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infectious diseases > mycobacterium, parasites > Flashcards

mycobacterium, parasites Flashcards

1
Q

Atypical Mycobacterial Disease
(Also known a nontuberculous mycobacteria (NTM))

___ related illness

May result to the following types of infections: (3)

A

HIV related illness

May result to the following types of infections:
Pulmonary disease is the most common issue
Lymphadenitis
Skin and soft tissue disease

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2
Q

May result to the following types of infections:
Pulmonary disease is the most common issue
Lymphadenitis
Skin and soft tissue disease

A

Atypical Mycobacterial Disease

Also known a nontuberculous mycobacteria (NTM)

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3
Q 
I came in to see my physician assistant because of…
Weight loss
Coughing up blood or mucus
Weakness or fatigue
Fever and chills
Night sweats
Lack of appetite and weight loss

Physical exam findings
Cervical and submandibular lymphadenopathy

A

Atypical Mycobacterial Disease

Also known a nontuberculous mycobacteria (NTM)

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4
Q

Diagnostic tests for Atypical Mycobacterial Disease (4)

A

Sputum Culture
Tissue Culture
Polymerase chain reaction (PCR)
Radiographic Imaging studies – Chest X-ray

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5
Q

Atypical Mycobacterial Disease treatment (5)

A

Medications – Depend upon the infecting organism and the severity of the infection

Antibiotics
Rifampicin
Ethambutol
Isoniazid,
Minocycline
Ciprofloxacin
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6
Q

Pinworms

  • Found where
  • describe worm traveling
A

Found all over the globe
Eggs are initially swallowed. Worms live in the cecum and females travel through the anus at night in order to lay their eggs.

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7
Q 
I came in to see my physician assistant because of…
Few symptoms especially at first
Itching around the anus
Restless sleep
Abdominal Pain
Nausea
A

Pinworms

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8
Q

Diagnosis of pinworms (3)

A

Worms may be visible with examination at night or after bowel movement

Tape test – Worms will get stuck on tape placed over the anus at night.
Fecal Analysis
Fecal egg-count method

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9
Q

Pinworm treatment (3)

A

single dose then another one 2-4 weeks later
Albendazole
Mebendazole
Pyrantel(none for kids under 5)

All members of the household must be treated
Decontamination of all sheets and bathrooms
Hand washing, hand washing, hand washing.

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10
Q

Hookworms
Found mostly where
Larva entrance

A

Found mostly in warm tropical areas
Larva enter the body through the feet. The entrance point is itchy.
Move through the bloodstream to the lungs. Once in the lungs they are carried by cilia to the mouth and swallowed. They attach to the small bowel and lay their eggs.

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11
Q

Found mostly in warm tropical areas
Larva enter the body through the feet. The entrance point is itchy.
Move through the bloodstream to the lungs. Once in the lungs they are carried by cilia to the mouth and swallowed. They attach to the small bowel and lay their eggs.

A

Hookworms

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12
Q

Found all over the globe
Eggs are initially swallowed. Worms live in the cecum and females travel through the anus at night in order to lay their eggs.

A

pinworms

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13
Q

I came in to see my physician assistant because of…
Itching from entry point – bottoms of feet

Non specific GI complaints
Pain
Nausea
Constipation / diarrhea
Vomiting
A

Hookworms

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14
Q

Hookworms symptoms

A

Itching from entry point – bottoms of feet

Non specific GI complaints

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15
Q

Diagnosis for hookworms (3)

A

CBC – may show anemia
Microscopic fecal exam for eggs
Fecal occult blood positive

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16
Q

hookworms treatment

A

***Mebendazole
Albendazole
Pyrantel

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17
Q

Malaria

Mode of transmission

Blood Transfusion from an infected person
Mother-to-child transmission during pregnancy

A

Mode of transmission

Through mosquito bite, by an Anopheles Mosquito

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18
Q

WHO estimates deaths between 500,000 and 1,000,000 per year

Four species of Plasmodium that infect humans:
P vivax
P ovale
P malariae
P falciparum
A

Malaria

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19
Q

Possible complications if left untreated:
Cerebritis
Hemolytic Anemia
Kidney failure
Liver failure
Meningitis
Pulmonary Edema – Respiratory failure from fluid in the lungs
Hemorrhage – due to rupture of the spleen leading to massive internal bleeding

