test 3 Flashcards
cycles of chills, fever, and sweating, caused by a protozoan of the genus ______ in RBCs. transmitted to humans by the bite of an infected ____ mosquito.
plasmodium, anaopheles, malaria
ct/mri for trichinellosis?
3-8mm nodular lesions
lake and risver freshwater fish
diphyllobothriasis
what is the treatment for strongyloidiasis?
ivermectin and albendazole
what is the MC cause of meningitis in children and adults?
s. pneumniae
who does poorly with babesiosis?
asplenic
if someone has fever and celulitis what do you do?
immediate aspiration
encephalitis is mostly what?
viral
what is the MC congenital presentation of toxoplasmosis?
chroioretinitis, blurred vision to vision loss, SA, columbia, brazil
knee infection w/ a rash?
neisseria gonorrhea
treatment for trichinellosis?
steroids, albendazole, mebendazole
long term infections are associated w/ bladder cancer
s. haematobium
what leads to 10% of seizure in emergency departments?
cysticercosis
labs for schistosomiasis
stool or urine identification most practical
causes of viral meningitis?
- enterovirus
- herpesvirus
- arthropod-borne viruses
- HIV
where is paragonimiasis located?
asia, americas, africa
several weeks diarrhea, bloody stools, fulminant colitis, rectovaginal fistulas, fulminant or necrotzing colitis
entamoeba histolytica (amebic colitis)
p. falciparum incubation
12 days
what are the signs and symptoms of california encaphalitis?
generalized or localized seizures
vesical plexus
s. haematobium
treatment for chronic osteomyelitis?
exisicion of bone, consider HBO
what is primary prophylaxis for toxoplasmosis?
trimethoprim-sulfamethoxazole
how long to monitor malaria?
6-12 hrs until parasitemia falls below 1%
what is the treatment for Herpes encephalitis?
acyclovir
labs for taeniasis?
cellophane tape swab
oocysts highly resitant to chlorine, infect entire GI tract when introduced to contaminated water
cryptosporidiosis
what causes louse borne typhus?
rickettsia prowazekii
where is s. mansoni?
s. america/caribbean, africa, middle east
what is the pharm treatment for dog and cat bite?
amoxicillin clavulanate
what are the diagnostic labs for malaria?
thick and thin smears, rapid dipstick test, Binax NOW
what are the cardinal signs of rocky mountain spotted fever
rash peripherally on the wrists and ankles and soles and spreads to invole the extemitis and trunk, hihg fever, confusion and calf tenderness
what is the treatment for giardia?
tinidazole and metronidazole
where is murine typhus found?
california and texas
lung fluke
paragonimiasis
if parasitemia does not fall by ___ within __ hours, or blood is not cleared of parasites after _ days change treatment
75% 48 hours, 7 days
new malaria med
artesunate
photochromogenic: dark= white, light=yellow, grows at 25-32 celsius?
fish tank granuloma
what must you do before a CT?
LP to look for mass effect, increased ICP, and obstructive hydrocephalus
what does q fever do?
directly causes disease in organs, lungs, vegetations of hear and granulomats in organs
what bacteria causes cat scratch fever?
bartonella henselae
reinfection is associated w/ what stand of malaria?
p. falciparum
reason for people not taking prophylaxis?
GI, forgetful, low perception of risk
this trematode has male and female parts
schistosoma
what is the treatment for schistosomiasis?
praziquantel
invasion of the female genital tract (pelvic/peritoneal granuloma), chronic salpingitis?
enterobiasis
P. falciparum found mostly where?
sub-Saharan africa
stage 3 pressure injury?
full thickness tissue loss, subcutaneous fat, slough
where is s. japanicum?
far east
aggressive leishmaniasis
face, joints, satellite lesions, 5-10 lesions, >4-5cm
sodium stibogluconate, amphotericin B, fluconazole
cold stage length?
