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Review Flashcards

1
Q

What causative agent of malaria has the worst prognosis?

A

Plasmodium Falciparum

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2
Q

How is malaria transmitted?

A

Bite of infected female anopheles mosquito

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3
Q

What are some S/Sx of poor prognostic factors of malaria?

A
  • Marked agitation
  • Hyperventilation
  • Hypothermia
  • Bleeding
  • Deep coma
  • Anuria
  • Shock
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4
Q

What is the causative agent for the Plague?

A

Yersinia pestis

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5
Q

What is the vector for the plague?

A

Rat flea

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6
Q

What is the MC form of the plague?

A

Bubonic plague

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7
Q

What are some s/sx of the plague?

A
  • F/C
  • HA
  • HypoTN
  • Shock
  • DIC
  • Blood clots leading to arterial obstruction and acral gangrene = black death
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8
Q

What is the reservoir for ebola hemorrhage fever?

A

Fruit bats

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9
Q

How is ebola hemorrhage fever transmitted?

A

Consuming bushmeat

bats, gorilla, chimpanzees, shrews, and duikers

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10
Q

What are some clinical manifestations of ebola hemorrhagic fever?

A

Hemorrhage:

  • Hematochezia
  • Petechiae
  • Ecchymosis
  • Mucosal bleeding
  • Hematemesis
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11
Q

How is schistosomiasis transmitted?

A

Blood flukes enter the skin from contaminated water (walking barefoot on the beach)

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12
Q

A clinical manifestations of schistosomiasis is Katayama fever, what species does that primarily occur with?

A

Schistosoma mansoni and Schistosoma japonicum

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13
Q

What are some s/sx of Katayama fever?

A
  • Chest pain
  • Hematochezia
  • Hepatosplenomegaly
  • F/C
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14
Q

What is a tx for schistosomiasis?

A

Praziquantel

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15
Q

What is the causative agent for toxoplasmosis?

A

Toxoplasma gondii

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16
Q

How is toxoplasmosis transmitted?

A
  • Inhalation of oocysts from cat feces
  • Vertical transmission from mother to fetus
  • Ingestion of oocysts in raw pork
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17
Q

What is a manifestation of Toxoplasmosis transmitted congenitally?

A

Retinochoroiditis

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18
Q

What is the tx for Toxoplasmosis?

A

Pyrimethamine and sulfadiazine w/ Leucovorin

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19
Q

What is a clinical finding in a pt who has contracted scabies?

A

Linear burrows in interdigital web spaces

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20
Q

What is the hallmark sx in some with scabies?

A

Intense pruritus

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21
Q

What is the tx for scabies?

A

Permethrin cream

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22
Q

What is the MC bedbug in the US?

A

Cimex Lectularis

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23
Q

How is bedbugs transmitted?

A

Fomite contact: mattress, cushions, pillows, wooden bed crevices

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24
Q

S/sx of someone who has been bitten by bedbugs?

A

Urticaria and itching

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25
Q

What is tx for bedbugs?

A
  • Malathion
  • Lindane
  • Calamine lotion
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26
Q

What is the causative agent for body lice?

A

Pediculus humanus corporis

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27
Q

Body lice is a human vector for what disease?

A

Rickettsia prowazekii - causative agent for epidemic typhus

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28
Q

What is the difference between flea bites and scabies bites?

A

Flea bites are more spread out lesions while scabies bites are more of a cluster and closer together.

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29
Q

What is the tx for ascariasis?

A
  • Mebendazole
  • Albendazole
  • Ivermectin
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30
Q

What is the tx for Enterobiasis (pinworms)?

A
  • Albendazole
  • Mebendazole
  • Pyrantel pamoate
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31
Q

What is the tx for Necatorisais (hookworm)?

A
  • Mebendazole
  • Albendazole
  • Pyrantel pamoate
  • AND Iron supplementation
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32
Q

What is the tx for Pork tapeworms?

A

Praziquantel

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33
Q

What is the tx for pork tapeworm if cystericosis occurs?

A
  • Albendazole + Praziquantel + Steroids

- or Albendazole +/- steroids

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34
Q

What is the tx for beef tapeworms?

A

Praziquantel

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35
Q

What is the causative agent for Necatoriasis (hookworms)?

