N213 Flashcards
Opportunistic Infections
HIV/AIDS Thrush Hep B and C Herpes Yeast STDs
HIV
.Retrovirus attacks CD4 cells
.Trans: blood, semen, breast milk, vag cerv secretions
.SS anorexia
SS of AIDS (subj)
Anorexia fatigue dyspnea chills sore throat weakness
SS of AIDS (obj)
Night sweats enlarged lymph nodes wasting (>10%) chronic diarrhea (>30 days) chronic fever memory loss decreased coordination opportunistic infection
AIDS Dx:
.ELISA Western Blot for HIV antibodies
.PCR, polymerase chain reaction for presence of HIV
**.low T4/CD4 (less than 200)
.Viral Load (amount of HIV in blood)
HIV related
Opportunistic infections
.Pnemocystis Carinii Pna .TB .Kaposi's sarcoma .bcell lymphoma .thrush .wasting syndrome .HIV encephalopathy .Toxoplasmosis .Kaposi's herpes zoster .HPV cervical neoplasia .Mycobacterium avium (MAC)
HIV mm: ABT
.Biaxin and Zithromax for MAC
.Trimethoprim for PCP
HIV MM: Antifungals
.Amphotericin B, Diflucan (memingitis)
.Nystatin swish (thrush)
HIV MM: Antivirals
Ganciclovir for CMV (leading cause of blindness in AIDS)
HIV mm: Antidiarrheal
Sandostatin
HIV Antivirals mech of action
inhibit, decrease viral replication
HIV Antivirals: NRTIs (nucleoside/nucleotide reverse transcriptase)
AZT, Retrovir
HIV Antivirals: Protease Inhib
Invirase, Ritonavir, Crixivan
HIV Antivirals: NNRTIs (non nucleoside reverse transcriptase inhibitors)
Viramune
HIV Nutr Supp
.carlorie count .oral supp .parental .appetite stim .synthetic oral progesterone (megace UP fat stores) .Marinol (decrease nausea/anorexia)
HEB B
.target liver
.blood bourne
.immun 3 shots
HBsAg
1st marker for HepB surface antigen (UP for >6mos) = CHRONIC
IgM anti HBc
dx for HBV (hepB)
IgG anti HBx
marker of past infection (hepB) pg 11
HEP C
.Most common chronic bb infection .blood bourne (bb) .Dx: Serologic essays for HEPC RNA .Plus Dx: EIA test pos .Meds for Chronic: Interferon, Ribavirin
HepC Meds
.Interferon
.Ribavirin
Bacterial STDs
gonorrhea
chlamydia
syphilis
Viral STDs
warts
herpes
Herpes Simplex 2
.caused by herp 2
.geneital tract/perenium
Herpes2 SS
burning, tingling, vesicula lesions
Herpes2 Dx
tissue culture
Herpes2 Tx
Acyclovir, Valtrex, Famvir
Herpes Simplex (herpes labialis) HSV1
small painful blisters on lips, mouth, gums, tongue, skin around mouth (“cold shores/fever blisters”)
.latend 2-12 days after inection
.activated by colds, flu, stress, sun/wind
HSV1 Tx:
.lesions 10-14 days
.Acyclovir, Valacyclovir
.tylenol/opioids for pain
.topical xylocaine, HerpacinL, Abrea (docusanol)
Fungal Yeast types: Tinea …
.Capitis: scalp .Corporis: round, oval (ring worm) .Cruris: jock itch .Pedis: athlete's foot .Candidiasis: yeast infection
Pulmonary Fungal Infection
.seriously ill on steroids, aids, immunospressive meds etc.
.Aspergillosis, cryptococcosis, candidiasis
Gonorrhea
.2nd most
.Neisseria Gonorrheoeas (g neg)
.direct contact
Gonorrhea SS
urethritis, purulent urethral discharge 2-5 days after inf.