15-60 min
preexposure prophylaxis for rabies?
human diploid cell vaccine, purified chick embryo vaccine, 1mL IM deltoid on days 0,7, and 21 or 28
what are the two types of leptospirosis?
anicteric leptospirosis, icteric leptospirosis
what is the treatment for neisseria gonorrhoeae?
ceftriaxone
what occurs 7-14 days after tick bite in lyme disease?
(localized) erythema migrans, fever chills, myalgia, tender lymphadenopathy
what tick causes lyme disease?
ixodes
postexposure prophylaxis for rabies?
1 ml IM deltoid 0, 3, 7, 14
1mL IM 0,3
____ phase of lifecycle leads to fever and ___ release
erythrocytic merozoite
who is listeria monocytogenes common in?
> 50, alcoholics and pregnant
what are the signs and symptoms of rocky mountain spotted fever?
rickettsia rickettsii
abraision that is exposed to salt or fresh water. papule or nodule at wound site, appears gramulomatous and moves up the arm
fish tank granuloma
what is used for eradication of persistent hypnozoites in vivax and ovale? what do you have to check first?
primaquine phsophate, G-6-pd, 14 days
what is the treatment for hook worm?
albendazole and mebendazole
when to begin/ end prevention prophylaxis?
1-2 weeks beofre departing, 1-2 days if dail, 4 weeks after return
what is the most common helminth world wide?
ascaria lumbricoides
treatment for cryptosporidiosis?
HAART, Nitazoxanide
_____ migrate into hepatocytes (___ phae) w/in minutes
sporozoites, liver
what is the MC place for a dog bite?
hand
fever of unknown origin, parinaud oculoglandular syndrome, rash, lymphadenitis (axillary, cevical, submandibular, preauricular)
cat scratch disease
what are the 2 MC arboviruses?
st. louis and california
incubation period in rabies is what?
asymptomatic
what is the MC parasitic infection of the CNS?
cysticercosis
fever,edema/swelling, tenderness, decreasd motion, ESR>30, increased crp
joint infections/ sepsis
what causes q fever?
coxiella burnetii
virus for rabies?
lyssavirus
P. ovale found where?
west africa
MC bursa’s infected?
olecranon and prepatellar
what worm causes cutaneous larva migrans?
ancylostoma caninum
what are viral infections of the knee joint?
rubella, parvovirus B19, hepatitis
what is the treatment for hymenolepiasis?
praziquantel
what is the treatment for p. aeruginosa?
ceftazidime
what is the MC cause of all cestode infectinos worldwide?
hymenolepis nana
wagner grading systme for diabetic foot ulcers
0: redness, callus, boney deformity
1: superficial, partial or full thickness ulcer: limited to dermis
2. deep ulcer: through subcutaneous tissue to tendon, joint or bone
3. deep ulcer w/ osteomyelitis, abscess, joint sepsis
4. localized gangrene of toes and forefoot
5. extensive gangrene
soil penetrates bare feet, tropical and subtropical, ground itch, pica, intestinal upset and pneumonitis?
hookworm
what is the rodent that gets rabies?
groundhog
how is murine typhus spread?
rats
treatment for MRSA
vanc + rifampin
what is the PEP for n. meningitids?
ceftriaxone 250 mg IM or Rifamipin X4
MC physical findings of encephalitis?
altered mental status and personality changes
heme positive stools?
amebic colitis (entamoeba histolytica)
what are the 3 major pathways for meningitis?
invasion of the blood stream, retrograde neuronal flow, and direct contiguous spread
what is brill zinsser disease?
relapsing louse borne typhus, 10-20 years later, fever, transient rash, falling BP
vitamin B12 and megaloblastic anemia, pallor, glossitis, hypesthesia
diphyllobothriasis
abdominal pain that starts then transitions to an intermittent biliary obstruction
fascioliasis
tropical countries, southeastern united states, intestinal obstruction, occlusion of the biliary tract, and oral expulsion. may also have cough, or hemoptysis?
ascariasis
superior mesenteric vein
s. japonicum
labs for lyme disease
EIA/IFA, confirm w/ western blot
lab for leptospirosis?
isolation of the leptospires, tissue/body fluids (urine)
thick and thin smears how?
