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Infectious Disease > DJ Sunday Review > Flashcards

DJ Sunday Review Flashcards

1
Q

Person or animal that harbors the infectious agent/disease and can transmit it to others but does not demonstrate signs of the disease

A

Carrier

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2
Q

Exposure to a source of an infection, a person who has been exposed. Does not imply infection, it implies possibility of infection

A

Contact

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3
Q

An increase, often sudden, in number of cases of a disease above what is normally expected in that population and area

A

Epidemic

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4
Q

Constant presence of an agent or health condition within a given geographic area or population

A

Endemic

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5
Q

Epidemic occurring over a widespread area (multiple countries or continents) and usually affecting a substantial proportion of the population

A

Pandemic

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6
Q

Describes any illness, impairment, degradation of health, chronic or age-related disease

A

Morbidity

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7
Q

Measure of death in a defined population during a specific time interval, from a defined cause

A

Morbidity rate

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8
Q

What is the leading cause of domestically acquired arboviral disease in the US?

A

WNV

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9
Q

What spreads WNV?

A

Culex mosquito

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10
Q

What time of year do WNV outbreaks occur?

A

Between mid-July and Early September

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11
Q

Presentation:
- Acute systemic febrile illness
- HA, weakness, myalgia or athralgia
- GI sx
- Transient maculopapular rash

A

WNV

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12
Q

Labs for WNV

A
  • IgM in serum or CSF
  • ELISA
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13
Q

Treatment of WNV

A

Supportive measures

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14
Q

Prevention of WNV

A
  • Mosquito repellant
  • Wearing long sleeves/pants
  • Limit outdoors exposure
  • Using air condition, windows and screens to prevent mosquitos
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15
Q

What condition do protozoan parasites of genus Plasmodium cause?

A

Malaria

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16
Q

Sub types of malaria

A
  • P. Valciparum/Vivax/Ovale/Malariae
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17
Q

What transmits malaria

A

Female anopheles mosquito

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18
Q

Presentation:
- Paroxsymal fevers
- Influenza-like sx
- Jaundice and mild anemia

A

Uncomplicated malaria

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19
Q

Paroxysmal fevers are a hall mark of what infection?

A

Malaria

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20
Q

Lab for dx of malaria

A

Blood smear

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21
Q

Treatment of Malaria

A
  • Atovaquone-proguanil (Malarone)
  • Artemether-lumefantrine (Coartem)
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22
Q

Treatment of Uncomplicated Malaria

A
  • Chloroquine Phosphate 1g (600mg) base PO
  • THEN 0.5g in 6 hours
  • THEN 0.5 daily for 2 days
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23
Q

Treatment of malaria with chloroquine resistance

A

Malarone (Atovaquone 250mg/Proguanil 100mg) 4 tabs PO QD for 3 days

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24
Q

Treatment of severe malaria

A
  • Artesunate 2.4mg/kg IV at 0, 12, 24, 48 hours
  • Followed by Doxycycline 100mg BID x 7 days after parenteral therapy
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25
Q

Treatment of P. Ovale

A
  • ADD primaquine 52.6mg (30mg=2 Tabs) PO QD x 14 days
  • Added regiment for hypnozoites
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26
Q

How do you prevent malaria

A
  • Long clothes
  • Stop mosquitos
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27
Q

What transmits Dengue Fever

A

Aeges Aegypti

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28
Q

3 Phases of Dengue Fever

A
  • Febrile Fever
  • Critical Phase
  • Convalescent Phase
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29
Q

Which phase of Dengue Fever:
(1) Typically lasts 2–7 days and can be biphasic.
(2) Signs and symptoms may include severe headache; retroorbital pain; muscle, joint, and bone pain; & transient maculopapular rash.
(3) Minor hemorrhagic manifestations, including petechiae, ecchymosis, purpura, epistaxis, bleeding gums, hematuria, or a positive tourniquet
test result.

A

Febrile Phase

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30
Q

WHich phase of dengue fever:
typically lasts
24–48 hours.
(2) Most patients clinically improve during this phase and move on to recovery & convalescence phase.

A

Critical Phase

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31
Q

Which phase of dengue fever:
(2) Patient begins to reabsorb extravasated intravenous fluids, pleural, &
abdominal effusions.
(3) As a patient continues to improve, hemodynamic status stabilizes and
diuresis ensues.
(4) The patient’s hematocrit stabilizes or may fall because of the dilutional
effect of the reabsorbed fluid, and the white cell count usually starts to
rise, followed by a recovery of platelet count.
(5) The convalescent-phase rash may desquamate and be pruritic.

