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Fall CLIN MED 1 > Test 1: Infectious Disease + cancer > Flashcards

Test 1: Infectious Disease + cancer Flashcards

1
Q

Tinea Capitis

A

Terbinifine (Lamisil), Griseofulvin

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2
Q

Tinea Capitis DX

A

KOH: M Canis- arthrospore outside of hair shaft
T tonsurans- arthrospore inside hair shaft
Woods Lamp- M canis will flouresce

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3
Q

Tinea Corporis, Cruris,Pedis, Manuum, Unguinum DX

A

KOH: T rubrum- septated hyphae

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4
Q

Tinea Unguinum

A

Terbinifine
fingernail: 6 weeks (see back for labs in 3 weeks)
toenail: 12 weeks (see back for labs in 6 weeks)
Labs: CBC and CMP

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5
Q

Candidiasis - Candida albicans

A

Nystatin/clotrimazole/ miconazole cream. or

Oral Nystatin

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6
Q

Candidiasis DX

A

KOH: short pseudo hypae with budding spores

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7
Q

Tinea Versicolor- Malassezia furfur

A

Ketoconazole shampoo

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8
Q

Tinea Versicolor DX

A

Woods Lamp: fluoresce

KOH: spaghetti and meatballs

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9
Q

Impetigo- Staph aureus, GAS

A

Mupirocin (localized)
ABX: Staph- SMX/TMP,
GAS- PCN

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10
Q

Impetigo DX. Gram stain will show?

A

Gram +, Culture

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11
Q

Erysipelas- Staph aureus, GAS

A

Vanco

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12
Q

Cellulitis-Staph aureus, GAS

A

Staph- puss. I&D abscess. TMP/SMX or Clindamycin

GAS- nonperulent. Pen VK

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13
Q

Furuncle- Staph Aureus (MRSA)

A

I&D. TMP/SMX (bactrim) or Clindamycin.

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14
Q

Follicutis- Staph Aureus

A

soap and water

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15
Q

Acute Paronychia- Staph aureus

A

I&D. Bactrim

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16
Q

Scarlet Fever- GAS

A

treat for strep- PCN, Amox if untreated

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17
Q

Staph scalded skin syndrome- S aureus

A

Vanco if MRSA, admit to burn unit

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18
Q

Staph scalded skin syndrome- S aureus DX

A

Blood culture

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19
Q

Necrotizing Fasciitis -GAS

A

Pen G, surgery ASAP

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20
Q

TSS- Staph, Strep

A

Admit ICU, monitor for specific organ failure, remove foreign body

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21
Q

Lyme disease- Borrelia burgdorferi

A

Doxy or Amox

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22
Q

Lyme disease DX

A

ELISA. Western Blot
< 30 days IgM
>30 days IgG

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23
Q

RMSF- Rickettsia rickettsii

A

Doxy (not for preggos)

Chloramphenicol- preggo

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24
Q

RMSF- DX

A

PCR

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25
Q

HPV warts- types 2 & 4

A

cryotherapy, salicylic acid

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26
Q

Pityriasis Rosea DX

A

KOH can help distinguish btwn T rubrum (tinea corpus)

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27
Q

HSV 1/ HSV 2

A

recurrent, burning, stinging.

TX: Acyclovir/ valacyclovir

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28
Q

HSV 1/ HSV 2 DX

A

Viral PCR

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29
Q

VSV- Herpes Zoster

A

acyclovir, valacyclovir

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30
Q

VSV- Herpes Zoster DX

A

DFA

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31
Q

Pediculosis Capitis/ Corporis

A

Ivermectin

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32
Q

Scabies

A

topical lindane. DONT give babies and elderly- CNS toxicity and anemia

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33
Q

IVDA- Infective Endocarditis - S. aureus

A

vancomycin

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34
Q

IVDA- Pneumonia- Strep pneumo

A

TX: amox, PCN
DX: lobar CXR

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35
Q

IVDA- Granulomatosis DX

A

CT ground glass opacities, or shaggy lungs

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36
Q

Tuberculosis DX

A

CXR: apical lesions

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37
Q

Supporative Thrombophlebitis- S aureus

A

Vanco and ceftriaxone

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38
Q

Diarrhea Small Intestine/ Colonic involvement

A

Small- high volume, watery, gas bloating cramps

Colonic- small volume, more frequent, blood pus mucus (dysentery), urgency

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39
Q

Norovirus

A

cruise ships. quick onset. sx last 1-2 days. supportive care.

