MTB 2 Flashcards
Most appropriate next step in pt w influenza and w/in 48 hrs
Nasopharyngeal swab or wash - Ag detection
Who should get annual influenza vaccine
> 50
Health care workers
Preg - 2nd/3rd
Annual
Most common causes of bloody diarrhea
Salmonella
Campylobacter
Presentation of E.coli 0157
HUS
Hemolysis
Increased Cr
Low platelets
Bloody diarrhea + Hx of liver dz
Vibrio vulnificus
Bloody diarrhea + hemochromatosis or blood trasfusions
Yersinia - high affinity for Iron
Best initial test in bloody diarrhea
Blood and/or fecal leukocytes
Lactoferrin = better choice
Most accurate test in bloody diarrhea
Stool culture
DDX for diarrhea w no blood or WBCs in stool
- Viral
- Giardia
- Cryptosporidiosis
Preformed toxins ass’d with vomiting
Bacillus
Staph
Scrombid Infxn
Rapid onset
Flushing, wheezing, rash
Fish - decayed
Tx: Antihistamines
TX for infectious diarrhea
Mild: Oral fluids
Severe: fluids + Cipro
Labs elevated in hepatitis
Direct BR
AP
ALT:AST
High PT in hepatitis
Risk for Fulminant hepatic failure
Best initial test hepatitis
IgM Ab for acute infxn
IgG Ab for resolution
Test for dz activity in HCV
PCR for RNA level
= viral replication
Serologic findings Acute or Chronic HBV Infxn
HBsAg +
HBeAg +
HBcAb IgM or IgG +
HBsAb -
Serologic finding Resolved/old Infxn HBV
HBsAg -
HBeAg -
HBcAb IgG +
HBsAb +
Serologic finding Vaccination HBV
HBsAg -
HBeAg -
HBcAb IgG -
HBsAb +
Serologic finding Window Period
HBsAg -
HBeAg -
HBcAb IgM + THen HBcAb IgG +
HBsAb -
What does HBsAg measure
Active Viral Particles
Which HBV marker correlates w the amt or quantity of active viral replication
HBeAg
E antigen is correlated to DNA Polymerase
Which HBV marker indicates that active infxn has resolved and is no longer transmissable
HBsAg - as long as present, still some viral replication occurring
Transmissability ceases when DNA polymerase ceases
Which HBV marker is the best indication for need for tx w antiviral meds?
HBeAg = strongest indicator of active viral replication
Which HBV marker is best indicator that pregnant woman will transmit infxn to her child
HBeAg
AEs of IFN
Arthralgia/myalgia Leukopenia Thrombocytopenia Depression Flu-like Sx's
What is the goal of chronic hepatitis therapy
- Reduce DNA Polymerase to undetectable levels
2. Convert pts w e-Antigen to e-Antibodies
Tx for HBV
Tenofovir - blocks DNA polymerase the most
Enteavir
Adefovir
When are Hep C pts treated and with what
Goal?
If PCR-RNA is elevated
IFN and Ribavarin
Goal = undetedtable viral load
AE of Ribavarin
Anemia
Best initial test for urethritis
Urethral swab for Gram stain
WU for urethritis
- Swab
- Culture
- Treat
Most accurate test for urethritis
Urethral culture
DNA Probe
Nucleic acid amplification test
TX for urethritis
Ceftriaxone/cefixime
+
Azithromycin/Doxycycline
Presentation of Urethritis
Dysuria
Urinary Frequency
Burning
Presentation of Cervicitis
Cervical Discharge
Inflamed strawberry cervix
Most accurate test for PID
Laparoscopy
PID TX Inpatient
Cefoxitin/Cefotetan
+
Doxycycline
PID TX Outpatient
Ceftriaxone
Doxycycline
PID TX pts w anaphylaxis with PCN
Outpatient - Levofloxacin + Metronidazole
Inpatient - Clindamycin + Gentamicin
Presentation of herpetic whitlow
TX
Viral Infxn of hand
Throbbing pain -> swollen, soft, tender
Self limiting
Health care workers
Ulcerative genital dz with:
Painless ulcer, painless nodes
Syphilis
Ulcerative genital dz with:
Painful ulcer
Chancroid - H. ducreyi
Ulcerative genital dz with:
LNs tender and suppurating
Lymphogranuloma venereum
Ulcerative genital dz with:
Vesicles prior to ulcer and Painful
HSV
Dx test for syphilis
Dark field microscopy
VDRL or RPR
FTA or MHA-TP to confirm
DX test for Chancroid
Stain/culture specialized media
DX test for Lymphogranuloma venereum
Complement fixation titers in blood
Nucleic acid amplification
Most accurate test for HSV
Viral culture
Syphilis TX
Pen G
Doxycycline if allergic
TX for chancroid
Azithromycin
TX for lymphogranuloma venerum
Doxycycline