3, 12-24 hrs apart, soon after fever spike
how is leishmaniasis transmitted?
sandflies (lutzomyia longipalpis)
fever, HA, neck stiffness, photphobia, fever, nuchal rigidity, mental status change
meningitis
consume raw watercress, in europe, middle east, or asia
fascioliasis
rapid dipstick detects what?
LDH
lyme disease spirochete?
borrelia burgdorferi
3 things that happen after infection w/ lyme disease?
- clear
- spreads through out the body and produces symptoms by direct invasion, manifests like a bacterial infection
- induces an immune response, little evidence of bacterial invasion
what lice type spreads louse borne typus?
pediculus humanus
what is louse borne typhus associated with and where?
overcrowding, europe, asia, africa (ethiopia and nigeria)
what is the treatment for ascariasis?
albendazole, mebendazole
treatment for babsiosis?
atovaquone + azithromycin
clindamycin + quinine
consider transfusion
who gets cryptosporidiosis?
kids and aids <200
test of choice for entamoeba histolytica?
enerica parasite panel PCR
misdiagnosed retinoblastoma?
toxocariasis
urticaria, pulomnary abnormalities, eosinophilia, discolored sputum, hemoptysis, CXR, after eating crazy fish what is the treatmetn?
praziquantel from paragonimiasis
what is the most common symptom of cat scratch disease?
regional adenopathy
what is the treatment for cutaneous larva migrans?
shoes, albendazole and ivermectin
if you have a prosthetic joint what bacteria are you concerned for?
MRSA/ s. pyogenes
complications of louse borne typhus?
gangrene, pericarditis, myocarditis, meningoencephalitis, delirium, fatal cardiac and renal failure
what signs and symptoms of st louis encaphalitis?
dysuria and pyuria
what are the treatment for ricketssial diease?
doxycycline
who has to get PEP for n. meningitidis?
> 8hrs
<3ft
directly exposed to oral secretions
w/in 1 week before onset
med personal near airway secretions
treatment for taeniasis?
praziquantel and surgery if (appendicitis, obstructed bile duct, and pancreatic duct)
in US what is #1 domestic animal reported?
cats
what do you use to irrigate a dog/cat bite?
isotonic soidum chloride solution
P. vivax found where?
all endemic areas
raised edge and central crater, crusting scab, regional lymphadenopathy
cutaneous leishmaniasis
mild leishmaniasis?
<4 lesions, none >5cm, not in cosmetic area
paromycin, LN2, may resolve in 6 months
subcutaneous nodules, weight loss, appendicitis and cholangitis?
taeniasis
what to use for speciation of malaria?
thin smear
prevention/prophylaxis meds for malaria?
chloroquine, mefloquine, doxycycline ,atorvaquone/proguanil, primaquine
what is the MC zoonosis in the world?
leptospirosis, think tropics
what is the treatment for viral meningitis?
supportive care
what is the most reliable rabies test and what would you see?
negri bodies on nuchal skin biopsy
lack an intestinal tract and instead, are able to absorb nutrients through their integuments, adult consists of a head (scolex, that attaches to mucosa) neck and segemented body where both male and female gonads (proglottids) are found.
cestodes
what are the forms of leishmaniasis?
cutaneous and visceral
most striking feature of t. saginata?
passage of proglottids
what is the treatment for syphilitic meningitis?
penicillin G
flatoworms, including both external and internal parasites of animal hosts, that have a thick outer cuticle and one or more suckers or hooks for attaching to host tissue, also called a fluke
trematodes
during the 2-7 day acute neurologic period of rabies agitation, reslessness, biting, hallucinations, hyperactivity, thrashing, and confusion in episodic intervals
furious rabies
what is the MC manifestation in toxoplasmosis w/ aids?
encephalitis w/ AID
what might be seen on radiographs for q fever?
multiple segmental opacities, pleural effusion, lobar consildation, linear atelectasis
what is the treatment for enterobius vermicularis?
mebendazole and family education, personal hygiene laundering of bedding
where is s haematobium?
africa and the middle east
where is entamoeba histolytica?
central and south America
Africa
asia
what is the treatment for entamoeba histolytica (amebiasis)?
metronidizale or tinidazole + iodoquinol or paramycin
sweating stage how long?