A

Necator americanus

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36
Q

What is the causative agent for enterobiasis (pinworms)?

A

Enterobius Vermicularis

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37
Q

What is the causative agent for pork tapeworms?

A

Taenia Solium

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38
Q

What is the causative agent for beef tapeworms?

A

Taenia saginata

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39
Q

What is the causative agent that caused a group of Mexican immigrants to get sick when they ate pickled pork?

A

Taenia Solium —> pork tapeworms

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40
Q

What lab work must be done in a pt with Necatoriasis?

A

Iron panel d/t iron deficiency anemia

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41
Q

How is Trichinellosis/Trichinosis transmitted?

A

Ingestion of encysted larvae in uncooked pork

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42
Q

What is the MC cause of death associated with Trichinellosis/Trichinosis?

A

Myocarditis

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43
Q

What is the tx for Trichinellosis/Trichinosis?

A
  • Mebendazole or Albendazole

- and Prednisone

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44
Q

What is the causative agent for Lyme disease?

A

Borrelia Burgdorferi

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45
Q

What are the vectors for lyme disease?

A

Deer tick, sheep tick, taiga tick, black-legged tick

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46
Q

What is the rash called in someone who has lyme disease?

A

Erythema migrans

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47
Q

What is the tx for lyme disease?

A

Doxy

- alt: amox and cefuroxime

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48
Q

What is the causative agent of Rocky Mountain fever?

A

Rickettsia Tickettsii

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49
Q

What is the vector for Rocky Mountain fever?

A

Dog tick or rocky mountain wood tick

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50
Q

What clinical presentation would you see in someone who has been infected with Rocky Mountain fever?

A

Centripetal; “inward” macular rash, palms and soles involved

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51
Q

What is the tx for Rocky Mountain fever?

A

Doxy

- alt: chloraphenicol

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52
Q

What mosquito born disease will have a positive tourniquet test?

A

Dengue: febrile phase

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53
Q

What clinical manifestation can occur if a pregnant women is bitten by a mosquito carrying the Zika virus?

A

Microcephaly

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54
Q

What mosquito born disease has a vaccine available?

A

Japanese Encephalitis

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55
Q

What is the highest mortality/most severe mosquito born illness in the US?

A

Eastern equine Encephalitis

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56
Q

Where is Hantavirus Pulmonary Syndrome found?

A

All 4 corners

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57
Q

Where are rabies found?

A

Worldwide

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58
Q

What is the MC rabies vector in the US and Africa and Asia?

A

US: bats

Africa and Asia: Dogs

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59
Q

What laboratory diagnostic finding would you see in someone who is infected with rabies?

A

Negri bodies histologically

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60
Q

Mother brings pt in with poss. conjuctivitis, reports they just got back from Costa Rica, what disease do you suspect pt has?

A

Chagas disease

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61
Q

What is the causative agent for chagas disease?

A

Trypanosoma cruzi

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62
Q

Pt comes in with photophobia nonproductive cough, and acute fever you ask if he has around any birds and he reports he loves to play with birds especially parrots what do you suspect the pt has?

A

Psittacosis

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63
Q

What is the causative agent for Psittacosis?

A

Chlamydia psittaci

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64
Q

What is the tx for Psittacosis

A

Doxycycline or Tetracycline

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65
Q

HIV is a member of what virus group?

A

Retroviridae group of viruses

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66
Q

HIV attacks what specific immune cell?

A

CD4

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67
Q

What is the MC way HIV is transmitted?

A

Sexual contact

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68
Q

What is the MC way healthcare workers contract HIV?

A

Needle stick

69
Q

What is the HIV post prophylaxis medication regimen?

A

Emtricitabine, Raltegravir, and Tenofovir

70
Q

What is the HIV pre prophylaxis medication regimen?

A

Truvada: Emtricitabine/ Tenofovir DF

71
Q

How often should you check the HIV antibody?

A

Every 3 mos

72
Q

Crystal-induced nephropathy associated with what drug?

A

Indinavir (Protease inhibitor)

73
Q

CNS sxs associated with what drug?

A

Efavirenz (NNRTI)

74
Q

What is the prophlyaxis tx for pneumocystis pneumonia?