A

Convalescent Phase

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32
Q

What is the TQ test?

A
  • For dengue fever
  • Pump BP cuff
  • Deflate and wait
  • Reinflate at midway
  • Keep cuff inflated for 5 minutes
  • Count petechiae below AC fossa
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33
Q

What is a positive TQ test

A

10 or more petechiae per 1 square inch

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34
Q

Treatment of Dengue Fever

A
  • Hydration
  • Avoid NSAIDS
  • Tylenol to control fever
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35
Q

Prevention of Dengue

A

Avoid mosquitos

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36
Q

What condition does R. rickettsia cause

A

RMSF

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37
Q

What transmits RMSF

A
  • Americsn Dog Tick
  • Rocky Mountain Wood tick
  • Brown dog tick
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38
Q

Hallmark of RMSF

A

Small pink macules on wrists, forearms and ankles that spread to trunk

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39
Q

Crucial history to r/i or r/o RMSF

A
  • recent tick bite
  • area where ticks are common
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40
Q

Treatment of RMSF

A

Doxycycine 100mg PO BID for 5-7 days

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41
Q

What does Borrelia burgdorferi cause

A

Lyme disease

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42
Q

What transmits lyme disease

A

Ixodes (Black legged) ticks

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43
Q

How long must tick be attached to transmit lyme

A
  • 36-48 hours
  • Has occured in as little as 24 hours
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44
Q

Hallmark for lyme disease

A

Erythema migrans (EM)- red ring-like homogenous expanding rash

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45
Q

Treatment of lyme disease

A

Early lyme/Early disseminated lyme
- Doxycyline 100mg PO BID x 14 days

Late disseminated
- Doxycycline 100mg PO BID x 28 days

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46
Q

Medication post exposure to lyme disease

A

Doxycyline 200mg PO once

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47
Q

Disposition of lyme

A

MED ADVICE

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48
Q

What can cause leishmaniasis

A

Sand fly exposure

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49
Q

Presentation:
- Pink colored papule that enlarges to a nodule or plaque like lesion
- Lesion ulcerates with indurated border and may have thick white-yellow fibrous materialk
- Lesions are painless

A

Leishmaniasis

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50
Q

IDC treatment of lyme disease

A
  • Ulcer should be debrided and kept clean
  • Bandaged and wrapped
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51
Q

Leishmaniasis disposition

A
  • Sent to MO or ID
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52
Q

Prevention of leishmaniasis

A

Stay away from sand flies

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53
Q

What is an acute or chronic inflammatory process involving bone and structures secondary to infection with pyogenic organisms including bacteria, fungi and mycobacteria

A

Osteomyelitis

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54
Q

Treatment of osteomyelitis

A
  • Surgical debridement
  • IV vancomycin and IV ceftriaxone
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55
Q

What does the spore forming, anaerobic, gram positive bacterium, clostidrum tetani cause?

A

Tetanus

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56
Q

Presentation:
- Lock jaw, nuchal rigidity, dysphagia, rigid abdominal muscles
- Muscle spams
- Apnea due to thoracic contraction or pharyngeal muscle contraction
- Fracture of long bones/vertebrae during muscle spasms
- Death due to respiratory arrest

A

Tetanus

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57
Q

Disposition of tetanus

A

MEDEVAC

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58
Q

Treatment of tetanus

A
  • Metronidazole 500mg IV q6-8hrs for 7-10 days
  • Pen G 2-4 mile IV
  • HTIG
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59
Q

Inflammation of meninges

A

Meningitis

60
Q

Inflamation of the brain

A

Encephalitis

61
Q

Viral causes of meningitis

A

Enterovirus (most common), coxsackie viruses, echoviruses, WNV, influenza, HSV, VZV, EBV, arboviruses

62
Q

Bacterial causes of meningitis

A

Strep, penumonia, influenza, e coli

63
Q

Classic meningeal tetrad

A

fever, nuchal rigidity, altered mental status, severe HA

64
Q

Imaging for meningitis

A

CT

65
Q

Treatment of meningitis

A
  • Ceftriaxone 2g IV q12h x 7 days
  • Pen G 4 million units IV q4h x 7 days
  • Dexamethasone 4mg IV
66
Q

