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Infectious Disease > Respiratory Illness, Systemic Infection, and Fungus > Flashcards

Respiratory Illness, Systemic Infection, and Fungus Flashcards

Diphtheria Cytomegalovirus(CMV) Mononucleosis Epstein-Barr virus Seasonalinfluenza Candidiasis Cryptococcosis Histoplasmosis

1
Q

Diphtheria

A

Immediately

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2
Q

Cytomegalovirus

A

Nope

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3
Q

Mononucleosis

A

Nope

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4
Q

Epstein-Barr Virus

A

Nope

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5
Q

Seasonal influenza

A

pediatric mortality- one work day

Influenza novel- immediately

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6
Q

Cryptococcosis

A

nope

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7
Q

Histoplasmosis

A

nope

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8
Q

What causes Diptheria

A

Corynebacterium diphtheria

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9
Q

What does Diphtheria usually attack?

A

Respiratory tract

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10
Q

What does the toxin produced by Diphtheria produce?

A

myocarditis and neuropathy

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11
Q

Who predominantly gets Diphtheria?

A

<15 years and poorly immunized adults

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12
Q

What are two risk factors for Diphtheria?

A
  • crowded living conditions

- Inadequate immunization

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13
Q

In which symptoms should Diphtheria be suspected?

A
  • severe sore throat
  • Difficulty swallowing
  • Low grade fever
  • GRAYISH adherent membrane on the nasopharynx
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14
Q

What does the Diphtheria toxin induce?

A

formation of coalescing pseudomembrane

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15
Q

As the pseudomembrane spreads it causes what?

A

Tonsillopharyngeal

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16
Q

Where does the membrane in diphtheria extend?

A

any portion of the respiratory tract

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17
Q

When does Diphtheria myocarditis begin?

A

as local respiratory symptoms are improving

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18
Q

When does diphtheria result in neurologic toxicity?

A

w/ severe diphtheria

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19
Q

What nerves are involved in diphtheria cranial neuropathies?

A

usually oculomotor and ciliary,

followed by facial or laryngeal paralysis

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20
Q

Severity of disease =

A

severity of membrane formation

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21
Q

How is diphtheria diagnosed?

A

Culture

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22
Q

What special culture is used for diphtheria?

A

tellurite media

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23
Q

What is ordered to isolate diphtheria toxin?

A

Elek test

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24
Q

How do you prevent diphtheria?

A

w/ active immunization w/ diphtheria toxoid

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25
Q

What treatment is used for diphtheria?

A
  • diphtheria antitoxin - 1st suspicion

- antibiotics (erythromycin and procaine penicillin G)

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26
Q

What is cytomegalovirus a member of?

A

Herpesvirus family

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27
Q

What are the 3 recognizable clinical syndromes in CMV?

A
  1. Perinatal disease and CMV inclusion disease
  2. Diseases in immunocompromised persons
  3. Diseases in immunocompetent persons
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28
Q

What is important in diagnosing CMV?

A

distinguishing between infection and disease

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29
Q

What diseases are seen in CMV?

A
  • CMV retinitis
  • CMV neurologic
  • Gastrointestinal hepatobiliary
  • Respiratory CMV
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30
Q

What is diagnosis for CMV in immunocompromised?

A

Initial diagnosis may be based on characteristic findings- Retinitis

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31
Q

How is CMV confirmed in immunocompromised?

A

CMV quantitative PCR (viral load/CMV replication) assay

CMV pp65 antigenemia (antigen)

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32
Q

What are two specific symptoms of CMV in immunocompetent?

A
  • Exudative pharyngitis

- Cervical lymphadenopathies

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33
Q

How is CMV diagnosed in immunocompetent?

A

-Strep test, monospot, and CBC in febrile pts wth pharyngitis, adenopathy, and fatigue

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34
Q

What is seen in the first week of CMV in immunocompetent?

A

Leukopenia

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35
Q

What serologic studies are used in diagnosing CMV?

