PANCE/PANRE Flashcards
This TB drug can cause hepatitis and peripheral neuropathy (which can be prevented by giving with B6)
Isoniazid
This TB drug causes orange colored secretions as a SE
Rifampin
Candida esophagitis DOC
Fluconazole
Associated with intracellular RBC parasites seen on peripheral thin and thick smears
Malaria
Associated with pathognomonic TETRAD inclusions** seen within RBCs
Babesiosis
Rickettsia rickettsii
**fevers, chills, myalgia with a red maculopapular rash that starts at the wrists and ankles, spreading to the palms and soles as well as centrally
rocky mountain spotted fever
Borrelia burgdorferi
*erythema migrants, arthritis, neurological and cardiac symptoms
Lyme disease
A PPD of ____ mm is considered positive in an HIV patient, or pts with granulomas seen on XRay
5
induration only! NOT erythema
A PPD of ___mm is needed for a positive in a pt with no risk factors
15
induration only!! not erythema!!
A PPD of ___mm is needed for a positive result in a prisoner who is at risk for TB exposure
10
A PPD of ___mm is a positive result for a health care worker
10
Malaria DOC
Chloroquine
Kaposi sarcoma (human herpesvirus 8) is seen in…
immunodeficient pts (ie AIDS)
Administering macrolides too quickly can cause…
Red Man syndrome
Darkfield microscopy is a direct method to diagnose…
syphilis
Treponema pallidum is a spirochete and the causative agent of…
syphilis
India ink is used in the diagnosis of…
Cryptococcus neoformans
can also use Cryptococcal antigen
Isoniazid plus pyridoxine (B6) for duration of 9 months is the treatment for…
positive PPD with negative Xray
not active TB
Pt with high fevers, HA, joint pain and CP.
ECG shows second degree heart block
Lumbar puncture consistent with lyme meningitis
DOC?
IV ceftriaxone
43 yo male went camping where he hunted and ate rabbits. 5 days later he develops HA, fever and nausea. On his hand, there is an ulcerated papule with a central eschar and tender regional lymphadenopathy. There is also splenomegaly and diarrhea. What is likely the dx?
Tularemia
Caused by Francisella tolerances, a gm negative coccobacilli
*transmitted via tick or inset bite or from handling rodent or rabbit tissues
Tularemia
This CNS histologic finding is seen in a patient with rhabdovirus (rabies)
Negri bodies
Leads to encephalitis
*definitive diagnosis is the presence of NEGRI BODIES** in the brain, especially in the hippocampus
Rhabdovirus (rabies)
Eosinophilic inclusions in the cytoplasm of neurons
Negri bodies (seen in rabies)
An 11 yo boy presents to the pediatric clinic with persistent temperatures. Exam shows significant lymphadenopathy, giving the child a “bull neck” appearance. There are gray/white membrane on the posterior pharynx that bleed when scraped. What is the management of choice?
Diphtheria antitoxin plus Penicillin
Treatment for baby who develops botulism from eating honey
botulism antitoxin with respiratory support
Infant who is vomiting and physical exam shows: flaccid paralysis, dry mouth, feeble cry, fixed dilated pupils. Dx?
Botulism
65 yo female who spent 2 months on Martha’s Vineyard presents to the urgent care with gradual onset of fever, chills and jaundice. No rash present. Labs show hemolytic anemia. Peripheral smear shows parasites within RBCs in a tetrad formation. Likely dx?
Babesiosis
Parasitic infection see in the northeast US that infects RBCs
**tetrad seen in RBCs!!
hemolytic anemia
Babesiosis
43 yo male presents to clinic with a 5 day hx of profound diarrhea. Describes bowel movements at grey, without odor, blood or pus. Tells you he just got back 2 days ago from New Orleans and he ate local crawfish and shellfish. No rash on exam. Vitals show high grade fever and a pulse rate of 128 bp. Likely dx?
Cholera
Invasive diarrhea commonly associated with the development of bloody diarrhea. Often described as “pea soup” colored
Salmonella
Cyrptococcal meningitis is the most common cause of…
fungal meningitis
seen in immunocompromised
HIV pt comes in with HA and stiff neck.
Labs show: decreased glucose, elevated WBCs with lymphocytes
You’re thinking maybe cryptococcal meningitis. What test can you do?
India ink! (or Cryptococcal antigen)
Histoplasma capsulatum is associated with soil containing….
bat and bird droppings (esp in Mississippi and Ohio river valley areas)
Bat and bird droppings..think?
Histoplasma
Oral hairy leukoplakia is associated with what virus?
EBV
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
(RIPE)
tx for TB
44 yo male with hx of longstanding HIV infection presents to the clinic with fever, body aches and HA for last 10 days. CT scan shows “ring enhancing lesions”. What is the is most common predisposing factor?
Cat exposure (Toxoplasmosis)
parasitic infection that is most commonly transmitted from soil, cat feces or undercooked meat
- flu like symptoms if immunocompetent
- encephalitis and chorioretinitis in immunosuppressed
Toxoplasmosis
RING ENHANCING LESIONS!!
Toxoplasmosis
Hemolytic uremic syndrome can be caused by enterohemorrhagic…
E.Coli
Clarithromycin plus ethambutol is used for management of..
mycobacterium
pain and prosthesis site of inoculation
Classic first sign of tetatanus infection
Is adminsitering measles mumps rubella (MMR) vaccine contraindicated in pt with history of HIV and CD4 count of 100?
YES..this is contraindicated!!*
can only be given to HIV pts with levels above 200