EBV causes what

A

Mononucleosis

67
Q

Does mono have a vector

A

NO

68
Q

Presentation:
- Erythematous, exudative pharyngitis or tonsillitis
- Malaise
- Fever
- Cervical lymphadenopathy
- Splenomegaly

A

Mononucleosis

69
Q

Labs for mono

A
  • Monospot
  • CBC: leukocytosis
  • LFT
70
Q

Treatment of mono

A

Treat symptomaticallt

71
Q

Disposition of mono

A
  • SIQ
  • No contact sports due to spleen pop
72
Q

How is rabies spread

A

Infected salvia innoculated through a break in skin

73
Q

What is the most characteristic feature of rabies

A

Hydrophobia
- Afraid of water due to involuntary pharyngeak soasns when they attempt to drink

74
Q

Aerophobia in rabies

A

Pharygneal muscle spasms triggered by feel draft of air leading to aspiration, coughing, choking, respiratory arrest

75
Q

Disposition of raabies

A

MEDEVAC

76
Q

Difference between inflammatory and non-inflammatory diarrhea

A
  • Inflammatory= Blood
  • Non-inflammatory= no blood
77
Q

Viral causes of diarrhea

A
  • Noro
  • Rota
78
Q

Bacterial causes of diarrhea

A
  • ETEC
  • Campylobacter jejuni
  • Shigella
  • Salmonella
79
Q

Protozoa causes of diarrhea

A
  • Giardia
  • Entamoeba
80
Q

Acute onset of abdominal cramps, nausea, vomitting and non bloody diarrhea

A

Norovirus

81
Q

Treatment of diarrhea

A
  • Rehydrate
  • Antimotility/antiemetics
  • Cipro
82
Q

Treatment of travelers diarrhea

A

Azithromycin 500mg PO daily x 3 days

83
Q

Common name for giardia

A

Beaver fever

84
Q

What can cause giardia

A

Contaminated lake water/streams

85
Q

Presentation:
- Foul smelling/greasy diarrhea
- 2-5 loose stools per dau with increasing fatigue

A

Giardia

86
Q

Treatment of Giardia

A

Metronidazole (Flagyl) 250mg PO TID x 5-7days

87
Q

When to consider antibiotics for diarrhea

A
  • Fever
  • > 10 stools per day w/ dehydration
  • significant operational or complete loss of effectiveness
88
Q

Transmitted through consumption of contaminated water or food and fecal-oral route to include certain sex practices

A

HEP A

89
Q

Transmitted through exposure to infective blood, semen, body fluids, contaminated blood products and IV drug use

A

HEP B

90
Q

Transmitted through exposure to infective blood, IV drug use. Can be transmitted sexually but less common.

A

Hep C

91
Q

Infections only occur with Hep B

A

Hep D

92
Q

Transmitted through consumption of contaminated water or food. Vaccine exists but are not widely available

A

Hep E

93
Q

Presentation:
- Jaundice
- RUQ pain
- Low grade fever
- Hepatomegaly
- Dark or brown urine
- Gray poop

A

Hepatitis

94
Q

Treatment of Hepatitis

A
  • IDC supportive care
  • MEDEVAC
95
Q

Myobacterium Tuberculosis

A

TB

96
Q

How is TB transmitted

A

Through the air

97
Q

What vaccine may cause a positive TST

A

BCG

98
Q

Preferred method of testing for TB for patients who have had BCG

A

QFT

99
Q

LTBI instruction

A

BUMEDINST 6224.8C

100
Q

LTBI treatment regiment

A

Isoniazid and Rifampin 1 PO daily x 12 weeks (3 months)

101
Q

Presentatioin:
- Prolonged and productive cough w or w/o hemoptysis
- Chest discomfort
- low grade fever
- decreased appetite
- anorexia
- unexplained weight loss
- Night sweats

A

TB

102
Q

Procedures for suspected or confirmed TB

A
  • Masks
  • Isolation of patient
  • MER submitted within 24 hours
  • Notify NEPMU
103
Q

Bacillus anthracis

A

Anthrax

104
Q

What increases your chance of getting anthrax

A

Working with unvaccinated animals. Common in ranchers, leather workers, vets, wildlife researchers

105
Q

Hallmark for anthrax

A

Eschar with extensive surrounding edema

106
Q

Antibiotics for anthrax

A
  • Ciprofloxacin 500mg PO BID 7-10 days
  • Levofloxacin 750mg PO QD 7-10 days
  • Doxycyline 100mg PO BID x 7-10 days
107
Q

