Exam 2 - Zoonoses and GU infections Flashcards
(172 cards)
1
Q
dysuria definition
A
burning/tingling/stinging of urethra and meatus associated with voiding
2
Q
most common cause of dysuria in women
A
acute cystitis
3
Q
acute cystitis mimics
A
vaginitis, prostatitis, STIs, derm conditions, allergies, hormonal conditions, bladder cancer
4
Q
anatomic abnormalities predisposing to UTIs
A
hypospadias, BPH, vesicoureteral reflux, polycystic kidney disease
5
Q
what is a complicated UTI
A
everything except simple cystitis in a healthy non-pregnant woman
6
Q
confounding factors in urinalysis
A
unclean catch, dilute urine (first morning urine is the best), AZO treatment
7
Q
major way to estimate gram + vs gram - UTI from urinalysis
A
gram negative will have nitrites, gram positive will not
8
Q
major way to determine contamination in urinalysis
A
presence of moderate-numerous squamous cells
9
Q
clues to UTI on urinalysis
A
cloudy color, presence of blood/protein, leukocyte esterase, WBCs, RBCs, bacteria, nitrites
10
Q
most common UTI pathogen
A
e coli
11
Q
which UTI pathogen is associated with struvite stones
A
proteus
12
Q
risk factors for pseudomonas uti
A
chronic catheter, hospitalized patients
13
Q
risk factors for enterococcus uti
A
debilitated/hospitalized patients
14
Q
risk factors for group b strep (agalactiae) uti
A
diabetes
15
Q
risk factor for staph saprophyticus uti (coagulase negative)
A
young, sexually active women
16
Q
mechanism and pathogen in descending UTIs
A
staph aureus, hematogenous spread to kidneys
17
Q
when to treat asymtpomatic bacteriuria
A
pregnant women, before invasive urologic procedures
18
Q
simple cystitis ssx
A
frequency, urgency, dysuria, suprapubic pain, hematuria
19
Q
pyelonephritis ssx
A
simple cystitis plus CVA tenderness, fever, flank pain, N/V
20
Q
simple cystitis tx
A
nitrofurantoin, cephalexin, bactrim, cipro
21
Q
pyelonephritis tx
A
empiric coverage for suspected GNR, consider pseudomonas if hospitalized patient
22
Q
which STI cannot use PCR for diagnosis and what does it use instead
A
treponema pallidum, dark field microscopy or RPR/VDRL
23
Q
gonorrhea morphology
A
gram negative diplococci
24
Q
chlamydia morphology
A
intracellular gram negative rods
25
trichomonas morphology
parasite - flagellate
26
BV pathogen
gardnerella vaginalis
27
gardnerella vaginalis morphology
gram variable rod
28
candida albicans morphology
budding yeast
29
treponema pallidum morphology
spirochete
30
which STI is characterized by clue cells on wet mount
gardnerella (BV)
31
what does the vaginal pathogens panel consist of?
candida, BV, trichomonas
32
treatment for gonorrhea
ceftriaxone 500 mg IM x 1 and azithromycin 1 gram PO x 1
33
treatment for chlamydia
doxycycline x 7 or azithromycin x 1 and ceftriaxone x 1
34
treatment principle for gonorrhea/chlamydia
treat for co-infection with both organisms
35
gonorrhea sequelae
PID, neonatal conjunctivitis, bacteremia, septic arthritis, tenosynovitis
36
chlamydia sequelae
PID, conjunctivitis, trachoma, ectopic pregnancy, chronic pelvic pain, infertility, reactive arthritis
37
causes of prostatitis
bacteria leaking into prostate gland from urinary tract, direct extension/lymphatic spread from rectum, STIs
38
prostatitis ssx
dysuria, urinary hesitancy/urgency, painful ejaculation, abd/groin/low back pain
39
epididymitis causes
UTI/STI
40
epididymitis ssx
swollen, red, warm scrotum, testicle pain/tenderness of gradual onset
41
balanitis definition
inflammation of the glans penis most common in uncircumcised men
42
balanitis causes
candida, irritation from soaps
43
treatment principle for prostatitis/epididymitis
in younger sexually active males, screen and treat for gonorrhea/chlamydia. In older males suspect UTI organisms
44
prostatitis/epididymitis treatment
cipro or bactrim x 1-2 weeks
45
why is cipro often used for prostatitis
it can achieve high concentrations in prostate
46
