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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
HPV warts- types 2 & 4
cryotherapy, salicylic acid
26
Pityriasis Rosea DX
KOH can help distinguish btwn T rubrum (tinea corpus)
27
HSV 1/ HSV 2
recurrent, burning, stinging. | TX: Acyclovir/ valacyclovir
28
HSV 1/ HSV 2 DX
Viral PCR
29
VSV- Herpes Zoster
acyclovir, valacyclovir
30
VSV- Herpes Zoster DX
DFA
31
Pediculosis Capitis/ Corporis
Ivermectin
32
Scabies
topical lindane. DONT give babies and elderly- CNS toxicity and anemia
33
IVDA- Infective Endocarditis - S. aureus
vancomycin
34
IVDA- Pneumonia- Strep pneumo
TX: amox, PCN DX: lobar CXR
35
IVDA- Granulomatosis DX
CT ground glass opacities, or shaggy lungs
36
Tuberculosis DX
CXR: apical lesions
37
Supporative Thrombophlebitis- S aureus
Vanco and ceftriaxone
38
Diarrhea Small Intestine/ Colonic involvement
Small- high volume, watery, gas bloating cramps | Colonic- small volume, more frequent, blood pus mucus (dysentery), urgency
39
Norovirus
cruise ships. quick onset. sx last 1-2 days. supportive care.
40
Rotavirus
daycares. MC age kids. severe vomiting first
41
Hep A
water, travel to underdeveloped countries, RUQ pain, acholic stool (white), coke colored urine, Hepatosplenomegaly, jaundice. TX: vaccine, IVIG within 2 wks exposure
42
Giardia Lamblia (protozoan)
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
Cryptosporidia (protozoan)
recreational water outbreaks. immunoincompetent: watery diarrhea >17 liters day TX: nitazoxanide, HIV pts- HAART DX: fecal acid staining.
44
GI pathogen: S aureus
picnic foods. EMESIS 1st. resolves 24-48 hrs.
45
B cereus
fried rice. EMESIS 1st
46
C perfringens
Crockpot, meat food left out warm. C for crockpot and clostridium
47
Listeria Monocytogenes
dairy foods. severely effects IIC | TX: immunoincompetent (IIC)- ampicillin, no antidiarrheals.
48
Vibrio Cholera
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
ETEC or Montezumas Revenge/ travelers diarrhea
onset 5-15 days after exposure. food/water during international travel. Tx: hydration, pepto. severe: Cipro (azithro for preggo)
50
Entamoeba Histolytica | invasive
fecally contaminated food. dysentery, toxic megacolon DX: ELISA or PCR TX: metronidazole + paromomycin
51
EHEC (invasive) Ecoli 0157:H7
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
Shigella (invasive)
MCC of bloody diarrhea. fecal oral, poor sanitation. bloody. HUS, Reiters syndrome. FEVER. DX: NAAT TX: all cases. Cipro, Azithro
53
Salmonella non- typhoidal (invasive)
turtles, poultry. fecal oral. purulent, +/- blood. Reiters syndrome, meningitis, UTI Dx: stool antigen NAAT Tx: only is severe- Cipro
54
Yersinia (invasive)
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
Campylobacter jejuni (invasive)
fecal-oral. purulent, bloody. LLQ pain, HUS, Guilain Barre. Tx: Azithromycin
56
Salmonella typhi- typhoid fever (invasive)
pea soup or bloody. developing nations. rose spots. sore throat. TX: FQ, ceftriaxone, azithromycin.
57
C diff
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
AML leukemia DX
Auer rods. CBC with diff. Leukocytosis. Thrombocytopenia.
59
AML Leukemia
Pretx: allopurinol for hyperuricemia. TX: IV cytarabine, tyrosine kinase inhibitors. autologous HSCT.
60
Acute Promyelocytic Leukemia
Translocation of chromosome 15:17. Tx: all trans retinoic acid
61
CML Philadelphia chromosome . DX
Translocation of 9:22. Eosinophilia, leukocytosis. Chloromas(masses)
62
CML Leukemia
TKI: imatinib *SE prolonged QT
63
ALL Leukemia Dx
Children! 25% lymphoblasts. TdT via Elisa. Cell markers. N-N amemia.
