PPP ROSH- IDz Flashcards
PPD reaction size results
≥5mm: Transplant, organ \+HIV Active TB contact Nodular/fibrotic CXR changes
≥10mm: Peds <4y/o High risk employee/resident Immigrant <5yrs Lab personnel IVDA
≥15mm:
No TB Rfs
MCC of cellulitis
How is this Tx
When does P jirovecci prophylaxis start
Staph/Strep
1st Gen Cephalosporin (Cephalexin) x 5-7d
CD4 <200
How is an opportunistic infection from Crypto Tx
MCC of pneumonia in adults
MC viral cause of rhabdo
Amphotericin B w/ Flucytosine
Influenza
Influenza
Syphilis microbe name
Three painless genital lesion etiologies
Two painful genital lesion etiologies
Treponema pallidum
Primary Syphillis- T pallidum
Lymphogranuoma- Chlamydia trach.
Granuloma inguinale- Klebsiella granuloma
Chancroid- H ducreyi
Herpes- HSV
Primary Histo presents like ? while chronic Histo presents like ?
How are Pts Tx
How is Syphilis Tx and w/ ? reaction seen
Flu, TB
Amphotericin
PCN G: Jarisch Herxheimer- F/HA, myalgia
MC rabid animal in US
MC rabid animal in world
How does congential CMV present and how is it Tx
Bats
Dog
Dec suck, small, microcephaly w/ SNHL, Blue-Berry muffin baby; IV Ganciclovir or PO Valganciclovir
Lyme Dz rash presentation
What reaction is seen after ABX initiation
What lab results are seen w/ Mono
Slower than cellulitis, expanding erythematous macule w/ central clearing and sharp borders that blanches w/ pressure
Jarish Herxheimer reaction
Significant lymphocytosis
MCC of infectious cervicitis
Best method to test for Dx
What PE finding suggests Trichomiasis and ? is the Tx
G/C
NAAT
Strawberry cervix- Metronidazole or Tinidazole 2g PO
What is the Tx for Post-herpetic Neuralgia
What causes RMSF
What are the MC presenting Sxs and how are PTs Tx
TCA, Pregabalin, Gabapentin
Rickettsia rickettsii from Dog/Wood Ticks
Fever HA Mylagia; Doxy/Chloramphenicol
How is RMSF Dx
What causes Chagas Dz
How is this Tx
PCR then Indirect fluorescent Ab
Reduviid bug carrying Trypanosoma cruzi or from blood transfusions
Nifurtimox, Benznidazole
What causes false-pos TSTs
What causes Lyme Dz
How is this Tx in pregnancy
Prior infection w/ non-TB mycobacteria, BCG vaccine
Spirochette Borrelia burgdorferi from Ixodes tick
Cefuroxime axetil (2nd Gen)
What causes syphilis
What is used for Tx
How are Pts w/ Tertiary Syphilis Tx
Treponema pallidum
PCN G benzathine, Doxy, Ceftriax
Weekly IM PCN BG x 3wks
How are Pts w/ PCN allergy Tx for Tertiary syphillis
How is Latent TB tx in Pts w/ liver dz
MOA of Rifampin
Desensitization then PCN (2* Syph Tx: Doxy, Erythromycin)
Rifampin x 4mon w/ f/u qmon for hepatitis
Inhibits RNA synthesis/transcription
What lab marker is used to track the progression of acute rheumatic fever
Major Jones Criteria
What are the minor Jones criteria
ESR/CRP
Two major or One major, Two minor: Joint involvement Oh no, carditis Nodules, SQ Erythema marginatum Sydenham chorea
CRP inc Arthralgia Fever ESR inc Prolonged PR
Where are the SQ nodules of rheumatic fever found
TMP alternatives for HIV Pts
Meds used to Tx hairy leukoplakia
Non-tender pea size along extensor surface of wrist, elbow, knee
Dapson, Atovaquone, Pentamidine
A/G-ciclovir, Foscarnet
Opportunistic HIV infections at CD4 levels
Any
<250
<200
<100
<50
A: Kaposi P-TB Zoster Pneumonia Lymphoma
250: esophageal candidiasis, HSV, Coccidio
200: PCP pneumonia, PML
100: Cerebral toxoplasmosis HIV encephalopathy Crytpo Miliary TB
50: CMV retinitis, Myco avium complex
What syndrome develops w/ bacterial meningitis
How is bacterial meningitis Tx
What E+ disturbance and lab result is seen w/ RMSF
Waterhouse Friderichsen- bilateral adrenal hemorrhage and septicemia
Ceftriax
HypoNa, Thrombocytopenia
4 criteria for Dx of BV
MOA of botulism
What can be used for Tx
Grey/White d/c
Clue cells
pH >4.5
Fishy odor on KOH
Inhibits Ach release at pre-synaptic cleft
> 1y/o: equine serum botulism antitoxin
<1y/o: human derived immune globulin
How is Pertussis Tx
How is mastitis Tx
How is Cholera Tx
Azithromycin, TMP-SMX
Dicloxocillin
Fluids w/ Doxy, Cipro; Preg/Peds- Azith
How is Lyme Dz Tx
Genital warts are called ?
Syphillis cutaneous growths are called ?
Doxy, Preg- Amoxicillin
Condylomata accuminata
Condylomata lata
Fe overdose can lead to infection d/t ? microbe
Chelation agent for Fe
What is the MCC of infectious diarhea in AIDS PTx
Yersinia enterocolitica
Deferasirox > Deferoxamine- IV only, causes ‘vin rose’ red urine
Crypto when CD4 <100
Define Behcet Syndrome
What meds are used for Sx control
? STD has high co-infection rate w/ HIV
Recurring genital/PO ulcers w/ relapsing uveitis
CCS
Treponema pallidum
Traveler’s Diarrhea is MCC by ? and is Tx w/ ?