A

TMP/SMZ (bactrim)

75
Q

What is the tx for thrush?

A

Nystatin: swish and swallow

76
Q

What is the difference between Cryptosporidiosis and Cryptococcosis?

A

Cryptosporidiosis: causes diarrhea- infection affecting small bowel mucosa

Cryptococcosis: causes meningitis

77
Q

Why are older pts at risk for HIV?

A
  • Divorces and death of a spouse
  • Erectile dysfunction meds
  • Contraception no longer a concern
  • postmenopausal
  • Vaginal atrophy = small cuts/tears = increased blood exposure
  • Less discussion during encounters with PCP
78
Q

Why are women at risk for HIV?

A
  • Irregular mensuration
  • Recurrent vulvovaginal candidiasis
  • HPV related cervical dysplasia
  • Invasive cervical cancer
79
Q

Why are children at risk for HIV?

A

Perinatal transmission- transplacental (MC)

In utero, during childbirth, breast-feeding

80
Q

Pt recently had an organ transplant and is now being diagnosed with a fungal infection, what do you suspect she has?

A

Aspergillosis: Aspergillus fumigatus

81
Q

What fungal infection will you see a halo on CT scan?

A

Invasive Aspergillosis

82
Q

What fungal infection will you see a reverse halo on CT scan?

A

Mucormycosis

83
Q

Pt reports he just got back from Michigan after digging lots of ditches and its presenting with flu-like sxs, what do you suspect?

A

Blastomycosis

84
Q

What is the tx for Blastomycosis?

A

Mild to moderate: Itraconazole

Severe: Amphotericin B then Itraconazole

85
Q

What fungal infection is most commonly associated with getting pricked by a rose thorn?

A

Sporotrichosis

86
Q

What is the causative agent for Sporotrichosis?

A

Sporothrix shenckii

87
Q

What is the tx for Sporotrichosis?

A

Itraconazole

88
Q

What fungal infection would you suspect if pt reports he was crawling/ spelunking through caves near the Ohio river this past weekend?

A

Histoplasmosis

89
Q

What is the causative agent for Histoplasmosis?

A

Histoplasma capsulatum

90
Q

What is the tx for Histoplasmosis?

A

Mild to moderate: Itraconazole

Severe: Amphotericin B

91
Q

What fungal infection is associated to disruption of soil during dust storm?

A

Coccidioidomycosis

92
Q

What is the causative agent for Coccidioidomycosis?

A

Coccidioides immitis

93
Q

Where is Coccidioidomycosis most likely to be found?

A

Desert region: Mexico, AZ, CA

94
Q

What is the causative agent for cat scratch disease?

A

Bartonella Henselae

95
Q

What is the drug of choice for cat scratch disease?

A

Azithromycin

96
Q

What is the causative agent for infections in wounds (cellulitis) related to dogs and cats (ie cat bites)?

A

Pasteurella multocida

97
Q

What is the treatment of choice for pasteurella multocida?

A

Amoxicillin-clavulanate (Augmentin)

98
Q

What is the causative agent for Tularemia?

A

Francisella Tularenis

99
Q

What is the hallmark clinical manifestation for Oculograndular Tularemia?

A

Painful auricular LAD

100
Q

What are the hallmark clinical manifestations for Ulceroglandular Tularemia?

A

Ulcerated skin, regional LAD

101
Q

Why are NSAIDS contraindicated in a pt with dengue hemorrhagic fever?

A

Thrombocytopenia

102
Q

What is the AIDS defining cancer caused by human herpes virus 8?

A

Kaposi Sacroma

103
Q

What is the toxicity associated with integrate strand transferase inhibitors?

A

Hypercholesterolemia

104
Q

Localized erythema and edema at the site of parasitic entry into the body associated with T. cruzi is called what?

105
Q

Clinical presentation of a pt who crawled through caves enriched with bird or bat guano and developed progressive disseminated histoplasmosis?

A

Oral mucosa ulcerations, erythema multiform/nodosum

Adrenal insufficiency

106
Q

What fungal disease is caused by encapsulated budding yeast associated w/exposure to contaminated soil and dried pigeon stool?

A

Cryptococcosis

107
Q

What is the MC first manifestation of Cryptococcosis?