A
  • Detection of CMV specific IgM

- Fourfold rise in CMV IgG

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36
Q

How is CMV treated in immunocompetent?

A

Ganciclovir or Foscarnet (IV med for severe cases (colitis or esophagitis))

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37
Q

What causes infectious mononucleosis?

A

Epstein-Barr Virus

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38
Q

What strain of Epstein-Barr Virus is the most ubiquitous human virus?

A

HHV-4 (human herpes virus-4)

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39
Q

Which age is prone to Epstein Bar virus?

A

ages 10 and 19 yrs

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40
Q

What persists asymptomatically for life in nearly all adults?

A

Epstein-Bar Virus

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41
Q

What human herpes virus is associated with malignancies?

A

HHV-4 (Epstein-Bar Virus)

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42
Q

How is Epstein Bar virus transmitted?

A

by saliva

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43
Q

What 3 symptoms are initially seen in acute infectious mononucleosis?

A

Malaise
Headache
Low grade fever

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44
Q

What are prominent pharyngeal symptoms in acute mono?

A

Tonsillitis and/or pharyngitis

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45
Q

What can be out of proportion to pharyngeal symptoms?

A

lymph node enlargement

46
Q

What is the most frequent symptom seen in mono?

A

mild hepatitis

47
Q

What is the highest complication we worry about in mono?

A

Splenic rupture

48
Q

If patient has sore throat, fever, headache, rash, cough and nausea lasting no more than 1 month, what do they likely have?

A

acute infectious mononucleosis

49
Q

What develops after the admin of ampicillin?

A

morbilliform rash

50
Q

What can develop due to intense EBV replication?

A

Oral hairy leukoplakia

51
Q

What is the biggest malignancy that we worry about with mono?

A

Nasopharyngeal and other head and neck carcinomas

52
Q

What is seen in the initial phase of acute mono?

A

granulocytopenia

53
Q

Diagnosis of mononucleosis?

A

Monospot (IgM response)

54
Q

What is used to diagnosis mono in high risk or high concern pts?

A

Viral capsid specific IgM and IgG

55
Q

What is the treatment for Mononucleosis?

A

Self limited

56
Q

What symptomatic relief is used for mono?

A
  • NSAIDS or acetaminophen
  • Throat lozenges or sprays
  • gargling w/ 2% lidocaine
  • Warm saline gargles 3 or 4 times daily
57
Q

What is considered early in the illness to reduce fever and pain for mono?

A

Corticosteroids

58
Q

When are corticosteroids not given for mono?

A
  • Impending airway obstruction from enlarged lymph nodes
  • Hemolytic anemia
  • Severe thrombocytopenia
59
Q

influenza is what type of virus?

A

orthomyxovirus

60
Q

How is influenza transmitted?

A

respiratory route (droplets)

61
Q

What causes acute respiratory illness?

A

Influenza A or B

62
Q

What causes minor respiratory illness?

A

Influenza C

63
Q

What undergoes antigenic drift?

A

Influenza A and B

64
Q

What undergoes antigenic shift?

A

Influenza A

65
Q

What is the biggest complication of influenza?

A

Necrosis of the respiratory epithelium

66
Q

What is associated with aspirin use in the management of viral infections in young children?

A

Reye syndrome

67
Q

What diagnostics can be used to distinguish influenzas and is used during beginning and end of flu season?

A

Rapid immunofluorescence assays and enzyme immunoassays

68
Q

What is the Gold Standard diagnosis for influenza?

A

Virus culture

69
Q

What has high sensitivity and very high specificity in diagnosing influenza?

A

PCR

70
Q

What is used for public health surveillance for influenza?

A

Virus culture and PCR

71
Q

When is antiviral medication used for influenza?

A

if the likelihood of influenza is high and the pt presents within 24 hrs of symptom onset

72
Q

What is the treatment for influenza?

A

largely supportive

73
Q

What antivirals are used to treat influenza?