64
ALL Leukemia
Chemo + ALLOGENIC HSCT (kids can handle this better) 3drugs: asparaginase + vincristine + dexamethasone. After 1-2 months: methotrexate
65
CLL Leukemia Dx
Smjdge cells. Most often involves B cells. Marked splenomegaly. NO thrombocytopenia.
66
Hairy cell leukemia
Splenectomy. Chemo
67
Hairy cell leukemia DX
Hair like B cells in bone marrow. Splenomegaly
68
Hodgkins Lymphoma DX
Reed Steinburg cells (owl eyes). B cell origin. nodular sclerosis bc enlarged lymph nodes.
69
Non Hodgkins Lymphoma DX
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
Non Hodgkins Lymphoma
Indolent: irradiate lymph node + Rituximab + R CHOP Aggressive: R-CHOP
71
Multiple Myeloma DX
``` rouleaux, plasmacytosis, hypercalcemia, proteinuria Chemistry: elevated BUN, creatinine UA: Bence Jones protiens UPEP: paraprotien Imaging: lytic lesions ```
72
Multiple Myeloma predictors of survival
B2 microglobulin + Albumin Levels
73
Hodgkins Lymphoma
ABVD => Stanfod V or BEACOPP
74
Pneumocystis jiroveci DX
Giemsa Stain. opportunistic infections for HIV
75
Pneumocystis jiroveci TX
TMP/SMX. opportunistic infections for HIV
76
Cryptococcus neoformans TX/ DX
TX: fluconazole DX: india ink .opportunistic infections for HIV
77
Mycobacterium avium TX/ DX
TX: Azithromycin DX:acid fast bacillus- TB. opportunistic infections for HIV
78
HIV DX
Elisa and Western Blot PCR Viral load CD4 count CBC and CMP
79
HIV TX
no cure but HART= Atripla= Tenofovir + Emtricitabine + Efavirenz pregnant- zidovudine
80
Gonorrhea- Neisseria gonorrhea
Ceftriaxone+ Azithro PCN/Ceph Alx: Gentamycin + Azithro Macrolide Alx: Ceftriaxone + Doxy
81
Gonorrhea and Chlamydia DX
NAAT | First catch urine/urethral swab
82
Chlamydia
azithro or doxy | consider Gonorrhea tx
83
Lymphogranuloma Venereum
Azithro or Doxy
84
Lymphogranuloma Venereum DX
NAAT
85
Pelvic Inflammatory Disease- Chlamydia and N gonorrhea
Ceftriaxone +Doxy
86
PID Dx
+Cervical Motion Tenderness | NAAT
87
Syphilis DX- Treponema pallidum
Primary- Dark field microscopy Secondary- RPR/VDRL FTA-ABS
88
Syphilis TX
Early: Pen G or if PCN alx Doxy >1yr dz Pen G weekly for 3 weeks Neuro dz: IV Pen G
89
Jarisch-Herxheimer rxn to syphilis
Give acetaminophen 2hrs before and after abx
90
Chancroid- Haemophilis ducreyl
Azithromycin
91
Chancroid DX- Haemophilis ducreyl
Gram -neg rods in chains. | "school of fish"
92
Trichomonas vaginalis DX
NAAT
93
Trichomonas vaginalis
Metronidazole
94
HPV
vaccine to prevent Gardasil | protects against high risk strains 16 & 18
95
HSV 1&2 DX
DFA for specific strain, Tzanck
96
HSV 1& 2
Acyclovir- pay attention to renal dosing
97
Hep B Dx
DNA Virus- HBsAG | Screen all preggos
98
Hep C Dx
HCV-Ab | Screen all baby boomers once- retest if sawtooth pattern
99
Which STIs are reportable to public health
EVERYTHING but Trichomonas and Herpes

Fall CLIN MED 1 (3 decks)

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