Infectious Disease Flashcards
•Initial symptoms of fever, malaise, sore throat, headache, GI upset, lethargy, stupor, and eventually coma
•Non pruritic maculopapular rash, along with neurological signs such as neck stiffness, mental status changes, tremors, seizures, cranial nerve palsies, pathological reflexes
•Muscle weakness and temporary paralysis in some patients
•Young - acute febrile syndrome with mild neurological symptoms
•Middle aged - aseptic meningitis
•Elderly - encephalopathy
**MEDEVAC**
West Nile Virus
- Residence or exposure in a malaria endemic area
- Intermittent attacks of fever/chills and sweating, headaches, malaise, myalgia, N/V, splenomegaly, anemia, thrombocytopenia
- Malaria parasites identified in blood smears
- The classical malaria attack lasts 6 to 10 hours
CLASSIC ATTACK
•Cold stage - with shivering
•Hot stage - with fevers, N/V, headaches
•Sweating stage - sweats, return to normal temperature, and fatigue
***MEDEVAC**
Malaria
- Self limited febrile illness with a sudden onset of fever/chills, aching of the head, back, and extremities, sore throat, prostration and malaise
- Some infections may be accompanied by a maculopapular rash
•Fever that lasts from 2 to 7 days with general signs and symptoms
•After the fever declines, symptoms including persistent vomiting, severe abdominal pain, and difficulty breathing
•Low platelet count and hemorrhagic manifestations
•Tendency to bruise easily or other types of skin hemorrhages
•Bleeding nose or gums and possibly internal bleeding
•Exposure 7-10 days prior to onset - sudden onset of high fever, chills, severe myalgias, arthralgias, headache, sore throat, and depression
•Biphasic fever curve with the initial phase in 3-7 days, then remission for a few hours to 2 days, followed by the second phase in 1-2 days
**MEDEVAC**
Dengue Fever/ Dengue Hemorrhagic Fever
•1st PHASE - flu like symptoms followed by a localized rash known as Erythema Migrans (EM) that appears about one week after the initial infection and begins as a slightly raised red lesion at the site of the tick bite; sometimes appearing as a ““bullseye”” but more often a muddled circular rash
•2nd PHASE - skin lesions may appear on the body unassociated with the EM that appeared earlier; myocarditis, arrythmias, meningitis, peripheral neurophathies, and Bell’s Palsy
•3rd PHASE - joint swelling, arthritis, rashes, lesions, and neurological manifestations months or years after the infection
**MEDEVAC**
Lyme Disease
•Will typically present with flu like symptoms with a cough; delirium, seizures, stupor and coma may be present
•A distinct maculopapular rash may develop between 2 to 6 days of the onset of fever; the rash will first appear on the wrist and ankles, then spread inward to the arms, legs, and finally the trunk - a distinct involvement of the palms and soles is usually present
•Other manifestations may include splenomegaly, hepatomegaly, jaundice, and myocarditis
**MEDEVAC**
Rocky Mountain Spotted Fever
MILD
•Malaise, headache, fever, retro-orbital pain, N/V, photophobia, bradycardia, conjunctival injection, and facial flushing
SEVERE
•Similar to mild form with the addition of a brief fever remission lasting from several hours to several days followed by a fever and relative bradycardia (Faget sign), hypotension, jaundice, GI, nasal, and oral bleeding, followed by delirium and coma
**MEDEVAC**
Yellow Fever
•Chronic, painless, moist ulcers or dry nodules
•Typical lesions will begin as small dry plaques or large incrusted ulcers with well demarcated raised margins
•Satellite lesions may surround the first lesion and are typically painless, unless infection has set in
•Hallmark is non-healing lesions which takes months to years to fully dissipate
•Localized lymphadenopathy may also be present
**MEDADVICE MIN; If mucosal, MEDEVAC**
Leishmaniasis
- Burrow; linear, curved, or S shaped slightly elevated vesicle or papule up to 1-2mm wide that are most likely to be found in the wrists, web space of the hands, sides of the hands and feet, genital area, and warm intertriginous areas of the abdomen
- Itching that is worse at night
Scabies
- Diarrhea, malaise, foul smelling and fatty stools, abdominal cramps and bloating, flatulence, N/V, weight loss, fever, constipation, and urticaria
- Usually develop after an incubation period of 7 to 14 days
- Symptoms may last 2 to 4 weeks
Giardia Lamblia
- Skin infections that appear as pustules or boils which often have accompanying erythema, edema, and pain; purulent drainage may be present, occasionally emanating from the ““head”” of the boil after it ruptures
- Initially, MRSA may appear as an insect bite or bumps that can mimic a pimple; commonly occur at sites of visible skin trauma, such as cuts and abrasions, and areas of the body covered by hair
- In advanced cases, surrounding cellulitis may be present; localized erythema with induration and drainage, abscess, and positive MRSA culture
Methicillin Resistant Staphylococcus
- Patients usually present with dull pain at the involved site, with or without movement
- Local findings - tenderness, warmth, erythema, and swelling
- Systemic symptoms - fever, rigors
- Chronic osteomyelitis may manifest as pain, erythema, swelling, sometimes in association with a draining sinus tract, and fever is usually absent; intermittent flares of pain and swelling
Osteomylitis
•CLASSIC TRIAD - Fever, nucchal rigidity, and change in mental status
•Headache usually severe and generalized, not easily confused with normal headache
•Photophobia, seizures, focal signs, papilledema
•Petechia and palpable purpura
•Arthritis
•Nuchal rigidity
•Evaluate for Kernig/Brudzinski sign
**MEDEVAC**
Meningitis
•Initial phase; fever, sore throat, fatigue, malaise, and anorexia
•Exam findings include fever, cervical lymphadenopathy, splenomegaly, maculopapular or petechial rash
•Many patients will have erythematous/exudative pharyngitis or gingivitis
•Essentials; malaise, fever, sore throat, palatal petechiae, lymphadenopathy, splenomegaly, positive monospot test
**MEDADVICE min; If severe or airway complications MEDEVAC**
Mononucleosis
- History of an ANIMAL BITE, paresthesia, hydrophobia, rage alternating with calm convulsions, paralysis, and THICC tenacious saliva
- Prodromal period of fever, malaise, headache, nausea and vomiting
- Neurological signs will manifest as sensation changes usually to temperature and air currents 10 days after the prodromal period
FURIOUS
•Delirium, alternating with periods of relaxation, spasms, hyper salivation and seizures
DUMB (PARALYTIC)
•Paralysis; with both forms resulting in coma and death
**MEDEVAC**
Rabies
- Recent travel to where infectious diarrhea is endemic
- Sudden onset of loose watery stools (may be bloody), cramping/abdominal pain, and N/V
- If suffering from dehydration, decreased skin turgor, lightheadedness, and positive tilt test
- Abdominal exam may reveal increased bowel sounds and diffuse tenderness but is typically negative
Acute Infectious Diarrhea
