Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

General ID 2019 > Masquerades, ICU, pharyngitis, immuno > Flashcards

Masquerades, ICU, pharyngitis, immuno Flashcards

1
Q

Chitlins…you say?

A

Yersinia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bulls eye - rash?

A

lyme disease (erythema migrans or STARI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Behcet’s disease? treatment?

A

triad of aphthous oral ulcers, genital lesions, and recurrent eye inflammation. Can also have pustule at site of venipuncture. Tx with colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sweet syndrome?

A

sudden onset of fever and painful rash on the arms, legs, trunk, face, or neck. It’s also known as acute febrile neutrophilic dermatosis. Associated with acute luekmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pyoderma gangrenosum syndrome, dx and associations?

A
  • Painful, pathergy, purulent base, purple
  • Inflammation, irregular border
  • Erosions
  • Dx of exclusion
  • Exam
  • Rule out Labs (RF, APLS, Cryoglobulin, ANCA)
  • Microscopic evaluation (neutrophilic dermatosis)
  • GI disorders (IBD)
  • Arthritis (RA, PAPA)
  • Neoplasms (solid organ, MPN)
  • Genetic predisposiiton
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Monospot test tests?

A

rapid test for EBV infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the two types of HLH?

A

HLH is hemophagocytic lymphohistiocytosis. Primary (familal) or secondary - triggered by infections (EBV, HIV histoplasmosis) or malignancy (lymphoma/leukemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HLH clues?

A
  1. EBV or other infection with progressively symptoms
  2. elevated ferritin
  3. cytopenia with negative infectious evaluation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the Yamaguchi criteria?

A

This is for adult still’s disease:

Major:

  1. Fever for more than 1 week
  2. arthritis/arthralgia more than 2 weeks
  3. nonpruritic mac-pap rash during febrile episodes
  4. >10K Leukocytes with 80% granulocytes

Minor:

  1. Sore throat
  2. lymphadenopathy
  3. hepatosplenomegaly
  4. Abnormal LFts or LDH
  5. Negative ANA & RF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clues to Adult Still’s disease?

A
  • Evanescent salmon colored rash
  • elevated ferritin
  • pharyngitis
  • Koebner phenomenon - rash elicited by stroking sin or areas of pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the infectious causes of Erythema nodosum?

A

SMORES SHINTS (Streptococci, Mycoplasma, OCP, Rickettsia, Eponymous (Behçet),Salmonella, Sulfonamides, Hansen’s Disease (Leprosy), IBD, NHL, TB, Sarcoidosis. Also, granulomatous infections, yersinia, and campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is lofgren syndrome?

A

triad of hilar lymphadenopathy, acute arthritis, erythema nodosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the buzz words for sarcoidosis?

A

hilar lymphadenopathy, erythema nodosum, uveitis, aspetic meningitis with basilar enhancement, non-caseating granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is kikuchi?

A

acute necrotizing histiocytic lymphadenitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

buzz words for kikuchi?

A

Young woman with acute onset of fever, cervical lymphadenopathy with atypical lymphocytes (mono-like syndrome) with lymph node biopsy showing necrotizing adenitis with histiocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is clinical characteristics of DRESS syndrome?

A

2-6 weeks after drug initiation with morbiliform rash, lymphadenopathy, facial edema with visceral invovlement (hepatitis, interstitial nephritis, interstitial pneumonitis). HIgh mortality, slow resolution with 6-9 weeks of relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what triggers do you need to look for in DRESS?

A

Allopurinol, anti-seizure drugs, vancomycin, raltegravir, dapsone, and sulfas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is erythema multiforme?

A

immune mediated distinctive target lesions associated with oral, ocular, genital mucosal lesions that is self-limiting 10-14 days associated with infections, drugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the difference between SJS and TEN?

A

SJS<10% while ten>30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

characteristics of SJS/TEN?

A

fever with erosive mucositis of oral, urogenital, ocular sites between 4-28 days with partial/full thickness, painful necrolysis with fever 8-12 days. Leucopenia and no eosinphils. positive nikolsky sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is a positive nikolsky sign?

A

slight rubbing of the skin resulting in exfoliation of the outermost layer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are notorious non-infectious drugs associated with hyperthermia?

A

allopurinol, anticonvulsants, recreational drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the common antibiotics associated with hyperthermia?

A

sulfonamides, nitrofurantoin, beta lactams, minocycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the things you need to think about with hyperpyrexia (T>41.5)?