A

Malaria

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20
Q

Parasites travel to the liver and reproduce, enter the bloodstream and infect red blood cells, where they break open and affect more blood cells

A

Malaria

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21
Q

I came in to see my physician assistant because of…

Classic symptoms are a cycle of coldness, shivering, fever and sweating occurring every 2-4 days based on the reproductive cycle of the organism

Flu like symptoms
Fever, Headache, Joint pain, Vomiting

A

Malaria

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22
Q

Malaria symptoms

A

Classic symptoms are a cycle of coldness, shivering, fever and sweating occurring every 2-4 days based on the reproductive cycle of the organism

Flu like symptoms

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23
Q

Physical exam – enlarged liver and spleen
-blood smear – taken at 6 to 12 hrs interval, diagnostic confirmation
Complete blood count – to identify anemia

A

Malaria

Recent travel history to places where Malaria exists

24
Q

Malaria exam and tests(2)

A

exam: enlarged liver and spleen
-blood smear – taken at 6 to 12 hrs interval, diagnostic confirmation
Complete blood count – to identify anemia

25
Q

Malaria treatment

A

**Chloroquine -used for treatment and prophylaxis
Fluid replacement and therapy

Prevent mosquito bites
Wear protective clothing over the arms and legs
Use mosquito netting while sleeping
Use insect repellent
Hospital admission – for severe cases
26
Q

Toxoplasmosis

Mode of transmission(4)

A

Waste from an infected cat
Fecal oral route with cats as a primary host
Eating infected undercooked meat
Receiving an infected organ transplant or blood transfusion

27
Q

Protozoan Toxoplasma gondii,

A

toxoplasmosis

- which forms cysts that can affect almost any part of the body

28
Q

toxoplasmosis symptoms

A

Normally asymptomatic or mild flu like symptoms, but immunosuppressed patients or children may become very ill.

29
Q 
I came in to see my physician assistant because of…
Fever
Aching muscles
Tiredness
Sore throat
Blurred vision
Confusion
Loss of Coordination
A

toxoplasmosis

30
Q

For people with weakened immune system:

Headache
Confusion
Poor coordination
Seizures
Lung problems that may resemble ___ or Pneumocystis jiroveci pneumonia
Blurred vision – due to severe retinal inflammation

A

toxoplasmosis

lung: TB

31
Q

In babies who acquired congenital ____:

Seizure
Enlarged liver and spleen upon physical examination
Jaundice – Yellowing of the skin and whites of the eyes
Severe eye infection

A

toxoplasmosis

32
Q

toxoplasmosis (7)

For people with weakened immune system

A

For people with weakened immune system:

Headache
Confusion
Poor coordination
Seizures
Lung problems that may resemble tuberculosis or Pneumocystis jiroveci pneumonia
Blurred vision – due to severe retinal inflammation

33
Q

toxoplasmosis (4)

In babies who acquired congenital toxoplasmosis:

A

In babies who acquired congenital toxoplasmosis:

Seizure
Enlarged liver and spleen upon physical examination
Jaundice – Yellowing of the skin and whites of the eyes
Severe eye infection

34
Q

Diagnosis (4)

toxoplasmosis

A
  • Antibody testing for IgG and IgM
  • Amniocentesis for pregnant women, to obtain a sample of the amniotic fluid for testing
  • CT scan showing ring-enhancing lesions
  • Brain Biopsy – Neurosurgeon takes a sample of the brain tissue and sent for laboratory analysis to check for toxoplasma cysts
35
Q

toxoplasmosis Treatment

A

Medications

  • high dose Pyrimethamine (Daraprim)
  • Sulfadiazine used with pyrimethamine

prophylaxis with bactrim or pyrimethamine plus dapsone

Cook food to safe temperatures
Ensure proper hygiene

36
Q

What is first line treatment for malaria?

What organism is the reason we warn pregnant woman about changing cat litter?

Drenching night sweats is the hallmark of which disease?

What medication do we use to treat pinworm and hookworm?

What side effect should you look for with ethambutol?