108
Q

Scotch-tape test helps diagnose what?

A

Pinworms (Enterobiasis)

109
Q

What is the causative agent of Scabies?

A

Scaroptes scabiei var. hominis

110
Q

How are respiratory sxs caused by Ascarias?

A

Ingestion of infectious eggs from fecal contaminated soil, water or vegetables then is carried into the circulation to the lungs resulting in SOB, cough and Loefflers syndrome

111
Q

What is Loefflers syndrome?

A

Eosinophilic pneumonia

112
Q

CD4 count is used to monitor HIV what does it measure?

A

Measures the status of the immune system and disease progression

  • shows risk of opportunistic factors
113
Q

Viral count is used to monitor HIV what does it measure?

A

Measures the response to and efficacy of HAART and gives correspond info to the CD4 count

114
Q

What needs to be done if viral load is >50 after 4 mos of treatment?

A

Regimen modifications may need to be done

below 50 = undetected stage

115
Q

What is the MC presentation of cytomegalovirus?

A

CMV retinitis

116
Q

What is one other presentation of cytomegalovirus?

A

CMV Esophagitis

117
Q

What are s/sx of CMV retinitis?

A

Unilateral (usually)

  • Vision changes, loss of peripheral vision, scotoma, and/or floaters
118
Q

What are s/sx of CMV esophagitis?

A
  • Chest pain, odynophagia and nausea

- EGD: ulceration in distal esophagus, biopsies to confirm dx

119
Q

Where is malaria most prevalent?

A

Sub-Saharan Africa and New Guinea

US: southern states

120
Q

What topical medication would you use to treat tinea unguium?

A
  • Ciclopirox (nail lacquer)
121
Q

What systemic medication would you use to treat tinea unguium

A
  • Terbinadine x 3 mos (1st line)

- Itraconazole x 3 mos

122
Q

What medication would not be used to treat tinea unguium?

123
Q

What is 1st line tx for SEVERE fungal infections?

A

Amphotericin B

124
Q

What necessary steps need to be taken if a pt is having infusion related ASEs with Amphotericin B?

A
  • Reduce infusion rate

- If rigors occurs give Meperidine

125
Q

What should be done prior to infusions of Amphotericin B to avoid ASEs?

A 
Test dose (required for deoxycholate formulation)
- 1 mg IV over 20-30 minutes

Pre-meds 30 minutes prior

  • Antipyretics: acetaminophen or NSAIDs
  • Antihistamine: diphenhydramine
  • Steroids: Hydrocortisone
126
Q

How is Fluconazole excreted?

A

Renal

- need to dose adjust

127
Q

How is Flucytosine excreted?

A

Renal (>90%)

- need to dose adjust

128
Q

How is Voriconazole excreted?

A

Liver

- need to dose adjust

129
Q

What is a core element for good antibiotic stewardship?

A
  • Effective communication

- Managing pt and family expectation for antibiotic during a clinical visit
ie viral vs bacterial

130
Q

What is the 1st line tx for Hep C?

A

Ledipasvir/sofosbuvir x 12 wks

131
Q

What is an advantage of Hep C tx?

A

99% curable!

132
Q

If CD4 count is <200 how would you treat?

A

Prophylaxis Bactrim PCP (pneumocystis pneumonia)

133
Q

If CD4 count is <100 how would you treat?

A

Bactrim prophylaxis TE (toxoplasma gondii encephalitis)

134
Q

What additional antibiotic therapy would you start in a pt whos CD4 was at 150 but now 50?

A

Azithromycin/Clarithromycin MAC (mycobacterium avium complex)

135
Q

A healthcare worker was stuck by a needle how would you treat and for how long?

A

Tenofovir DF 300mg/Emtricitabine 200mg (Truvada) once daily

PLUS

Raltegravir 400mg BID or Dolutegravir 50 mg qd

x 28 days

136
Q

What is the treatment for Influenza?

A
  • Oseltamivir (Tamiflu) - dose adjust for renal function
137
Q

What is 1st line initial tx for HIV infection?

A

Intergrase Strand Transfer Inhibitor based regimens

-gravir

138
Q

What is 1st line tx for HBV?

A

Tenofovir

- monitor for HBV reactivation after d/c

139
Q

What is the medication regimen for a pt co-infected with HBV + HIV?

