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Infectious Disease > Green PANCE book > Flashcards

Green PANCE book Flashcards

1
Q

How is norovirus spread?

A

Food
water
person to person

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2
Q

Onset 1-3 days
Watery diarrhea
Low grade fever
Duration= 1-2 days

Therapy= hydration! and prevention (hand washing)

A

Norovirus

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3
Q

How is cholera (vibrio spp.) spread?

A

Water

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4
Q 
Onset 2-3 days
Profuse, watery diarrhea 
Some N/V
Rarely a fever
Duration= days!

Therapy= hydration!

A

Cholera (vibrio spp.)

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5
Q

What is the source of enterotoxic E. coli

A

Food

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6
Q 
Onset 5-15 days
Cramping, watery diarrhea
Some N/V
Low grade fever
Duration= 1-5 days

Therapy= hydration, bismuth/loperamide

A

Enterotoxic E. Coli

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7
Q

What is the source of Salmonella?

A

Poultry

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8
Q 
Onset 6-72 hours
Purulent diarrhea
Nausea, some vomiting
FEVER! Septicemia
Duration= 4-7 days

Therapy= hydration!

A

Salmonella

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9
Q

What is the source of Enterohemorrhagic E. coli?

A

Undercooked ground beef

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10
Q 
Onset 12-60 hours
Purulent, bloody diarrhea. cramping
No N/V
Fever
Duration= 5-10 days

Therapy= supportive, unless severe

A

Enterohemorrhagic E. Coli

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11
Q

What is the source of Shigella?

A

Fecal-oral

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12
Q 
Onset 1-6 days
Purulent, bloody diarrhea. cramping
No N/V
Fever
Duration= 1-7 days

Therapy= supportive

A

Shigella

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13
Q

systemic immune response occurring 15-20 days after exposure to streptococcal pharyngitis

*early tx of streptococcal infection is imperative to prevent!

A

Acute rheumatic fever

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14
Q

A strictly anaerobic, spore forming bacillus found in the soil
*may accidentally end up in food (home canned, smoked or commercial)

A

Clostridium botulinum

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15
Q

Inhibits the release of Ach at the neuromuscular junction

  • IV drug users at high risk!
  • babies who eat honey are at high risk!
A

Botulism

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16
Q

Initial clinical sx= visual changes, including diplopia and loss of accommodation
*manifestation usually 12-36 H after ingestion

Additional sxs…ptosis, impaired EOM, fixed dilated pupils, cranial nerve palsies, dysphonia, dry mouth, dysphagia, N/V

A

Botulism

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17
Q

Tx of botulism?

A

Anti toxin

and respiratory support if needed

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18
Q

Produces a toxin than activates adenylyl cyclase in intestinal epithelia cells of the small intestine..results in hyper secretion of water and Cl ion and massive diarrhea

*death results from HYPOvolemia

A

Cholera

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19
Q

“rice water” diarrhea (gray, turbid and without odor, blood or pus”

A

Cholera

stool cultures positive for Vibrio cholerae

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20
Q

Tx of cholera

A

Fluid and electrolyte replacement

Oral if tolerated, IV if severe
*Abx will shorten duration and reduce severity of symptoms (tetracycline, ampicillin, etc)

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21
Q

Is a cholera vaccine available?

A

Yes! but protection is temporary, with boosters needed every 6 months

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22
Q

Clostridium tetani spores are found in…

A

soil

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23
Q

Spores germinate in wounds (esp puncture wounds!!) where the bacteria produce a neurotoxin, which interferes with neurotransmission at spinal synapses of inhibitory neurons

*result=uncontrolled spasm and exaggerated reflexes

A

Tetanus

incubation pd= 5 days to 15 weeks

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24
Q

Pain and tingling at site of inoculation, followed by spasticity of muscles nearby

  • *jaw and neck stiffness, dysphagia, irritability
  • hyerperreflexia and muscle spasms, especially in jaw (truisms) and face
A

Tetanus

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25
Q

Painful tonic convulsions, spasms of the glottis and respiratory muscles and asphyxia if pts is untreated

A

Tetanus

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26
Q

Treatment for tetanus?

