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Tom > STIs, TORCHES, Childhood Rashes, HIV > Flashcards

STIs, TORCHES, Childhood Rashes, HIV Flashcards

1
Q

HPV

A

E6 (p53)-E7(Rb); DNA VIRUS

Low Risk: 6, 11; High Risk: 16, 18, (31, 33)

Most clear virus, few progress to CIN I, fewer to II/III;

Cervical, Anal, Oral, vulvular.

Conoldymoas (PAINLESS****), flat and confluent lesions. CERVICITIS WITHOUT PURULENT DISCHARGE

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2
Q

HSV

A

DNA Virus; HSV1 (oral; trigemnal gang, (Temporal lobe) Enchepalitis in newborns), HSV2 (Genital, sacral ganglia, cervicits, herpetic vsciles, dyuria).

Oral Pharyngitis, painful “shingle-like” type of outbreak in pharyx.

Tx with Zovirax.

Preg women with active lesions should get C-section; if active on nipple don’t breast feed.

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3
Q

Gonorrhea

A

G negative (neisseria), 2nd most common STD (prevelent in young adults). COINFECTION WITH CHLAMYDIA COMMON (tx for both)

Cervicits, or Pelvic Inflam Disease (PID; causes scaring of fallopian tubes which messes up ovulation=infertility), skin rash, eye vagina, anus, urethra (GREEN/Colored discharge)

CAN BE ASSYMPTOMATIC. Tx with DNA PCR (female); Males (gram stain)

Ceftriaxone (Cefalosporin) AND CHLAMYDIA TX (Doxy or Azythromycin)

Can cause Disseminated Septic Joint disease

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4
Q

Chlamydia Trichomatus

A

Gram negative obligate intracuellar bacteria (CANNOT PRODUCE OWN ATP).

Most common for women under 25******; Common co-infection with Gonorrhea

LEADING CAUSE OF PID (infertility from fallopian tube scaring causing poor ovulation).

ASSYMPTOMATIC WOMEN (cervicits, mucolpurelent discharge*), PID/ectopic pregnancies

Tx: Doxy/Azithromycin And Tx for gonorrhea (cefatriaxone)

Serotype L–Lympogranuloma Venerium: swelling of groin lymph nodes

Fitzhugh Curtis Sydnrome (adhesions between the liver and diaphragm)

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5
Q

HIV

A

ELISA (highly sensitive) followed by Western blot (highly specific, rules out false positives)

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6
Q

Scabbies

A

Parasite, like lyse; common among children can be transmitted sexually.

Gential itching RASH WITH BURROW FROM MITE***

Vesicular maculopapular rash on vuvla.

Dx via visualization of MITE

Permetrhin Cream/shampoo

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7
Q

Mulcosum Congentiosa

A

DOME SHAPED PAPULES WITH CENTRAL DIMPLE

DNA Pox. Autoinnoculation or close contact

Small painless papules (usually assymptomatic, highly contagious)

Kids/Daycares

Dx: clinical appearance then biopsy looking for viral bodies in cytoplasm

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8
Q

Trichomonas Vaginalis

A

Protazoa, Oval, flagella; TX WITH METRONAZOLE

Most curable and most common

Females with FOUL SMELLING, FROTHY green discharge, STRAWBERRY CERVIX, vulvular edema, itching/burning

Asymptomatic in men; sexual transmission

Dx: Wet mount pH of vagina (w/t 4.5, more alkaine with parasite)

TX PREG WOMEN BECAUSE IT CAN CAUSE PRETERM LABOR AND DELIVERY (LOW BIRTH WEIGHT)

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9
Q

Syphillis

A

Treponmoa Pallidum: Gram Negative spirocye.