Women - asymptomatic
Gonorrhea Complication
prostatitis, urethral strictures, sterility, PID, ectopic preg
Gonorrhea Tx
Rocephin IM
Syphilis
.caused Treponema pallidum
. sex contact, needles
Syphillis SS
.PAINLESS cancres, fever, sore throat, h/a, fatigue, lymphadenopathy
Syphillis Tx
Penicillin
Chlamydia
.most common
.by Chlamydia Trachomatis
.may cause PID, ectopic preg, infertility
.Neonates r/f pna in first 30days
Chlamydia Tx
.Vibramycin/Zithromax
.Amoxicillin/Docycline
.Erythromycin
Genital Herpes
.by HSV2
.genital/perineum
Genital Herpes: SS
burning/tingling, lesions
Genital Herpes: DX
tissue culture
Genital Herpes: Tx
Acyclovir, Valtrex, Famvir
Gardnerella
frothy, grey/white discharge, fishy odor, vaginal pink mucosa
Tx: Flagyl
Vulvitis
wear cotton undies
Tx: Flagyl
Trich
frothy, green, yellow foul discharge, tender red vaginal mucosa
Tx: Flagyl
TB
.by Mycobacterium tuberculosis .BACTERIA .Airborne . Ghon Lesion (encapsulated bacteria after exposure) .bact remains dormant until SS appear
TB: SS
.asymptomatic .fever w night sweats .anorexia, wt loss .malaise, fatigue .cough/hemoptysis .dyspnea, pleuritic chest pain on inspiration .cavitation or calicification visible on xray .pos sputum culture
TB:NI
.resp isolation .cough into tissue/dispose .meds 9-12mos .wash hands .sputum culture .return to work after 3 NEG Cultures
TB:TX
.INH (isoniazid) B6
.Rifampin (orange body fluids)
.Ethambutol (check vision)
COMPLETE REGIMEN
Pharyngitis
.sudden pharynx inflam
.<25 (5-15)
.mostly VIRAL
Bronchiolitis
.result of RSV (Respiratory Synctial Virus)
.infants
.CONTAGIOUS
.thick secretions
.SS paroxysmal coughing, nasal flaring, prolonged expiration, wheezing
.develops shallow respiration
Mononucleosis
.acute, self limiting
.by EBV
.droplet airborne, saliva
SS: fever, lymphadenopathy, pharyngitis, fatigue
.EBV Titer test >1:29
TX: bed rest, saline gargle, analgesic. SS over in 7-10d, Fatigue ends 2-3wks
H. Influenza (FLU)
.productive cough .lo fever, chills. .Bacteremia common .Chest Xray: multibar, patch bronchopna or areas of consolidation. .one or more lobes.
H Influemza: TX
.Ampicillin
.3rd/4th generation cephalosporin macrolines (axithromycin, clarithromycin)
.Fluoroquinolones
H. Influenza: Complicatins
.lung abcess .pleural effusion .meningitis .arthritis .pericarditis .Epiglottis
Streptococcal Pna
.community acquired pna
.by Streptococcus pneumoniae
.elderly, etoh, copd
Streptococcal Pna: SS
.abrubt onset .toxic appearance .pleuritic chest pain .one or more lobes .bacteremia in 15-25% pts
Strep Pna: Tx
.penicillin
.cefotaxime
.ceftriaxone
.fluoroquinolones (levofloxacin, gatifloxacin, moxifloxacin)
Strep Pna: Complication
.shock
.pleural effusion
.pericarditis
.otitis media
Strep Throat
.airborne droplet, direct contact
.SS: sore throat, chills, fever, swollen lymph nodes neck, throat red, tonsils white exudate
Dx: culture
Tx: PCN 10days. Erythromycin
Rheumatic Fever
inflammatory disease of heart . Rheumatic heart disease results from RFever. Scarring, deformity of heart valves.
.Acute Rheu Fever (ARF): group A strep pharyngistis ad affects heart, joint, CNS, skin
ARF (Acute Rheum Fever):SS
pg 54