A 
Tenofovir 
\+ 
Lamivudine (or emtricitaine) 
\+ 
Efavirenz
140
Q

What medications are used to boost therapeutic levels of other antiviral?

A

Protease inhibitors (ie. Ritonavir)

141
Q

What is the tx for HSV encephalitis?

A

Acyclovir

10mg/kg (IBW)/dose IV q 8 hrs x 14-21 days

142
Q

Primaquine is a medication that is used to manage Malaria, what can it cause?

A

Hemolytic Anemia in G6PD deficiency

143
Q

Pt is in the hospital, they have used IV and multi-system resistance Malaria what is the most appropriate combo regimen?

A

Artemisinin + Lumefantrine

144
Q

When taking antihelminth drug (ie Praziquantel) what do you want to avoid doing when taking these drugs?

A

Chewing tablets

- induces retching and vomiting, very bitter

145
Q

When you take Albendazole for luminal agent what do you want to make sure you do?

A

Take on empty stomach

146
Q

When you take Albendazole for systemic agent what do you want to make sure you do?

A

Take with food to get absorbed

- fatty meal is best

147
Q

What is first line tx for pinworms?

A

Pyrantel Pamoate

- only effective for helminths in the GI tract (luminal)

148
Q

What malaria medication and dose do you take only 1 tablet a week and is good for longer duration?

A

Mefloquine

- 250mg/wk 1-2wks before/4 wks after

149
Q

What ASEs do you want to be cautious of when taking Mefloquine?

A

Neuropsychiatric ASES

- seizures and psych disorders

150
Q

Malarone is an antimalaria prophylaxis that is made up of what two medications and what dose?

A

Atovaquone + proguanil

- 100mg-250mg/day 2 days before/7 days after

151
Q

What malaria prophylaxis is used for mission trips to Haiti and what is the dose?

A

Chloroquine

- 500mg/wk 1-2wks before/4wks after

152
Q

What is 1st line tx for HSV and shingles?

A

Valacyclovir

153
Q

What is 1st line tx for CMV?

A

Valganciclovir or Ganciclovir

154
Q

How would you tx a symptomatic pt who gets entamoeba histolytica?

A

Metronidazole + Paromomycin (luminal agent)

- combo used when needing to treat luminal infection

155
Q

How would you treat an asymptomatic pt who gets entamoeba histolytica?

A

Only need to be treated with luminal agent: paromomycin

156
Q

How would you treat a pt who is returning in from a trip from India, states he has a “tough GI system did not care about what food or water he consumed” you are concerned about flagellated protozoa how would you treat?

A

Metronidazole

157
Q

What causes ASEs of Mebendazole?

A

Dying helminths may cause inflammation/immunologic/allergic response to proteins released from dying helminths.

158
Q

How do you avoid the ASEs of antihelminths?

A

Take in combo with glucocorticoids (prednisone or dexamethasone) to reduce inflammatory response.
- ie: Praziquantel + prednisone to prevent inflammation

159
Q

What is the dose for Doxycycline for malaria prophylaxis?

A

100mg/day 2 days before/4 wks after

160
Q

What is the tx for Toxoplasmosis?

A

Pyrimethamine + sulfadiazine (w/ folinic acid )

161
Q

What Biomarker that is usually elevated in systemic bacterial infections but not viral?

A

Procalcitonin

162
Q

How is crack cocaine use associated with increased prevalence for HIV infxn?

A

Cocain for sex bartering

163
Q

What is amebiasis mode of movement?

A

Pseudopods

164
Q

What is Giardias mode of movement?

165
Q

What drug is used to treat influenza resistant to neuraminidase inhibitors?

A
  • Baloxavir Marboxil - out patient labeling
166
Q

What is the first line treatment of roundworms (AKA ascariasis)?

A

Albendazole

167
Q

What is the first line treatment for hookworms (AKA necator americanus)?

A

Albendazole

168
Q

What is the first line treatment of lymphatic filariasis?

A

Diethylcarbamazine
OR
Albendazole + Ivermectin

169
Q

What is the first line treatment for strongyloidiasis and onchocerciasis?

A

Ivermectin

Infectious Disease 2 (6 decks)

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