Prevention of anthrax

A
  • Vaccine
108
Q

Chlamydia trachomatis

A

Chlamydia

109
Q

Most frequently reported bacterial STI

A

Chlamydia

110
Q

Why is chalmydia known as the “Silent Killer”

A

Most are asymptomatic

111
Q

Labs for chlamydia

A
  • NAAT
  • UA
112
Q

Treatment of chlamydia

A
  • Doxycyline 100mg PO BID x 7 days
  • ALT= Azithromycin 1g
  • Can treat with ceftriaxone if concerned for coinfection
113
Q

Neisseria gonnorhoeae

A

Gonorrhea

114
Q

Who is asymptomatic and symptomatic in terms of gonorrhea

A
  • Males= symptomatic
  • Females= asymptomatic
115
Q

Presentation:
- Dysuria
- White/yellow/green urethral discharge
- epididymitis
- discharge, anal itching, bleeding, painful bowel movements
- sore throat

A

Gonorrhea

116
Q

Labs for gonorrhea

A

GC/NAAT

117
Q

Treatment of gonorrhea

A

Ceftriaxone 500mg
Doxycycline 100mg po bid x 7 days
ALT= Azithromycin 1g po

118
Q

Treponema pallidum

A

Syphilis

119
Q

Syphilis is also called

A

Great pretender as it can look like many diseases

120
Q

Presentation:
- Painless papule called chancre

A

Syphilis

121
Q

Describe Secondary Syphilis

A
  • Skin rashes/mucous membrane lesions
  • Syphilitc rash on trunk and extremities that includes palms and soles
122
Q

S/s of latent syphilis

A

no visible signs and sx

123
Q

Untreated syphilis that appear 10-30 years after infection and can be fatal

A

Tertiary syphilis

124
Q

Labs for syphilis

A

Treponemal test (FTA_ABS)

125
Q

Treatment of syphilis

A

PCN G
PCN allergy: Doxycycline

126
Q

Differentials for syphilis

A
  • Atopic dermatitis
  • Psoriasis
    -Tinea versicolor
  • RMSF
127
Q

Trichomonas vaginalis

A

Trichomniasis

128
Q

Presentation:
- Purulent, malodorous d/c, burning, pruritis, dysuria, dyspareunia
- Strawberry cervix

A

Trichomonas

129
Q

Labs for Trichomonas

A

NAAT

130
Q

Treatment of trichomonas

A

Metronidazole 2g orally
- Avoid alcohol

131
Q

Which HPV types cause anogenital warts (condyloma acuminata)

A

6 and 11

132
Q

Which HPV types cause malignancy

A

16 and 18

133
Q

Presentation:
- Lesions are generally found in multiples and can coalesce

A

Condyloma acuminata

134
Q

Topical treatment of HPV

A

Podophyllotoxin solution

135
Q

Clinician applied therapy for HPV

A
  • Cryo
  • Surgical excision
136
Q

Vaccine for HPV

A

Gardasil

137
Q

Gardasil protects against which types of HPV

A

6 and 11
16 and 18

138
Q

Who should get gardasil

A

Everyone from 11-26
>26 can request

139
Q

Acute (symptomatic) phase of HIV

A

Acute Retroviral syndrome (ARS)

140
Q

Can present similarly to mono and the flu

A

Acute Retroviral syndrome

141
Q

HIV Testing

A

Rapid 1/2 antibody test
4th gen HIV

142
Q

Do we initiate PrEP in an operational environment?

A

No

143
Q

Initiation of PrEp requires what?

A
  • Negative 4th gen HIV within 7 days if infection is not suspected
  • Negative 4th gen and docuemented negative NAAT within 7 days if infection is suspected
144
Q

Initiation of PrEp requires what?

A
  • Negative 4th gen HIV within 7 days if infection is not suspected
  • Negative 4th gen and docuemented negative NAAT within 7 days if infection is suspected
145
Q

When is nPEP relevant

A
  • Sexual assault
  • Unprotected sex with high risk contact
146
Q

When is PEP relevant

A
  • Needle stick
  • Healthcare related exposure to high risk substances
147
Q

When are clinical evaluations required for DoD member with HIV?

A

q 6-12 months

Infectious Disease (20 decks)

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