrim x 2 weeks

46
Q

what will the diarrhea be like with shigellosis?

A

mixed blood AND mucous

diarrhea, cramps, TENESMUS, fever, chills, anorexia

47
Q

shigellosis is linked with what type of systemic manifestation?

A

reactive arthritis!

48
Q

what is the difference in onset between salmonellosis vs. shigellosis?

A

salmonellosis is insiduous, shigellosis is ABRUPT

49
Q

how to diagnose shigellosis?

A

stool culture for leukocytes, RBC, and culture

sigmoidoscopy: punctate lesions and ULCERS

50
Q

treatment of shigellosis?

A

replace fluid volume!

bactrim

51
Q

where is clostridium tetani found? how does it infect us?

A

it is ubiquitous in the soil; germinates through puncture and crush wounds

52
Q

what is the pathogenesis of clostridium tetani?

A

blocks release of acetylcholinesterase, leading to Ach-mediated sustained contractions at neuromuscular junction

53
Q

early symptoms & late symptoms of tetanus?

A

early: local muscle spasms, neck/jaw stiffness, dysphagia, hyperirritability
late: trismus (lockjaw), drooling, muscle rigidity in DESCENDING fashion

54
Q

treatment of tetanus?

A

metronidazole or penicillin + tetanus immune globulin

55
Q

prophylaxis of tetanus?

A

Tdap vaccine given every 10 years

or if major cut occurs >5 years since last booster)

Elaina: Infectious Disease (3 decks)

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