SUM - CH10 - Infectious Disease

Question 1

HIV - primary stage

Answer 1

Mononucleosis like syndrome. 2-4 weeks after exposure to HIV. Duration of illness is about 3 days - 2 weeks

Question 2

HIV - Asymtomatic Infection

Answer 2

CD4 normal. 4-7 years

Question 3

HIV - Asymptomatic HIV

Answer 3

First evidence of immune dysfunction. Generalized lymphadenopathy, localized yeast infection, recalcitrant vaginal yeast and trichina all infections. Oral hair leukoplakia. Seborrheaic dermatitis. Molluscum, warts.

Question 4

HIV - AIDS

Answer 4

CD4

Question 5

HIV stages (general)

Answer 5

1. Primary infection
2. Asymptomatic infection
3. Symptomatic HIV
4. AIDS

Question 6

HIV - cryptococcal meningitis: treatment

Answer 6

Amphotericin 10-14 days.

Flu console for life (or 8-10wks)

Question 7

HIV - Diagnosis

Answer 7

PCR RNA viral load test.
P24 antigen assay.
Seroconversion 3-7 weeks after infection. Confirm diagnosis with ELIZA (screen) and western blot (confirm)

Question 8

HIV - treatment: indications

Answer 8

Symptomatic or cd4

Question 9

HIV - Treatment: HAART

Answer 9

Two nucleoside reverse transcriptase inhibitors. Plus either a non-nucleoside RT or protease inhibitor.

Monitor with HIV plasma RNA load. Continued in pregnancy

Question 10

HIV - treatment: of opportunistic infections

Answer 10

Cd4

Question 11

HIV - vaccinations.

Answer 11

Pneumococcal polysaccharide vaccine (pneumovax) every 5-6 years. Influenza virus, early. Hep B

Question 12

Lower UTI - Clinical features

Answer 12

Dysuria, 
Frequency,
Urgency,'
Suprapubic tenderness,
Sometimes gross hematuria,
CHARACTERISTIC LACK OF FEVER

Question 13

Lower UTI - Diagnosis

Answer 13

Dipstick: Urine leukocyte esterase test, Nitrite test for presence of bacteria
Urinalysis: pyuria, bacteriuria
Urine gram stain:
Urine Culture: Confirms diagnosis (only if complicated infection)

Question 14

Complicated UTI

Answer 14

Spreads above bladder - Risk factors: pregnancy, diabetes, vesicoureterial reflux

Caused by Structural abnormalities, metabolic disorder, or neurologic dysfunction

Question 15

Acute Uncomplicated UTI - Treatment:

Answer 15

Oral TMP/SMX,
Nitrofurantoin, Fosfomycin (do not give if early pyelonephritis is suspected)
Amoxicillin (less popular dt/ resistance)
Fluoroquinolones,
Phenazopyridine: Analgesic for dysuria

Question 16

Pregnant woman with UTI - Treatment

Answer 16

Amoxicillin, ampicillin, or oral cephalosporins

avoid fluoroquinolones

Question 17

Recurrant UTI - Treatment

Answer 17

Give chemoprophylaxis:

- TMP/SMX after intercourse, or low dose chronically