non-infectious causes of vaginitis
atrophic (post menopausal), allergies to condoms/spermicides/washes
47
most common vaginitis pathogens
candida, bacterial vaginosis pathogens, trichomonas
48
vaginitis treatment challenge
if due to BV, pathogens form biofilm leading to high rates of recurrence
49
candida vaginitis tx
monistat cream or PO diflucan
50
bacterial vaginosis ssx
vaginal pain/itching, dyspareunia, thin grayish milky discharge, fishy odor
51
trichomonas ssx
vaginal itching/pain, thin grayish frothy discharge
52
bacterial vaginosis diagnosis
PCR, clue cells on wet mount
53
trichomonas diagnosis
PCR, moving protozoa on microscopy
54
BV/trichomonas tx
PO metronidazole, vaginal metronidazole, vaginal clindamycin
55
syphilis tx
PCN
56
non-treponemal antibody detection
RPR, VDRL: Quantitative, titers go down with treatment, false positives and negatives
57
treponemal antibody detection
TPPA, MHA-TP, FTA: Qualitative, stays positive for life, more specific than non-treponemal
58
stages of syphilis
primary, secondary, latent, tertiary
59
primary syphilis timeline and characteristics
2-3 weeks after infection, chancre at entry site, regional lymphadenopathy, serology may or may not be positive
60
secondary syphilis timeline and characteristics
6-12 weeks after infection: rash, joint pain, hepatitis, general lymphadenopathy
61
latent syphilis characteristics
positive blood test with no ssx
62
tertiary syphilis characteristics
CNS damage, aortitis, gumma
63
when does neurosyphilis occur
can happen at any stage
64
how is congenital syphilis transmitted
through placenta
65
genital ulcers differential diagnosis
HSV II, syphilis, chancroid, HPV, Behcet's, drug reaction
66
HSV II ssx
painful vesicular lesions
67
chancroid ssx
painful necrotic lesions
68
chancroid pathogen
haemophilus ducreyi
69
HPV ssx
wart-like lesions
70
Behcet's ssx
sores in mouth and genitals
71
HSV II tx
acyclovir
72
chancroid tx
azithromycin, ceftriaxone
73
HPV tx
imiquimod, condylox
74
Behcet's tx
prednisone, immunosuppressants
75
how long to refrain from sexual activity after STI treatment initiation
7 days
76
major diagnosis principle for STIs
always evaluate for other STIs including HIV
77
zoonoses definition
infections normally found in non-humans that may infect humans
78
when to consider zoonoses
fever of unknown origin with recent travel history
79
differential for fever within one week of return from African, South America, SE Asia
malaria, dengue, chikungunya, zika, yellow fever
80
zoonoses from cats
pasteurella, bartonella
81
pasteurella morphology
small gram negative coccobacilli
82
pasteurella ssx
acute onset of cellulitis, lymphangitis, purulent drainage from wound 12-24 hours after bite/scratch
83
pasteurella tx
surgical drainage and PCN
84
Bartonella morphology
fastidious, slow-growing GNR
85
bartonella diagnosis
PCR, lymph node culture
86
bartonella mechanism
transmitted to cat via infected flea
87
pasteurella mechanism
normal oral flora in cats and dogs
88
bartonella ssx
fever, fatigue, swollen lymph nodes
89
bartonella tx
self-limiting, can use azithromycin or PCN
90
rickettsial infections morphology
very small, usually intracellular bacteria
91
rickettsial infections tx
doxycycline
92
rickettsial infections ssx
fevers, HA, rash, tache noire (eschar)
93
most important rickettsial infection
rocky mountain spotted fever
94
RMSF pathogen
rickettsia rickettsii
95
RMSF geographic distribution
US (NC, OK, TN, Arkansas, Missouri), Canada, Mexico, Central America, Brazil
96
RMSF vector
American dog tick
97
RMSF ssx
fever, HA, abd pain, maculopapular rash or petechiae that begins on wrists/ankles and progresses towards the trunk - can be seen on palms and soles
98
RMSF diagnosis
serology, skin biopsy
99
RMSF treatment
doxycycline, chloramphenicol
100
rickettsialpox pathogen
rickettsia akari
101
rickettsialpox ssx
fever, HA, papulovesicular rash
102
rickettsialpox vector
