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NURS 518 > 526 Infectious Disease > Flashcards

526 Infectious Disease Flashcards

(67 cards)

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1
Q

what is hyperpyrexia

A

temperature over 41.5

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2
Q

what is fagets sign or sphygmothermic dissociation

A

elevated temperature with relative bradycardia

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3
Q

what are 2 common tropical diseases to be considered in a febrile patient with recent travel

A

malaria
dengue

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4
Q

what drug classes are commonly implicated in drug induced fevers

A

antihypertensives
antiarrhythmics
antibiotics
thryoid medication
antiepileptics

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5
Q

elevated lymphocytes in a febrile patient may indicate what

A

viral infection

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6
Q

elevated monocytes in a febrile patient may indicate what

A

mono

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7
Q

eosinophils in a febrile patient may indicate what

A

parasites
asthma or allergy

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8
Q

an elevated ESR >100 greatly increases possibility of what diseases in a febrile patient

A

osteomyelitis
endocarditis
temporal arteriris
rheumatological disease

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9
Q

at what temperature should fever always be aggressively treated

A

41 degrees or above

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10
Q

immunosuppressed patients should seek medical care for a fever above what

A

37.8

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11
Q

true or false: vertebral osteomyelitis with neuro symptoms can be treated as outpatient

A

false, it requires urgent hospitalization

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12
Q

what timelines define acute and chronic osteomyelitis

A

acute less than 2 weeks
chronic more than 3 months

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13
Q

what is the treatment for osteomyelitis once bone necrosis has occured

A

surgical debridement

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14
Q

what is the Cierny-Mader classification

A

to determine the extent of anatomic involvement of osteomyelitis to help determine treatment

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15
Q

which stage of osteomyelitis can be treated with antibiotics alone

A

stage 1

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16
Q

what are the 3 stages of the cierny mader classification

A

stage 1 - medullary
stage 2 - superficial
stage 3 - localized
stage 4 - diffuse

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17
Q

what symptoms would you suspect to see in osteomyelitis

A

localized pain, erythema, swelling, +/- fever

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18
Q

true or false: osteomyelitis of the hips, pelvis and spine are more likely to present as subacute with a dull persistent pain

A

true

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19
Q

what blood work should be completed for a suspected osteomyelitis

A

CBC with diff and CRP

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20
Q

when should blood cultures be obtained with osteomyelitis

A

vertebral osteomyelitis
or is febrile

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21
Q

what is used for the definitive diagnosis of osteomyelitis

A

bone biopsy

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22
Q

what is first line investigation for possible osteomyelitis? what is used if first line is inconclusive

A

first line is xray
mri if xray is unclear

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23
Q

true or false: wound biospy is just as useful as bone biopsy in determining causitive organism in osteomyelitis

A

false, bone biopsy is gold standard

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24
Q

what are the main differentials other than osteomyelitis that need to be ruled out

A

soft tissue infection
septic arthritis

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25
when is surgical consultation needed for osteomyelitis
patient with vascular insufficiency debridement or drainage needed
26
although ID should be consulted, what is typical first line treatment for osteomyelitis
vancomycin plus 3rd gen cephalosporin like ceftriaxone
27
how long are antibiotics usually given for osteomyelitis
6 weeks of IV abxw
28
what is the difference between lymphadenitis and suppurative lymphadenitis
lympadenitis is tender, warm, ertyhematous nodes suppurative includes fluctuance
29
pain associated with a rapidly growing lymph node is usually a sign of what
infection
30
what does an enlarged virchow node indicate and where is the virchow node
left supraclavicular node concern for malignancy within abdominal organs
31
unilateral or bilateral lymph nodes are more likely to be malignant
unilateral
32
what abdominal assessment should be completed with any upper lymphadenopathy below the neck?
check for splenomegaly and enlarged liver
33
how long should lymphadenopathy with no known cause by left for a period of observation
3-4 weeks
34
what is the acronym CHICAGO and what is it used for
Cancers hypersensitivities infections connective tissue disease atypical lymphoproliferative disorders granulomatous lesions other unusual causes framework for differential for lymphadenopathy
35
right sided supraclavicular lymph nodes suggest pathology in the ____ and left sided suggest pathology in the ____
right - thoracic/lungs left - abdominal/peritoneal
36
what is a sister mary joseph sign and what does it indicate
palpable nodes around the umbilicus. Sign of significant intra-abdominal lymphadenopathy, usually malignant
37
what conditions present with generalized lymphadenopathy, fever, fatigue, weight loss and night sweats
lymphoma and TB
38
what are shotty nodes, what do they indicate, when would you find them
inguinal nodes that are firm, not fixed and less than 1 cm they are common in adults as a result of recurrent infection or injury in the feet and legs
39
what other organs are part of the lymph system and should be assessed with generalized lymphadenopathy
spleen and tonsils
40
true or false: sarcoidosis is an allergic reaction
false, it is an inflamatory
41
erythema nordosum, lymphadenopathy, and respiratory symptoms is indicative of what condition
sarcoidosis
42
a 20-30 year old black female patient with dry cough, shortness of breath and nodules on the shins is indicative of what disease
sarcoidosis
43
what are lupus pernio and when are they seen
raised purple lesions on tip of nose and across cheeks with sarcoidosis
44
true or false: sarcoidosis only affects the lungs and skin
false, it can affect all systems throughout the body causing multiple different sequela
45
what is lofgrens syndrome
caused by sarcoidosis includes: erythema nodosum, bilateral hilar lymphadenopathy, and polyarthralgia
46
what condition would cause an increased serum ACE and increased CA
sarcoidosis
47
how is sarcoidosis diagnosed
histology with skin biopsy or bronchoscopy
48
what is the difference between primary and post primary TB
primary is first occurence of TB and is usually not symptomatic post primary is when TB is reactivated from not being treated and is usually symptomatic
49
how long after being infected with TB before a TST will be reactive
2-8 weeks
50
when measuring a TST test, what is measured?
mm of induration, not erythema
51
does a negative TST conclusively rule out TB
no, there are many causes for a false negative
52
true or false: having HIV or AIDs means you are more likely to have a false negative on the TST test
true
53
what is the two step method for a TST
if first reaction is + = infected if first reaction is -, repeat test in 1-3 weeks
54
true or false, history of the BCG vaccine will not affect your TST result
false, it is variable and may or may not affect the result
55
is history of BCG vaccine a contraindication for the TST test
no
56
what is another diagnostic way to test for TB other than the TST
serum IGRAs
57
TST or IGRA is perferred testing method for children under 5
TST, there is little evidence on the IGRA for children under 5
58
true or false: IGRA or TST play a role in diagnosing active TB
false, they are screening test
59
true or false: CXR results may suggest TB but cannot be diagnostic
true
60
true or false: a positive AFB is diagnostic of TB
false, although strongly suggestive, it is not diagnostic
61
what is the test that is diagnostic for TB
positive culture
62
what are the most potent first line drugs in TB treatment
INH and rifampin
63
what is the major side effect associated with INH
hepatitis
64
what influenza type symptoms would warrant emergency referral
new onset confusion CP difficulty breathing abdo pain persistent vomiting worsening symptoms suspicion of epiglottis
65
how long does a fever associated with influenza usually last
2-3 days but can last as long as 8 days
66
amantadine and rimantadine are effective against what strain of influenza
influenza A
67
at what age can people start to recieve an annual influenza vaccine?
6 months or older

NURS 518 (15 decks)

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