Infectious diarrhea after eating dirty vegetables
Tetanus poisoning presentation
ETEC, Azithromycin (or Rifaximin)
Salmonella enterica. Tx: Cipro
Descending spasms d/t clostridium spores leading to dec GABA release, lock jaw (risus sardonicus), dysphagia, opisthotonos (rigid spasms); Tx; benzos, opioids, metronidazole
Ascariasis infection Tx
What part of the body do these infect
+HIV w/ herpetic whitlow are Tx w/ ?
Albendazole
Ileum
Acyclovir
How is Lyme Dz in CNS Tx
Infection mimicking B12 deficiency
MC Sxs of acute HIV infection
Ceftriaxone
Diphyllobothriasis latum
Fever Malaise Myalgia Rash Sore throat
How is genital herpes Dx confirmed w/ lab work
How is malaria Dx
? forms have fevers every other/third day
Viral culture
Thick/Thin smears
Other: Vivax, Ovale, Faciparum
Third: Milariae
? causes elephantitis
? pathognomonic hair manifestation occurs in Pts w/ 2* Syphillis
Define Sporotrichosis
Filariasis- parasitic dz caused by Wuchereria/Brugia nematodes carried by Black Fly
Moth-eaten alopecia
Landscape/Garden exposure to Sporothrix schenckii causing suppurating SQ nodules along lymph channels; Tx- Itraconazole/Amphotericin
When is Mumps most fatal during pregnancy
What will lab results show in Pts w/ Lyme Dz induced meningitis
How are non-immunized Pts prophylactically Tx for tetanus
First trimester
Lymphocytic pleocytosis w/ elevated protein
Tetanus immune globulin
Age cut off for DTap vs TDaP
What is the only true c/i to receiving the immunization
What causes 5th Dz
D: <7y/o, T: >7y/o
Hx of neurologic/severe hypersensitivity reaction to previous dose
Erythema infectiosum d/t Parvovirus B19- Slapped cheek w/ circumoral pallor and lace-like reticulated rash; Tx: support
? OTC med can be used for HSV-1 outbreaks to reduce Sx/time
? is the primary manifestation of early Lyme Dz
MC precipitating infection of erythema multiform
Docosanol
Erythema migrans
HSV
How is G/C Tx
Triad presentation of Ramsay Hunt Syndrome
What other c/c will SOME Pts have
Ceftriax IM x 1, Doxy BID x 7days
Ipsilateral facial paralysis
Ear pain w/ EAC vesicles
Lost sweet taste, Tinnitus/hyper acusis, Dec tears and Vertigo
Define Taenia Solium
What 3 c/c can Pts present w/
How is this Tx
Pork tapeworm- tropical areas w/ under cooked pork ingestion, travels to brain causing neurocysticercosis
New onset seizure
Obstructive hydrocephalus
Ring enhanced lesion on CT
Albendazole
What vitamin deficiency can be seen in Peds w/ Chronic Ascariasis
How to Tx Latent TB in order
What are the 3 C’s of Measles
Vitamin A
1st: Rifampin daily x 4mon
2nd: INH daily x 9mon
Rubeola- Cough Coryza Conjunctivitis
MC complication from Measles
MC cause of mortality from Measles
Criteria for Systemic Inflammatory Response
Diarrhea
Pneumonia
HR >90 Temp >100.4 RR >20/min WBC >12K or <4K
? blood type puts Pts at risk for severe Cholera
MC helminthe infection in USA and Tx
Previously Tx syphillis will have ? positive lab result and is not useful for Dx
O pos
Enterobius vermicularis- pinworms; -bendazole, Pyrantel pamoate
Fluorescent treponemal Ab absorption
Alternative for Pts allergic to B-lactam ABX
Highest transmission of HIV is from ?
What post-exposure prophylaxis is sued
Clinda > Azith
Receptive anal from HIV pos
Triple therapy: Tenofovir, Emtricitabine, and Rategravir or Dolutegravir
? image is ordered for retrophrayngeal abscesses
What causes Cat Scratch Fever
How does this present and how is it Tx
CT w/ contrast
Bartonella henslae
Axillary adenopathy; Azithromycin > Rifampin/TMP/Cipro
MCC of meningitis in adults
? anti-parasitic is used to Tx schistosomiasis
How often should homosexual men be screened for HIV
Strep pneumo
Praziquantel
Annually
Viral meningitis lab results
Starting doxy w/in ? hrs of tick removal reduces likelihood of contracting Lyme Dz
Infectious Shigella causes ? diarrhea Dx and is Tx w/ ?
WBCs 25-2K Protein: normal, Glucose: low/normal
<72hrs
Dysentery w/ Azithromycin
Spelunkers are at risk for ? fungal infection
MC neuropathy d/t Lyme Dz is ?
How does Ehrlichiosis present and how is it Tx
Histoplasmosis
CN7 palsy
Abrupt fever, HA, myalgia, shaking chills; Doxy or Rifampin
How does Disseminated gonorrhea present
How is this Tx
MC CNS infection in Pts w/ AIDS
Arthritis-Dermatitis Syndrome: pustule/vesicle w/ erythematous halo
Ceftriaxone
Cerebral toxoplasmosis w/ CD4 <100, ring enhanced lesions w/ edema; Tx: Sulfadiazine and Pyrimethamine
What can cause false-pos RPR test
German Measles is AKA ? and appears as ?
Exanthem subitum is AKA ? and caused by ?
Autoimmune dz
Rubella- macuopapular rash from head to foot, fades in 3 days w/ post-cervical and auricular adenopathy 5-10 days prior to rash
Roseola- HHV-6