A

NMS, malignant hyperthermia, serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is malignant hyperthermia?
Usually less than 1 hour, with muscle conraction, elevated CK, autosomal dominant associated with halothane, succinylcholine
26
what is neuroleptic malignant syndrome?
1-3 days within first 2 weeks with lead pipe rigidity, fever, associated with antiemetics like metoclopramide, antipsychotics. Tx with dantrolene adn dopamine agonists (bromocriptine)
27
what is serotonin syndrome?
6-24 hours of starting a drug/increasing dose with shivering , myoclonus, GI symptoms
28
what drugs are associated with serotonin syndrome?
Linezolid, SSRI inhibitors (buproprion), antiemetics (granisetron), TCA (amitriptyline)
29
what causative drugs associated with hypothermia?
beta blockers, alpha blockers, opioids, ethanol, antidepressants, antipsychotics, oral hypoglyemics
30
what signifies that a blood culture is likely due to line infection?
If blood culture drawn through IV line is 3 hours prior to blood culture drawn peripherally.
31
quick SOFA score calculation?
1. AMS? 2. RR\>22? 3. SBP\<100 1 = low risk, 2 = intermediate risk, 3 = high risk
32
which antibacterials can be given through rapid infusion?
Meropenem (3-5 min), Ceftaroline (5-60 min), and daptomycin (10 min after mixing)
33
what are teh common pathogens associated with VAP?
Staph aureus, pseduomonas, klebsiella, enterobacter, E.Coli
34
Pneumonia with eosinphophils ddx?
* Tobacco * Collagen diseases (wegners, eosinophilic granulomatosis with polyangitis) * Helminths (ascaris, strongyloides) * Fungi (cocici, bronchopulmonary aspergilosis) * Drugs (dapto, sulfa etc)
35
what is cryptogenic organizing pneumonia?
inflammation of the bronchioles with pneumonia like picture, nonresponsive to antibiotics. "organizing" means unresolved pneumonia in which alveolar exudate persists undergoing fibrosis in which fibrous tissue forms in teh alveoli, typically following bacterial infection. Treatment is steroids.
36
How would you characterize pharyngitis of group A strep?
* Sudden onset * Fever * winter and spring * lymphadenopathy * exposure to close contact * Complications of peritonsilar and retrophyarngeal abscess * immunologic complications of rheumatic fever, glomerulonephritis
37
clinical characteristics of viral pharyngitis?
* Cough, coryza, conjunctivitis * hoarseness and diarrhea * ulcerative stomatitis * red tonsils but not enlarged and purulent
38
what is the modified centor score?
useful for negative predictive valvue to exclude streptococcal pharyngitis * Can't Cough * Exudate * Neck adenopathy * Temperature elevation * OR: Age\<15 + 1 and Age\>44 - 1
39
Strawberry tongue ddx?
* group A strep * Staph Toxic shock * kawasaki disease
40
what is the tx for GAS pharyngitis?
First line: * Benzathine PCN 1.2 M x 1 * oral penicillin or amoxicillin x 10 days Second line: * cephalosporin * macrolides * clindamycin
41
what does arcanobacterium hemolyticum illness script?
* young adult with fever, sore throat * scarlet fever like rash * negative strep test
42
what type of abx and characteristics of arcanobacterium haemolyticum?
* gram positive rod * scarletniform rash, most prominent on extremities * tx with azithromycin, clinda, penicillin
43
what types of pharyngitis would you expect after receptive oral intercourse?
* Neisseria gonorrhea (mimics strep pharyngitis, dx with NAAT) * HSV-1/2 with acute infection, nonspecific presentation with tonsilar erythema and exudates, lymphadenopathy with oral and genital ulcers
44
what illness script is suggestive of adenovirus phyarngitis?
college kid with sore throat, fever, conjunctivitis with closed quarters.
45
Hand, foot and mouth. Symptoms and organism?
Caused by an enterovirus (most common is coxsackie). If oral lesions only, herpangina. sore throat, low grade fever, lesions on palms and soles with sick contacts
46
Symptoms of oropharyngeal tularemia?
exudative tonsilitis, ulcers, swollen LAN, through the inadequately cooked game, rodent contamination, contaminated tap water (turkey).
47
Dx and tx of oropharyngeal tularemia?
dx through culture and serology. Tx is streptomycin or doxycycline
48
pharyngitis + chest pain
Lemierre syndrome caused by fusobacterium necrophorum.
49
Describe Lemierre syndrome?
* sore throat, chills, GI upset with new-onset cough and pleuritic chest pain * Septic phlebitis of the internal jugular vein * Often follows strep pharyngitis or mono * Causes septic pulmonary emboli * The classic cause is fusobacterium necrophorum, anaerobic GNR
50
Describe epiglotttitis?
* Fever, sore throat * Hoarse, drooling * thumb sign on lateral neck x-ray * H.Influenza B, pneumooccus
51
Describe vincent angina?
* Trench mouth/acute necrotizing ulcerative gingivitis * oropharyngeal pain, bad breath, sloughing of gingiva * mixed anaerobes
52