2-4 hours
u/s= homogenous hypoechoic round lesion, CT scan= rounded, low attenuation lesion with an enhancing rim?
entamoeba histolytica
flaccid paralysis-flavivirus?
west nile
what is the treatment for TB meningitis?
Isoniazid (ING) and pyrazinamide
bone bx for osteomyelitis is done when?
48 hours after a/b stopped or before a/b started
what is the sing of ancylostoma caninum?
intense itching, erythematous linear lesion
what are the two acute neurologic periods of rabies?
paralytic and furious
what is the most common symptom of hookworm?
iron deficiency
school or preschool children, all socio-economic levels, nocturnal pruritis?
enterobius vermicularis
splenic rupture complication?
vivax and ovale
what will the joint fluid show in lyme disease?
WBCs
treatment for MSSA?
nafcillin, oxacillin
labs for babesiosis?
wright/giemsa ring forms
stage 4 pressure injury?
full thiicness tissue loss, w/ exposed bone, tendon or muscle,
what is the treatment for toxoplasmosis pregannacy <18 weeks
spiramycin
when does acute osteomyelitis occur?
w/in 2 weeks, bacteria penetrates the bone causing abscess formation leading to necrosis of the bone
inadequately cooked crab or cray fish
paragonimiasis
when do you close a wound from an animal bite?
face and clean
stage 2 pressure injury
shiny shallow ulcer w/o slough
entero-test/duodenal biopsy/ abdominal x-ray
giardiasis
top 3 US bat rabie vectors?
raccoons, skunks, bats
why is falciparum so bad?
microvascular sequestraion, hyperparasitiemia >250,000, targets all RBCs (not just reticulocytes) severe, anemia
labs for cysticercosis?
CT, biopsy of subqu nodule
what is the treatment for cysticercosis?
care for seizure, O2, anticonvulsants, increased ICP, (steroids, osmotic agents, diuretics)
NCC: albendazole and/or praziquantel + dexamthasone and etanercept
amebic liver abcess caused by what?
entamoeba histolytica
P___ and P____ have a ___ form that linger is inthe liver for months that can cause a ___ infection
ovale, vivax, hypnozoite, recurrence
routes for osteomyelitis?
trauma, contiguous spread(ulcer, post-op), hematogenous seeding of bone
splenomegaly, hepatomegaly, recurrent high fevers, darkening of the skin, pancytopenia
visceral leishmaniasis
what are the fungal meningitis?
c. neoformans
c. immmits
B. dermatitidis
candidal species
h. capsulatum
what is the treatemtn for fascioliasis?
triclabendazole
what is the MC bacteria infection of the knee?
staph A
what happens 3-10 weeks afer the tick bite in lyme disease?
multiple EMs, tender adenopathy, (HEARTBLOCK) carditis, aseptic meningitis, VII and bell’s palsy
relapse is assoicate with which malaria strands?
vivax and ovale
what is MC cause of encephalitis in western coutnries?
herpes simplex
what is murine typhus caused by?
rickettsia typhi
what is the treatment for leptospirosis?
pen G if severe, out patient doxy
what causes rocky mountain spotted fever?
rickettsia rickettsii
serpiginous (snake like) lesion
cutaneous larva migans
sheep liver fluke
fasciola hepatica
1-2 week RUQ pain, prominent weight loss, hx of dysentery in last year
entamoeba histolytica (hx of dysentery in last year)
what to do if there is a bat and you are sleeping?