Homosexual men, HIV +, 13-35 yo

Dx: VDRL/RPR antidodies (non-trep antiody titer—false positives w/ autoimmunity); confirm with FTA (once you have infection always will be positive even after you clear it)

ALWAYS TX PREGNANT WOMEN: PENCILLIN (EVEN IF THEY HAVE ALLERGY)

PAINLESS LESION AT INFECTION (high infectioius)

Secondary: More Disseminated: Systemic, fever, maculopapular rash, palms fo sole feet (highly infectious still)

Teritary: neurosphyillus, destruction of vaso vasorum, argyl robersonian pupil (accomodate, but don’t react to light), tabes dorslais (not infectious anymore)

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10
Q

Blood Markers for:

Seminoma:
Yolk Sac tumor:
Choriocarcinoma:
Embyronal carcinoma:

A

o Seminoma: Placental alkaline phosphatase or Lactate Dehydrogenase (whats seen in lysed RBCs) “semen, milk lactate”
o Yolk Sac tumor (endodermal cyst): Alpha feto protein
o Choriocarcinoma: Beta-hCG
o Embyronal carcinoma: Alpha feto AND beta hCG

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11
Q

Enlarged ventricles and calcifications on CT with white-yellow lesions on retina.

A

Congential Toxoplasmosis:

Hydrocephalus, Intracranial Calcifications, and Chorioretinitis

Transplacental Transmission

Also can get seizures, rash, and eye movement defects and hepatosplenomegaly

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12
Q

Chorioretiniits, hydrocephaus and intracranial calcifications.

Cause, mode of transmission, and maternal manifestations?

A

Toxoplasma Gondii

Ingestion of undercooked meat or Cat feces

Assymptomatic, rare lymphadenopathy

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13
Q

PDA (Tet of Fallot or Pulmonary Atery Hypoplasia), Cataracts, Deafness?

Cause, mode of transmission, and maternal manifestations?

A

Rubella (also can have blue berry muffin rash): German Measles (Togavirus; + strand RNA)

Respiratory Droplets

Rash Lymphadenopathy, arthritis

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14
Q

Hearing Loss, Seizures, Petcheial Rash

Cause, mode of transmission, and maternal manifestations?

A

CMV (also have blueberry muffin rash)–UNILATERAL HEARING LOSS****

Sexual Contact, organ transplant

Mononucleosis like sxs

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15
Q

Recurrrent infections, Chronic Diarrhea

Cause, mode of transmission, and maternal manifestations?

A

HIV

Sexual Contact, Needlestick

Variable penetration based on mom’s CD4 count

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16
Q

Encephaltitis, rash on skin

Cause, mode of transmission, and maternal manifestations?

A

Herpes simplex 2 (rash will be vesicular)

Skin or mucous membrane contact

Herpetic lesions

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17
Q

Facial Abnormalities and Deafness

Cause, mode of transmission, and maternal manifestations?

A

Syphills (often still birth=hydrops fetalis); notched teeth, saddle nose, short maxilla, saber shins, CN8 deafness

Chancre (1) or disseminated rash (2) more likely than teritary syphyllis to present as infection

Sexual Contact

18
Q

Hydrops Fetalis in newborn

A

ParvoB19

19
Q

Meningitis in neonate

A

Group B strep (name?), E coli, Listeria

20
Q

In AIDS Patient:

Systemic Disease

A

Histoplasmosis Capsulatum

21
Q

In AIDS Patient:

Vascular Proliferation

A

Bartonella Henselae causing bacillary angiomatosis

22
Q

In AIDS Patient:

Ring enhancing lesion? Tx?

A

Toxoplasmosis Gondii

Pyrimethamine and Sulfadiazine

23
Q

In Aids Patient:

Meningitis

A

Cryptococcus Neoformans (NOT CRYPTOSPORIDIUM)

Coccus=Cock=penis has a head=brain=meningitis

Sporidium=spores=oocytes in GI tract

24
Q

In AIDS Patient:

Encephalopathy

A

JC virus causing PML

JC=Junky Cerebrum (BK virus = Bad kidney)

25
Q

In AIDS Patient:

Retinitis (what else?)