A

Oseltamivir or zanamivir

74
Q

What is side effect we worry about with Zanamivir?

A

bronchospasm

75
Q

Who recommends the yearly influenza vaccine?

A

ACIP

76
Q

What are the influenza vaccine options?

A

2A and 1B OR 2A and 2B

77
Q

What are 3 contraindications to influenza vaccine?

A
  • Hypersensitivity to eggs and/or vaccine components
  • Hx of vaccine-associated Guillain-Barre syndrome
  • Persons w/ an acute febrile illness until symptomatic improvement
78
Q

What causes candidiasis?

A

Candida albicans

79
Q

What does immunodeficiency predispose in candidiasis?

A

mucocutaneous disease

80
Q

If a pt has persistent oral or vaginal candidiasis what does that suggest?

A

increased suspicion of HIV infection

81
Q

What are 6 candidiasis infections?

A
  • Oropharyngeal candidiasis
  • Esophagitis
  • Vuvovaginitis
  • Balanitis
  • Chronic mucocutaneous candidiasis
  • Mastitis
82
Q

What causes thrush?

A

oropharyngeal candidiasis

83
Q

How is thrush diagnosed?

A

Potassium hydroxide (KOH) prep

84
Q

What is a AIDS defining ilness

A

Esophagitis

85
Q

What is the most common mucosal candidiasis?

A

Vulvovaginitis

86
Q

What is often associated with invasive focal or systemic infections?

A

candidemia

87
Q

What occurs pretty much anywhere?

A

invasive focal infections

88
Q

What is also called chronic disseminated candidiasis

A

Hepatosplenic candidiasis

89
Q

What is the treatment for Candidiasis?

A

oral - fluconozole, Itraconazole

90
Q

What is the treatment for severely ill candidiasis?

A

Intravenous amphotericin B

91
Q

What are topical treatment for Candidiasis?

A

Clotrimazole and Miconazole

92
Q

How is vulvovaginal candidiasis treated?

A

one 150mg oral dose of fluconazole

93
Q

How is candidial funguria treated?

A

w/ discontinuance of antibiotics

94
Q

What causes cryptococcosis?

A

C. neoformans and C. gattii

95
Q

What is the most common cause of fungal meningitis?

A

C. neoformans and C. gattii

96
Q

Where is cryptococcosis transmitted from?

A

soil and dried pigeon dung

97
Q

Who are most pts with cryptococcal infections?

A

immunocompromised

98
Q

How do you diagnose meningoencephalitis?

A

Lumbar puncture

99
Q

What do you do prior to lumbar puncture?

A

CT or MRI to check for papilledema

100
Q

What causes bacterial meningitis?

A
  • Tuberculous meningitis

- Partially treated bacterial meningitis

101
Q

What is the txt for cryptococcosis?

A

Amphotericin B + Flucytosine for at least 2wks followed by Fluconazole

102
Q

What causes Histoplasmosis?

A

Histoplasma capsulatum

103
Q

What disease is linked to bird droppings and bat exposure?

A

Histoplasmosis

104
Q

What two river valleys is histoplasmosis found?

A

Ohio River and Mississippi River valleys

105
Q

What is the most common clinical problem in Histoplasmosis?

A

Respiratory illness

106
Q

What is not a symptom of Histoplasmosis?

A

NO coryza or pharyngitis

107
Q

Where is progressive disseminated histoplamosis seen?

A

In endemic areas- pts taking TNF blocking agents

108
Q

Miliary pattern is seen in what?

A

Histoplasmosis

109
Q

How is histoplasmosis diagnosed?

A

Chest xray and CT

110
Q

How is histoplasmosis treated?

A
  • under 4 weeks and stable- NO TREATMENT
  • Itraconazole
  • Amphotericin B
111
Q

What is the lifelong suppressive therapy for histoplasmosis?

A

Itraconazole

Infectious Disease (6 decks)

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