mouse mites
103
rickettsialpox tx
doxycycline
104
granulocytic anaplasmosis pathogen
anaplasma phagocytophilum
105
cells affected by granulocytic anaplasmosis
granulocytes (neutrophils, eosinophils, basophils
106
granulocytic anaplasmosis vector
ixodes tick
107
granulocytic anaplasmosis geographic distribution
upper midwest, New England, northeast Atlantic states
108
granulocytic anaplasmosis ssx
fever, myalgias, HA, GI ssx, no rash
109
granulocytic anaplasmosis tx
doxycycline
110
cells affected by monocytic ehrlichiosis
blood monocytes, tissue phagocytes
111
monocytic ehrlichiosis vector
lone star tick (amblyomma)
112
monocytic ehrlichiosis geographic distribution
Midwest, coastal Atlantic states
113
monocytic ehrlichiosis ssx
same as anaplasmosis except 1/3 of patients have rash
114
monocytic ehrlichiosis tx
doxycycline
115
monocytic ehrlichiosis vs anaplasmosis on blood smear
anaplasmosis: often see morulae. Ehrlichiosis: rarely see morulae
116
Q fever pathogen
coxiella burnetti
117
Q fever reservoirs
sheep, cattle, goats (placental tissue, feces, urine)
118
Q fever transmission
inhalation, unpasteurized dairy, tick bite (rare)
119
Q fever ssx
acute or chronic: fevers, chills, myalgia, HA, GI symptoms, chest pain
120
Q fever sequelae
culture negative endocarditis, pneumomia, hepatitis, aneurysms, CNS
121
Q fever tx
doxycycline
122
Plague pathogen
yersinia pestis
123
plague vectors
fleas, prairie dogs, rock squirrels, cats/dogs
124
plague morphology
gram negative coccobacilli with safety pin appearance
125
plague diagnosis
culture, antibody test
126
plague presentation
buboes, pneumonic
127
plague season
spring, summer, fall
128
plague treatment
doxycycline, cipro
129
plague geographic distribution
Western US, especially NM
130
Hantavirus geographic distribution
Four corners NM
131
Hantavirus mechanism
inhalation of deer mouse feces
132
Hantavirus ssx
flu-like ssx one week after contact +/- severe respiratory distress
133
Hantavirus diagnosis
>10% immunoblasts on blood smear, antibody test
134
hantavirus season
spring, early summer
135
hantavirus treatment
supportive care, ECMO
136
west nile geographic distribution
continental US
137
West nile vectors
mosquitoes, dead birds
138
west nile ssx
flu-like, meningitis/encephalitis, paralysis
139
west nile diagnosis
IgM serology
140
west nile treatment
supportive
141
rabies animals
bats, racoons, skunks, cats/dogs, etc
142
rabies tx
rabies vaccine, immunoglobulin
143
rabies ssx
cerebral dysfunction, anxiety, AMS, usually fatal if ssx develop
144
rabies diagnosis
PCR, antibody testing
145
tularemia geographical distribution
hunting areas, Arkansas
146
tularemia risk factor
hunting and skinning rabbits
147
tularemia vectors
lone star tick, deer fly
148
tularemia ssx
glandular, oropharyngeal, pneumonic
149
tularemia diagnosis
PCR, fluorescent antibody stain, culture
150
tularemia morphology
gram negative coccobacilli
151
tularemia season
summer, fall
152
tularemia tx
doxycycline, cipro
153
Dengue geography
tropical regions
154
dengue vector
mosquito
155
dengue ssx
bleeding, jaundice, elevated LFT/creatinine
156
dengue diagnosis
PCR
157
dengue treatment
supportive
158
brucellosis risk factors
immigrants, ranchers, slaughterhouse/meat packing workers, hunters, vets
159
brucellosis animal
ungulate and farm animals (horses, cattle, pigs, goats)
160
brucellosis ssx
flu-like
161
brucellosis diagnosis
serology
162
brucellosis morphology
gram negative coccobacilli
163
brucellosis season
spring/summer
164
brucellosis tx
doxycycline, cipro
165
lyme disease pathogen
borrelia burgdorferi
166
lyme disease geographic distriubtion
northeast, upper midwest
167
lyme disease vector
deer tick (ixodes scapularis)
168
lyme disease ssx
erythema migrans, bell's palsy
169
borrelia burgdorferi morphology
spirochete
170
lyme disease diagnosis
serologies
171
lyme disease tx
doxycycline
172
lyme disease season
summer/early fall