post exposure prophylaxis
contact w/ aquarium, salt water marine animals
mycobacterium marinum, fish tank granuloma
what stage of tick will infect you from spring to summer?
nymph
acute, infectious, fatal viral disease of most warm-blooded animals, especially wolves, bats, cats, and dogs, that attacks the central nervous system and is transmitted by he bite of the infected animals
rabies
tropical and subtropical, including southern united states, and intitutional settings. Larvae from soil penetrate bare feet. Cause pulmonary symptoms called ____ ____, eoshinophila in acute and chronic stages, abdominal pain, diarrhea?
strongyloidiasis
what is the number one rabies vector world wide?
dog
walking barefoot on beach?
cutaneous larva migrans (ancylostoma caninum)
where is lyme disease common?
Maryland to maine, wisconsin to minnesota, northern california
treatment for prion related disease?
avid brain/eye tissue, cerebral electrodes, infected instruments
what meningitis has a high mortality depsite appropriate therapy due to overwhelming endotoxin cascade?
neisseria meningitidis
trichinella nativa
artic bears
no fever, seizures, chronic HA, N/V, vision changes, focal neurolgoical complaints, mental status change, hyperreflexia, nystagmus, muscular pseudo hypertrophy, papilledema
neurocysticergosis
serious life threatening manifestations of trichnellosis?
myocarditis, encephalitis, meningitis,
what are the 2 MC places that malaria are imported from?
sub-saharan africa and india
at birth: anemia, thrombocytopenia, jaundice, microcephaly, hydrocephalus
toxoplasmosis
where is leishmaniasis MC found?
brazil, middle east, west asia,
bit buy lice, followed by abrupt fever, headache, rash from trunk to the extermities sparing face, palms and soles. start as macules->maculopapules->petechiae. DOES NOT BLANCH
louse borne typhus
cestode with itchy anus, resless sleep, nasal pruruitis, extermity pain
hymenolepiasis
what is the treatment for erythema migrans?
doxy and amoxicillin
what will show PMNs in CSF for meningitis?
bacteria
p. falciparum treatment
quinidine gluconate IV plus Doxy or clinda
malaria like
besisosis
where is diphyllobothriasis?
Northern hemisphere, uganda, chile
prodromal period in rabies is what?
paresthesia and pain, prickly or itchy feeling, at inoculation site. anorexia, fever, chills, malaise, 2-10 days
katayma’s fever?
actue schistosomiasis
what stage of a lyme disease infection is considered late?
persistent
how long can a taenia live?
25 years w/ 50, 000 eggs per day
what are the signs and symptoms fo toxocariasis?
weight loss, wheezing, hepatosplenomegaly, hypereosinophilia, fever, ocular issues, misdiagnosed retinoblastoma,
who gets neisseri meningitidis?
college students and military recruits
treatment for encephalitis
mostly supportive
p. malariea incubation
28 days
trichnella pseudospiralis?
mammals/birds world wide
visceral larva migrans, ocular larva migrans?
toxocara canis/ toxocariasis cati
what is the largest intestinal namatode 15-35 cm?
ascaria lumbricoides
what is the treatment for carditis in lyme disease?
ceftriaxone IV and doxy PO
flatulence, malodorous greasy stools, weight loss, neurologic sx (irritable, sleep disorder, mental depression, neuroasthenia)
giardia
what shows as air bubbles on radiology?
air bubbles
villous atrophy and distorted microvillic cause malabsorption?
Giardia
what is the treatment for listeria monocytogenes?
listeria
highly motile, unicellular eukaryotes, usually predatory or parasitic; movement by cilic, flagella or ameboid motion; may be aquatic or terrestrial
protozoa
what is the hallmark of late disease in lyme disease?
arthritis, tends to involve the large joints, migratory poly articular process
p. vivax incubation
14 days
hydrocephalus
toxoplasmosis
what are the big causes of bacterial meningitis?
s. pneumoniae, n. meningitidis, h. influenzae
when does chronic osteomyelitis occur?