A

CMV (can also cause esophagitis)

“COTTON WOOL SPOTS on retina”

26
Q

In AIDS Patient:

Oropharyngeal cancer?

Primary CNS lymphoma?

Squamous cell carcinoma?

Superficial Neoplastic proliferation of Vasculature?

A

EBV

EBV

HPV 16/18/31/33 (usually anal/cervical cancer)

HHV8 (kaposi)–DD this bacillary angiomatosis. HHV8 you will see skin and GI tract (GI=almost exclusively seen in AIDS pnts aka not middle eastern old dude)

27
Q

In AIDS Patient:

Intersitial Pneumonia?

Pleuritic pain hemoptysis, infiltrates on imaging?

Ground glass appearance on imaging?

Pneumonia?

Tb like disease?

A

CMV

INVASIVE Aspergillus fumigatus

PJP

S. Pneumoniae

Mycobacterium avium-intracellulare (Mycobacterium avium complex=MAC)

28
Q

Prophylaxis in AIDS at (drug + condition):

CD4<200

<100

<50

A

200: Sulfa (Dapsone if allergic): risk for PJP
100: Reactivation of Toxoplasmosis (Sulfa or Dapsone+pentaminidine+leucovorin)
50: MAC (mycobacterium avaieum): Azithromycin

Nb: Dapsone and sulfa need to watch out for G6PD def

29
Q

Codes for?

pol gene

env

gag

A

pol: reverse transcriptase (is a POLymerase)
env: gp120/41
gag: p24

30
Q

navirs?

General SEs?

SEs specific for Ritonavir?

Specific for Indinavir/Atazanavir?

A

Protease inhibitors “navir tease a protease”

SEs: fat redistribution syndrome (cushionoid body type); Pancreatitis

Nephrolithitiasis (atazanavir=increase bilirubin=harmless but distinct jaundice)

31
Q

NRTIs?

A

Need to be activated by thymidine kinase.

COMPETITIVE inhibitors of reversetranscriptase.

32
Q

Didanosine

Type of drug? MOA? SEs?

A

Pancreatisis.

Class in general: Lactic acidosis

33
Q

Abacavir?

Type of drug? MOA? SEs?

A

NRTIs: Lactic acidosis

Life threatening Hypersensitivity Rxn

34
Q

Zidovudine

Type of drug? MOA? SEs?

A

NRTIs: Lactic acidosis

Megaloblastic anemia, bone marrow supression.

Used in prophylaxis, preggers, and occupational exposure.

ZDV (used to be called AZT; this is the big gun to remember)

35
Q

NNRTIs?

MOA? SEs?

A

Noncompetitive inhibitors of reverse transcriptase

No phosphorylation needed for activation.

SEs: Rash and hepatotoxicity, contraindicated in preggers (except for nevirapine).

36
Q

Efavirenz?

Type of drug? MOA? SEs?

A

NNRTI, Rash and haptotoxicity, and teratogen

CNS sxs common (vivid dreams)

37
Q

Nevirapine?

Type of drug? MOA? SEs?

A

NNRTI

Rasha nd hepatotoxicity, SAFE IN PREGGERS

38
Q

Delaviridine?

Type of drug? MOA? SEs?

A

NNRTI

Rash and hepatoxicity and no preggers.

39
Q

Raltegravir?

Type of drug? MOA? SEs?

A

Integrase inhbitor (competitively inhibited HIV integrase)

SEs: hypercholesterolemia

40
Q

Enfuvirtide?

Type of drug? MOA? SEs?

A

Fusion inhibitor (enFUV stops the FUSion)

binds gp41 inhibiting entry.

Skin reactions at injection sites

41
Q

Maraviroc?

Type of drug? MOA? SEs?

A

Fusion inhibitor

Binds CCR-5 on surface of T-cells/monocytes (“change the letters around to macro-avir=antiviral for macros”)

Tropism test: before therapy need to test HIV virus for CCR5 tropism

Tom (30 decks)

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