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40
Q

Rotavirus

A

daycares. MC age kids. severe vomiting first

41
Q

Hep A

A

water, travel to underdeveloped countries, RUQ pain, acholic stool (white), coke colored urine, Hepatosplenomegaly, jaundice.
TX: vaccine, IVIG within 2 wks exposure

42
Q

Giardia Lamblia (protozoan)

A

water, rocky mtns, traveling and camping. 1-4 weeks after exposure. green frothy stool. Chronic infx: Fe anemia, steatorrhea.
TX: metronidazole, nitazoxanide, -azole bc protozoan
DX: stool ag test

43
Q

Cryptosporidia (protozoan)

A

recreational water outbreaks.
immunoincompetent: watery diarrhea >17 liters day
TX: nitazoxanide, HIV pts- HAART
DX: fecal acid staining.

44
Q

GI pathogen: S aureus

A

picnic foods. EMESIS 1st. resolves 24-48 hrs.

45
Q

B cereus

A

fried rice. EMESIS 1st

46
Q

C perfringens

A

Crockpot, meat food left out warm. C for crockpot and clostridium

47
Q

Listeria Monocytogenes

A

dairy foods. severely effects IIC

TX: immunoincompetent (IIC)- ampicillin, no antidiarrheals.

48
Q

Vibrio Cholera

A

contaminated water, rice water stool. severe dehydration and shock.
TX: HYDRATION!. rare Rx per local isolates: Tetracycline, doxycycline , azithromycin, or EES in cases of severe diarrhea/ dehydration
DX: special stool culture media for vibrio

49
Q

ETEC or Montezumas Revenge/ travelers diarrhea

A

onset 5-15 days after exposure. food/water during international travel.
Tx: hydration, pepto. severe: Cipro (azithro for preggo)

50
Q

Entamoeba Histolytica

invasive

A

fecally contaminated food. dysentery, toxic megacolon

DX: ELISA or PCR

TX: metronidazole + paromomycin

51
Q

EHEC (invasive) Ecoli 0157:H7

A

fecal oral food, watery than severe bloody. kids/old at risk for HUS so dont give antidiarrheals/abx. RARE FEVER.

DX: stool culture, stool antigen test (NAAT preferred)

TX: only for severe Azithro+ hospitalization

52
Q

Shigella (invasive)

A

MCC of bloody diarrhea. fecal oral, poor sanitation. bloody. HUS, Reiters syndrome. FEVER.

DX: NAAT

TX: all cases. Cipro, Azithro

53
Q

Salmonella non- typhoidal (invasive)

A

turtles, poultry. fecal oral. purulent, +/- blood. Reiters syndrome, meningitis, UTI

Dx: stool antigen NAAT

Tx: only is severe- Cipro

54
Q

Yersinia (invasive)

A

Rodents, birds, fecal oral. bloody cramping. pseudo appendicitis. RLQ pain. Reiters Syndrome.

DX: stool culture for yersinia

TX: only if severe- IV Doxy + Tobramycin. Bactrim

55
Q

Campylobacter jejuni (invasive)

A

fecal-oral. purulent, bloody. LLQ pain, HUS, Guilain Barre.

Tx: Azithromycin

56
Q

Salmonella typhi- typhoid fever (invasive)

A

pea soup or bloody. developing nations. rose spots. sore throat.

TX: FQ, ceftriaxone, azithromycin.

57
Q

C diff

A

RF: elderly, immunocompromised. hospital stay longer than 3 days. abx (clindamycin). occult blood in stool (bright red). toxic megacolon.

Dx: stool culture for C diff

TX: WBC <15k : Metronidazole
WBC>15k: Vanco

58
Q

AML leukemia DX

A

Auer rods. CBC with diff. Leukocytosis. Thrombocytopenia.

59
Q

AML Leukemia

A

Pretx: allopurinol for hyperuricemia. TX: IV cytarabine, tyrosine kinase inhibitors. autologous HSCT.

60
Q

Acute Promyelocytic Leukemia

A

Translocation of chromosome 15:17. Tx: all trans retinoic acid

61
Q

CML Philadelphia chromosome . DX

A

Translocation of 9:22. Eosinophilia, leukocytosis. Chloromas(masses)

62
Q

CML Leukemia

A

TKI: imatinib *SE prolonged QT

63
Q

ALL Leukemia Dx

A

Children! 25% lymphoblasts. TdT via Elisa. Cell markers. N-N amemia.