1- several months of bone infection. acute can become chronic
inferior mesenteric vein
s. mansoni
what are the two types of rabies?
bat rabies and terrestrial rabies
dwarf tape worm
hymenolepis nana
northeastern US specifically NY, MA from a tick
babesisosis
stage 1 pressure injury?
intact skin w/ non-blanchable redness
eating infected meat of carnivores, like AK, CA bear/boar/pork?
trichinella spiralis
how long for x-ray to show lytic lesion?
2-6 weeks
sudden onset joint pain, decreased motion, fever >102.2, swelling of joint, effusions, warmth, monoarticular infection. Elevated ESR, WBCs >50,000, >75% PML, glucose low
infections of the joints
lab for leishmaniasis?
isolate of organism in tissue, giemsa stained slides
new malaria found in SE asia?
P knowlesi
what is the vector for cat scratch fever?
fleas
during invasive phase causes periobital and facial edema, conjunctivitis, fever >104, rash, splinter hemorrhages?
trichinellosis
what lab do you need for osteomyelitis?
bone biopsy
what is the MC helminthic infection in the US?
enterobius vermicularis
what is the treatment for toxocariasis?
albendazole/mebendazole
what is the treatment for a tick bite in an endemic area for lyme disease?
doxy
what is the treatment for strep pneumoniae and neisseria meningitidis?
cefotaxime or ceftriaxone and vanc + dexamethasone
muscle and caf pain, sudden HA rigors, conjunctival hemorrhage and ICTERUS following exposure fresh water, soil and animals in the jungle or tropics
leptospirosis
> =1 red papule in .5 cm, lymphadenitis that persisits 4-6 weeks, sinus track may form, axillary nodes most frequently affected, polonged fever w/o a source
cat scratch disease
what is the treatment for chorioretinits, cong. and preg >18 weeks?
pyrimethamine + sulfadiazine + leucovorin
in US MC parasite identified in stool specimens?
Giaria lamblia
chloroquine resistant treatment?
coartem, malarone, quinine sulfate + doxy
what are the big causes of bacterial meningitis in neonates?
group b beta hemolytic strep, e. coli, listeria monocytogenes
where will you find q fever?
slaugherthouse, live stock handling plants, contact w/ fluids of animals
if someone that has acute toxoplasmosis what is important that you do?
screen family members especially pregnant women and immuncompromised persons
what is the treatment for fish tank granuloma?
clarithromycin + ethambutol or ethambutol + rifampin for 1 month, but up to 6 maybe
what are physical findings during the neurologic period of rabies?
thashing, lacrimation, perspiration, drooling, postural hypotension, hydrophobia, aerophobia
60 or 70 presenting with dementia. Has myoclonic fasciculations, ataxia and progressive cognitive impairment?
prion related disease
no fever, subcu nodule that looks like sebacious cyst, calcified intramuscular lesions
cysticercosis
hot stage how long?
2-6 hours
capillary blockage/microvascular stasis from RBC fragments. Hemolytic anemia, thombocytopenia, chills, fever, diaphoresis, and prostration
babesiosis
what is called the human pinworm?
enterobius vermicularis
trichinella britovi
carnivors of europe and western asia
osteomyelitis frequently affects where?
metaphases of long bones
cestode that’s 15-40 mm in length
hymeolepsis nana
patient develops nonpurulent conjunctivitis, ocular granuloma, preauricular adenopathy, resolve in a few months
cat scratch disease (bartonella)
treatment for diphyllobothriasis?
vitamin supplementation and praziquantel
what malaria causes nephrotic syndrome?
p. malariae
p. ovale incubation
17 days
what is recrudescence and what malaria strand is it assocaited w/?
incomplete treatment, p. falciparum
trichinella nelsoni
african scavengers and predators
what is the treatment for cat scratch disease and parinaud oculoglandular syndome?
self limited