A

What is first line treatment for malaria?
Chloroquine

What organism is the reason we warn pregnant woman about changing cat litter?
Toxoplasmosis

Drenching night sweats is the hallmark of which disease?
TB

What medication do we use to treat pinworm and hookworm
Mebendazole

What side effect should you look for with ethambutol?
Optic neuritis

37
Q

Tuberculosis

  • bacteria? fast or slow growing?
  • Mode of transmission?
  • About __% of people exposed will develop primary TB – __% of those will go on to progressive TB
A
  • Mycobacterium tuberculosis – slow-growing bacteria
  • Mode of transmission: Droplet/Contact
  • About 10% of people exposed will develop primary TB – 50% of those will go on to progressive TB
38
Q

Active vs latent TB

  • who will never have had symptoms
  • They (are or are not) infectious
  • They may have reactivation especially in ___ states
A

Most people will who move into a latent phase will never have had symptoms
They ARE NOT infectious
-immunocompromised states

39
Q 
Infection outside the lungs – 
Extrapulmonary tuberculosis
Pleura 
Central nervous system 
Lymphatic system
Genitourinary system
Bones and joints 
Abscess through skin
Disseminated TB
A

Infection outside the lungs – Extrapulmonary tuberculosis
Pleura – tuberculous pleurisy
Central nervous system – tuberculous meningitis
Lymphatic system – in scrofula of the neck
Genitourinary system – urogenital tuberculosis
Bones and joints – Pott disease of the spine, osseous tuberculosis
Abscess through skin – tuberculous ulcer
Disseminated TB – miliary tuberculosis

40
Q 
I came in to see my physician assistant because of…
A cough with thick, cloudy, bloody sputum for more than 2 weeks
Shortness of breath
Chest pain
Drenching night sweats
Fatigue
Generalized weakness
Loss of appetite
Unexplained weight loss (consumption)
Nail Clubbing
A

TB

41
Q

Physical exam findings
Apical post tussive rales
Look of chronic illness and weight loss

A

TB

42
Q

TB exam (3)

A

Apical post tussive rales

Look of chronic illness and weight loss

43
Q

TB Skin test / PPD Test (purified protein derivative) / Mantoux Test?
Read at ___ hours

A

Mantoux Test does not differentiate between active infection and latent infection
Read at 48-72 hours

44
Q

No risk factors induration > than __ mm

A

No risk factors induration > than 15 mm

45
Q

High risk induration of > __ mm (3)

A

High risk induration of > 5 mm
HIV positive
Evidence of TB on chest X-ray
Any immunosuppressant

46
Q

Medium risk factors induration > __ mm (5)

A 
Medium risk factors induration > 10 mm
Travelers from high TB area
Injection drug user
Healthcare workers
DM, Renal failure etc
47
Q
  • What is indicative of TB
  • What give a definitive diagnosis? and how long for a result
  • What is also definitive and takes 1-2 days?
A

Sputum with acid fast bacilli is indicative of TB
Sputum culture give a definitive diagnosis – 6 to 8 weeks to provide result
DNA / RNA amplification is also definitive and takes 1-2 days

48
Q

Chest X-ray of TB (4)

A

Chest X-ray
Apical CASEATING granulomas
Nodular infiltrates
Hilar/paratracheal lymph node enlargement
Ghon and or Ranke complexes may be found after healed primary

49
Q

For Extrapulmonary Tuberculosis (5)

A 
For Extrapulmonary Tuberculosis
Biopsy
Urine culture – renal TB
Lumbar puncture – TB meningitis
CT scan – miliary TB and to detect lung cavities caused by TB
MRI – TB in the brain or the spine
50
Q

Standard TB treatment begins with 4 medications x __ months

Continuing treatment for ___ months or longer if needed

A 
4 medications x  2 months
Isoniazid (INH)
Rifampin (RIF)
Ethambutol (EMB)
Pyrazinamide (PZA)
Continuing treatment for 4 to 9 months or longer if needed
51
Q

For Latent Tuberculosis Tx

A 
-Using one medicine to kill the TB bacteria and prevent active TB.
Isoniazid x 9 months
Rifampin x 4 months
- 2 antibiotics once a week x 12 weeks
Isoniazid and Rifapentine
Isoniazid and Rifampin
52
Q

TB Med side effects
INH
RIF
EMB

A

INH – peripheral neuropathy, B6 helps reduce this
RIF – hepatitis, flu like symptoms, orange body fluid
EMB – optic neuritis – red green vision loss

53
Q

peripheral neuropathy SE

A

INH: B6 helps reduce this

54
Q

SE: hepatitis, flu like symptoms, orange body fluid

A

RIF

55
Q

SE – optic neuritis – red green vision loss

A

EMB

infectious diseases (7 decks)

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