64
Q

ALL Leukemia

A

Chemo + ALLOGENIC HSCT (kids can handle this better) 3drugs: asparaginase + vincristine + dexamethasone. After 1-2 months: methotrexate

65
Q

CLL Leukemia Dx

A

Smjdge cells. Most often involves B cells. Marked splenomegaly. NO thrombocytopenia.

66
Q

Hairy cell leukemia

A

Splenectomy. Chemo

67
Q

Hairy cell leukemia DX

A

Hair like B cells in bone marrow. Splenomegaly

68
Q

Hodgkins Lymphoma DX

A

Reed Steinburg cells (owl eyes). B cell origin. nodular sclerosis bc enlarged lymph nodes.

69
Q

Non Hodgkins Lymphoma DX

A

B and T cell origin. mostly B.
CBC w/diff is normal.
Bone Marrow Biopsy: PMLA paratrabecular monoclonal lymph aggregates
Lymph node Biopsy
CXR: mediastinal mass
Neurological involvement. malignant cells in CSF

70
Q

Non Hodgkins Lymphoma

A

Indolent: irradiate lymph node + Rituximab + R CHOP
Aggressive: R-CHOP

71
Q

Multiple Myeloma DX

A 
rouleaux, plasmacytosis,  hypercalcemia, proteinuria
Chemistry: elevated BUN, creatinine 
UA: Bence Jones protiens
UPEP: paraprotien
Imaging: lytic lesions
72
Q

Multiple Myeloma predictors of survival

A

B2 microglobulin + Albumin Levels

73
Q

Hodgkins Lymphoma

A

ABVD => Stanfod V or BEACOPP

74
Q

Pneumocystis jiroveci DX

A

Giemsa Stain. opportunistic infections for HIV

75
Q

Pneumocystis jiroveci TX

A

TMP/SMX. opportunistic infections for HIV

76
Q

Cryptococcus neoformans TX/ DX

A

TX: fluconazole
DX: india ink .opportunistic infections for HIV

77
Q

Mycobacterium avium TX/ DX

A

TX: Azithromycin
DX:acid fast bacillus- TB. opportunistic infections for HIV

78
Q

HIV DX

A

Elisa and Western Blot
PCR Viral load
CD4 count
CBC and CMP

79
Q

HIV TX

A

no cure but HART= Atripla= Tenofovir + Emtricitabine + Efavirenz

pregnant- zidovudine

80
Q

Gonorrhea- Neisseria gonorrhea

A

Ceftriaxone+ Azithro
PCN/Ceph Alx: Gentamycin + Azithro
Macrolide Alx: Ceftriaxone + Doxy

81
Q

Gonorrhea and Chlamydia DX

A

NAAT

First catch urine/urethral swab

82
Q

Chlamydia

A

azithro or doxy

consider Gonorrhea tx

83
Q

Lymphogranuloma Venereum

A

Azithro or Doxy

84
Q

Lymphogranuloma Venereum DX

A

NAAT

85
Q

Pelvic Inflammatory Disease- Chlamydia and N gonorrhea

A

Ceftriaxone +Doxy

86
Q

PID Dx

A

+Cervical Motion Tenderness

NAAT

87
Q

Syphilis DX- Treponema pallidum

A

Primary- Dark field microscopy
Secondary- RPR/VDRL
FTA-ABS

88
Q

Syphilis TX

A

Early: Pen G or if PCN alx Doxy
>1yr dz Pen G weekly for 3 weeks
Neuro dz: IV Pen G

89
Q

Jarisch-Herxheimer rxn to syphilis

A

Give acetaminophen 2hrs before and after abx

90
Q

Chancroid- Haemophilis ducreyl

A

Azithromycin

91
Q

Chancroid DX- Haemophilis ducreyl

A

Gram -neg rods in chains.

“school of fish”

92
Q

Trichomonas vaginalis DX

A

NAAT

93
Q

Trichomonas vaginalis

A

Metronidazole

94
Q

HPV

A

vaccine to prevent Gardasil

protects against high risk strains 16 & 18

95
Q

HSV 1&2 DX

A

DFA for specific strain, Tzanck

96
Q

HSV 1& 2

A

Acyclovir- pay attention to renal dosing

97
Q

Hep B Dx

A

DNA Virus- HBsAG

Screen all preggos

98
Q

Hep C Dx

A

HCV-Ab

Screen all baby boomers once- retest if sawtooth pattern

99
Q

Which STIs are reportable to public health

A

EVERYTHING but Trichomonas and Herpes

Fall CLIN MED 1 (3 decks)

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