Describe ludwig angina?
* bilateral cellulitis of floor mouth often starts with infected molar * Fever, chills, drooling, dysphagia * mixed oral organisms (viridians, anaerobes)
53
Bull neck, gray pseudomembrane association
Diptheria
54
what does grey pseudomembrane mean?
diptheria; extends onto palate or uvula, bleeds when scraped
55
what does TNF do?
fever acute phase response
56
What conditions do you use TNF alpha blockers?
RA, Crohns, GVH, psoriasis
57
GIve examples of TNF blocking agents?
I - CAGE Infliximab - Remicade Certolizumab - Cimiza Adalimumab - Humira Golimumab - Simponi Etanercept - Enbrel
58
what are viral infections associated with TNF blockade?
CMV, vzv, HBV, HCV
59
what do TNF blockers basically do in respect for infections?
break down granulomas
60
what do you need to screen for prior to initiating TNF blocking agents?
Screen for HBV, HCV, TB, probably HIV, h/o of exposure to endemic fungi. Vaccinate at least 4 weeks prior to Rx for Influenza, pneumococcus, HBV, Zoster age\>50, no live virus vaccines
61
what bacterial infections associated with TNF blockade?
listeria monocytogenes, nocardia, salmonella, legionella, septic arthritis
62
what things outside bacteria and fungi that are associated with TNF blockade?
Mycobacteria (NTM, TB) and Fungi (molds, PCP, candida, aspergillus)
63
what happens if HCV is positive prior to TNF inhibitor initiation? What about HBs Ag positive?
Treat HCV if possible prior to TNF inhibitor. IF HBSAg positive, start entecavir or tenofovir
64
what happens if HBsAb negative but HBcAb positive prior to initiation to TNF inhibitor?
Monitor LFTs and HBV q3 months and treat if positive
65
what are IL-1 blockers used for?
RA and autoinflammatory syndromes
66
Give examples of 3 agents that are IL-1 blockers?
Anakinra, rilonacept, canakinumab
67
what are adverse events associated with IL-1 blockade?
* Injection site reactions are common * URI * Dose-dependent reactions
68
what do cytokine receptors use?
janus kinases
69
what adverse events associated with Jakinibs?
dose dependent Cytopenias Intracellular infections (TB, Fungi, VZV)
70
what is CAMPATH?
* ALemtuzumab * CD52 target * Used for lymphoma, leukemia, BMT, (MS)
71
what infections do you need to be wary of in patients that deplete lymphocyte T-cells?
Viral (CMV), bacterial, fungal especially PCP (Campath)
72
what is muromonab used for and target?
Solid organ transplant OKT3, CD3
73
Drug regimen for prophylaxis for alemtuzumab?
CAMPATH. Start bactrim at the initiation of therapy. Stop 2 months post-therapy or CD4\>200
74
when do you use rituximab?
CLL, lymphoma, SLE, RA, MG
75
Give examples of B-lymphocyte depleting immunosuppressants?
Rituximab, ibritumomab, ibrutinib
76
what infections do you need to worry about with B-cell lymphocyte depleting drugs?
PML, occasional hypogammaglobulinemia
77
when do you use Ibrutinib?
CLL, mantle cell, waldenstrom
78
what infections do you need to worry about Rituximab?
HBV reactivation with case reports showing PML, CMV, cryptococcus, and PCP
79
Give examples of adhesion blocking agents (2) and their use? Infection to be worried about?
* Natalizumab (Tysabri) - MS, Crohns * Vedolizumab (Entyvio) - Crohns, UC * PML
80
Give 2 examples of checkpoint inhibitors and their complications?
Pembrolizumab (Keytruda) and Nivolimab (opdivo) Complications: Infection, autoimmunity, IBD, derepression of autoimmune tolerance
81
which immunosuppresant associated with checkpoint augmentation and infection associated?
Abatacept (orencia, CTLA4 mimic), used for RA. Not much infection
82
what is the MOA, and indication for Eculuzimab? Infection risk?
* blocks terminal complement activation * Used for atypical HUS, PNH * Encapsulated organisms * Meningitis vaccine 2 weeks prior to administration
83
Give two examples of anti-cancer drugs and their use?
Gemtuzumab (CD33, myelotarg) - AML Bevacizumab (avastin, anti-VEGF), solid tumors, ocular for retinopathy
84
what are the infections associated with anticancer drugs?
* post-op bowel rupture * wound dehiscence * poor wound healing
85
what complicated associated with anticytokine autoantibody of FIN?
disseminated OI
86
what complicated associated with anticytokine autoantibody of EPO?
pure red cell aplasia
87
what complicated associated with anticytokine autoantibody of IL-6?
staphylococcal infections
88
what complicated associated with anticytokine autoantibody of G-CSF?
Felty syndrome (SANTA) * S: Splenomegaly * A: anemia * N: neutropenia * T: thrombocytopenia * A: Arthritis (Rheumatoid)
89
what complicated associated with anticytokine autoantibody of GM-SCF?
pulmonary alveolar proteinosis (no surfectant)
90
what complicated associated with anticytokine autoantibody of IL-17?
severe mucocutaneous candidiasis

General ID 2019 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions