DJ Sunday Review Flashcards
(147 cards)
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
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
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
4
Q
Constant presence of an agent or health condition within a given geographic area or population
A
Endemic
5
Q
Epidemic occurring over a widespread area (multiple countries or continents) and usually affecting a substantial proportion of the population
A
Pandemic
6
Q
Describes any illness, impairment, degradation of health, chronic or age-related disease
A
Morbidity
7
Q
Measure of death in a defined population during a specific time interval, from a defined cause
A
Morbidity rate
8
Q
What is the leading cause of domestically acquired arboviral disease in the US?
A
WNV
9
Q
What spreads WNV?
A
Culex mosquito
10
Q
What time of year do WNV outbreaks occur?
A
Between mid-July and Early September
11
Q
Presentation:
- Acute systemic febrile illness
- HA, weakness, myalgia or athralgia
- GI sx
- Transient maculopapular rash
A
WNV
12
Q
Labs for WNV
A
- IgM in serum or CSF
- ELISA
13
Q
Treatment of WNV
A
Supportive measures
14
Q
Prevention of WNV
A
- Mosquito repellant
- Wearing long sleeves/pants
- Limit outdoors exposure
- Using air condition, windows and screens to prevent mosquitos
15
Q
What condition do protozoan parasites of genus Plasmodium cause?
A
Malaria
16
Q
Sub types of malaria
A
- P. Valciparum/Vivax/Ovale/Malariae
17
Q
What transmits malaria
A
Female anopheles mosquito
18
Q
Presentation:
- Paroxsymal fevers
- Influenza-like sx
- Jaundice and mild anemia
A
Uncomplicated malaria
19
Q
Paroxysmal fevers are a hall mark of what infection?
A
Malaria
20
Q
Lab for dx of malaria
A
Blood smear
21
Q
Treatment of Malaria
A
- Atovaquone-proguanil (Malarone)
- Artemether-lumefantrine (Coartem)
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
23
Q
Treatment of malaria with chloroquine resistance
A
Malarone (Atovaquone 250mg/Proguanil 100mg) 4 tabs PO QD for 3 days
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
25
Treatment of P. Ovale
- ADD primaquine 52.6mg (30mg=2 Tabs) PO QD x 14 days
- Added regiment for hypnozoites
26
How do you prevent malaria
- Long clothes
- Stop mosquitos
27
What transmits Dengue Fever
Aeges Aegypti
28
3 Phases of Dengue Fever
- Febrile Fever
- Critical Phase
- Convalescent Phase
29
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.
Febrile Phase
30
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.
Critical Phase
31
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.
Convalescent Phase
32
What is the TQ test?
- For dengue fever
- Pump BP cuff
- Deflate and wait
- Reinflate at midway
- Keep cuff inflated for 5 minutes
- Count petechiae below AC fossa
33
What is a positive TQ test
10 or more petechiae per 1 square inch
34
Treatment of Dengue Fever
- Hydration
- Avoid NSAIDS
- Tylenol to control fever
35
Prevention of Dengue
Avoid mosquitos
36
What condition does R. rickettsia cause
RMSF
37
What transmits RMSF
- Americsn Dog Tick
- Rocky Mountain Wood tick
- Brown dog tick
38
Hallmark of RMSF
Small pink macules on wrists, forearms and ankles that spread to trunk
39
Crucial history to r/i or r/o RMSF
- recent tick bite
- area where ticks are common
40
Treatment of RMSF
Doxycycine 100mg PO BID for 5-7 days
41
What does Borrelia burgdorferi cause
Lyme disease
42
What transmits lyme disease
Ixodes (Black legged) ticks
43
How long must tick be attached to transmit lyme
- 36-48 hours
- Has occured in as little as 24 hours
44
Hallmark for lyme disease
Erythema migrans (EM)- red ring-like homogenous expanding rash
45
Treatment of lyme disease
Early lyme/Early disseminated lyme
- Doxycyline 100mg PO BID x 14 days
Late disseminated
- Doxycycline 100mg PO BID x 28 days
46
Medication post exposure to lyme disease
Doxycyline 200mg PO once
47
Disposition of lyme
MED ADVICE
48
What can cause leishmaniasis
Sand fly exposure
49
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
Leishmaniasis
50
IDC treatment of lyme disease
- Ulcer should be debrided and kept clean
- Bandaged and wrapped
51
Leishmaniasis disposition
- Sent to MO or ID
52
Prevention of leishmaniasis
Stay away from sand flies
53
What is an acute or chronic inflammatory process involving bone and structures secondary to infection with pyogenic organisms including bacteria, fungi and mycobacteria
Osteomyelitis
54
Treatment of osteomyelitis
- Surgical debridement
- IV vancomycin and IV ceftriaxone
55
What does the spore forming, anaerobic, gram positive bacterium, clostidrum tetani cause?
Tetanus
56
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
Tetanus
57
Disposition of tetanus
MEDEVAC
58
Treatment of tetanus
- Metronidazole 500mg IV q6-8hrs for 7-10 days
- Pen G 2-4 mile IV
- HTIG
59
Inflammation of meninges
Meningitis
60
Inflamation of the brain
Encephalitis
61
Viral causes of meningitis
Enterovirus (most common), coxsackie viruses, echoviruses, WNV, influenza, HSV, VZV, EBV, arboviruses
62
Bacterial causes of meningitis
Strep, penumonia, influenza, e coli
63
Classic meningeal tetrad
fever, nuchal rigidity, altered mental status, severe HA
64
Imaging for meningitis
CT
65
Treatment of meningitis
- Ceftriaxone 2g IV q12h x 7 days
- Pen G 4 million units IV q4h x 7 days
- Dexamethasone 4mg IV
66
EBV causes what
Mononucleosis
67
Does mono have a vector
NO
68
Presentation:
- Erythematous, exudative pharyngitis or tonsillitis
- Malaise
- Fever
- Cervical lymphadenopathy
- Splenomegaly
Mononucleosis
69
Labs for mono
- Monospot
- CBC: leukocytosis
- LFT
70
Treatment of mono
Treat symptomaticallt
71
Disposition of mono
- SIQ
- No contact sports due to spleen pop
72
How is rabies spread
Infected salvia innoculated through a break in skin
73
What is the most characteristic feature of rabies
Hydrophobia
- Afraid of water due to involuntary pharyngeak soasns when they attempt to drink
74
Aerophobia in rabies
Pharygneal muscle spasms triggered by feel draft of air leading to aspiration, coughing, choking, respiratory arrest
75
Disposition of raabies
MEDEVAC
76
Difference between inflammatory and non-inflammatory diarrhea
- Inflammatory= Blood
- Non-inflammatory= no blood
77
Viral causes of diarrhea
- Noro
- Rota
78
Bacterial causes of diarrhea
- ETEC
- Campylobacter jejuni
- Shigella
- Salmonella
79
Protozoa causes of diarrhea
- Giardia
- Entamoeba
80
Acute onset of abdominal cramps, nausea, vomitting and non bloody diarrhea
Norovirus
81
Treatment of diarrhea
- Rehydrate
- Antimotility/antiemetics
- Cipro
82
Treatment of travelers diarrhea
Azithromycin 500mg PO daily x 3 days
83
Common name for giardia
Beaver fever
84
What can cause giardia
Contaminated lake water/streams
85
Presentation:
- Foul smelling/greasy diarrhea
- 2-5 loose stools per dau with increasing fatigue
Giardia
86
Treatment of Giardia
Metronidazole (Flagyl) 250mg PO TID x 5-7days
87
When to consider antibiotics for diarrhea
- Fever
- >10 stools per day w/ dehydration
- significant operational or complete loss of effectiveness
88
Transmitted through consumption of contaminated water or food and fecal-oral route to include certain sex practices
HEP A
89
Transmitted through exposure to infective blood, semen, body fluids, contaminated blood products and IV drug use
HEP B
90
Transmitted through exposure to infective blood, IV drug use. Can be transmitted sexually but less common.
Hep C
91
Infections only occur with Hep B
Hep D
92
Transmitted through consumption of contaminated water or food. Vaccine exists but are not widely available
Hep E
93
Presentation:
- Jaundice
- RUQ pain
- Low grade fever
- Hepatomegaly
- Dark or brown urine
- Gray poop
Hepatitis
94
Treatment of Hepatitis
- IDC supportive care
- MEDEVAC
95
Myobacterium Tuberculosis
TB
96
How is TB transmitted
Through the air
97
What vaccine may cause a positive TST
BCG
98
Preferred method of testing for TB for patients who have had BCG
QFT
99
LTBI instruction
BUMEDINST 6224.8C
100
LTBI treatment regiment
Isoniazid and Rifampin 1 PO daily x 12 weeks (3 months)
101
Presentatioin:
- Prolonged and productive cough w or w/o hemoptysis
- Chest discomfort
- low grade fever
- decreased appetite
- anorexia
- unexplained weight loss
- Night sweats
TB
102
Procedures for suspected or confirmed TB
- Masks
- Isolation of patient
- MER submitted within 24 hours
- Notify NEPMU
103
Bacillus anthracis
Anthrax
104
What increases your chance of getting anthrax
Working with unvaccinated animals. Common in ranchers, leather workers, vets, wildlife researchers
105
Hallmark for anthrax
Eschar with extensive surrounding edema
106
Antibiotics for anthrax
- Ciprofloxacin 500mg PO BID 7-10 days
- Levofloxacin 750mg PO QD 7-10 days
- Doxycyline 100mg PO BID x 7-10 days
107
Prevention of anthrax
- Vaccine
108
Chlamydia trachomatis
Chlamydia
109
Most frequently reported bacterial STI
Chlamydia
110
Why is chalmydia known as the "Silent Killer"
Most are asymptomatic
111
Labs for chlamydia
- NAAT
- UA
112
Treatment of chlamydia
- Doxycyline 100mg PO BID x 7 days
- ALT= Azithromycin 1g
- Can treat with ceftriaxone if concerned for coinfection
113
Neisseria gonnorhoeae
Gonorrhea
114
Who is asymptomatic and symptomatic in terms of gonorrhea
- Males= symptomatic
- Females= asymptomatic
115
Presentation:
- Dysuria
- White/yellow/green urethral discharge
- epididymitis
- discharge, anal itching, bleeding, painful bowel movements
- sore throat
Gonorrhea
116
Labs for gonorrhea
GC/NAAT
117
Treatment of gonorrhea
Ceftriaxone 500mg
Doxycycline 100mg po bid x 7 days
ALT= Azithromycin 1g po
118
Treponema pallidum
Syphilis
119
Syphilis is also called
Great pretender as it can look like many diseases
120
Presentation:
- Painless papule called chancre
Syphilis
121
Describe Secondary Syphilis
- Skin rashes/mucous membrane lesions
- Syphilitc rash on trunk and extremities that includes palms and soles
122
S/s of latent syphilis
no visible signs and sx
123
Untreated syphilis that appear 10-30 years after infection and can be fatal
Tertiary syphilis
124
Labs for syphilis
Treponemal test (FTA_ABS)
125
Treatment of syphilis
PCN G
PCN allergy: Doxycycline
126
Differentials for syphilis
- Atopic dermatitis
- Psoriasis
-Tinea versicolor
- RMSF
127
Trichomonas vaginalis
Trichomniasis
128
Presentation:
- Purulent, malodorous d/c, burning, pruritis, dysuria, dyspareunia
- Strawberry cervix
Trichomonas
129
Labs for Trichomonas
NAAT
130
Treatment of trichomonas
Metronidazole 2g orally
- Avoid alcohol
131
Which HPV types cause anogenital warts (condyloma acuminata)
6 and 11
132
Which HPV types cause malignancy
16 and 18
133
Presentation:
- Lesions are generally found in multiples and can coalesce
Condyloma acuminata
134
Topical treatment of HPV
Podophyllotoxin solution
135
Clinician applied therapy for HPV
- Cryo
- Surgical excision
136
Vaccine for HPV
Gardasil
137
Gardasil protects against which types of HPV
6 and 11
16 and 18
138
Who should get gardasil
Everyone from 11-26
>26 can request
139
Acute (symptomatic) phase of HIV
Acute Retroviral syndrome (ARS)
140
Can present similarly to mono and the flu
Acute Retroviral syndrome
141
HIV Testing
Rapid 1/2 antibody test
4th gen HIV
142
Do we initiate PrEP in an operational environment?
No
143
Initiation of PrEp requires what?
- 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
Initiation of PrEp requires what?
- 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
When is nPEP relevant
- Sexual assault
- Unprotected sex with high risk contact
146
When is PEP relevant
- Needle stick
- Healthcare related exposure to high risk substances
147
When are clinical evaluations required for DoD member with HIV?
q 6-12 months