A

Tetanus immune globulin given intramuscularly (IM)

Full course of tetanus toxoid once pt recovers

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27
Q

Salmonella enteric are transmitted by ingestion of contaminated….

A

food and water

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28
Q

Enteric fever (typhoid fever)
Gastroenteritis
Bacteremia

A

3 patterns of Salmonellosis

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29
Q

incubation pd 5-14 days
*organisms enter mucosal epithelium of the intestine and invade and replicate within macrophages in Peyer patches, mesenteric lymph nodes and the spleen

A

Enteric (typhoid) fever

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30
Q

Onset insidious with a prodrome of malaise, HA, cough and sore throat
*abdominal pain, distention and constipation and/or diarrhea (“pea soup”) develops as fever increases

*fever reaches peak on 7-10 days and the pt appears toxic, then generally improves over the next 7-10 days

A

Typhoid fever

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31
Q

Splenomegaly, abdominal distention and tenderness, bradycardia

  • rash develops during second week
  • organism can be isolated from blood during 1st week
A

Typhoid fever

32
Q

DOC- ampicillin, chloramphenicol, TMP-SMX

if resistant, ceftriaxone or fluoroquinolones

A

Typhoid fever

33
Q

Most common form of Salmonella infection
*incubation= 8-48 hrs after ingestion of food or drink that is contaminated
fever, N/V/D
BLOOD DIARRHEA 3-5 DAYS!

A

Gastroenteritis

34
Q

Dx and treatment of Gastroenteritis

A

Dx= stool culture

Tx=usually self limiting

35
Q

Caused by salmonella
*characterized by prolonged or recurrent fevers, can have local infection in bone, joints, pleura, pericardium, lungs or other sites

A

Bacteremia

36
Q

Shigella sonnei
Shigella flexneri
Shigella dysenteriae

*most common species that cause dysentery

A

Shigellosis

37
Q

Illness starts abruptly with diarrhea, lower abdominal cramps and tenesmus accompanied by fever, chills, anorexia, HA and malase

stools are loose and mixed with blood and mucus!***

A

Shigellosis

38
Q

Stool positive for leukocytes and RBCs, culture yields shigella spp.

*sigmoidoscopy will reveal inflamed engorged mucosa, punctate lesions or ulcers

A

Shigellosis

39
Q

Shigellosis tx

A

Replacement of fluid volume

Abx= TMP-SMX

40
Q

Corynebacterium diphtheria is transmitted via…

A

respiratory secretions

organism has a propensity for mucous membranes, especially respiratory tract

41
Q
  • nasal infection produces few symptoms other than nasal discharge
  • laryngeal infection causes upper airway and bronchial obstruction
  • pharyngeal is MOST COMMON! a tenacious gray membrane cover the tonsils and phyarnx. pt will have mild sore throat, fever and malaise
  • myocarditis ad neuropathy
A

types of Diphtheria infections

42
Q

Pharyngeal infection= most common type!!

A tenacious gray membrane covers the tonsils and pharynx, and pts complain of mild sore throat, fever, malaise

A

Diphtheria

diagnosis is clinical!!!!

43
Q

A horse serum antitoxin must be given in all cases of…

A

Diphtheria

44
Q

Does diphtheria have a vaccine?

A

YES!

45
Q

Human herpes virus 4, a universal virus transmitted via saliva

A

EBV

46
Q 
Mono
Burkitt lymphoma
Nasopharyngeal carcino,a
Pediatric leiomyomas
Collagen vascular dz
A

caused by EBV

47
Q

Oral lesions: exudative pharyngitis, tonsillitis, gingivitis, soft palate petechiae
*malaise, anorexia, myalgias

A

EBV

48
Q

An early granulocytopenia is followed by a lymphocytic leukocytosis
*atypical leukocytes appear as larger cells that stain darker and frequently vacuolated

A

EBV

49
Q

Tx of EBV?

A

Symptomatic!

50
Q

caused by orthomyxovirus

*readily transmitted thru droplet nuclei and occurs in epidemics and pandemics during fall and winter

A

influenza

51
Q

3 strains exist: A (more pathogenic), B, C

*different types based on surface antigens hemagglutinin (H) and neuraminidase (N)

A

influenza

52
Q

Incubation period 18-72 hours
fever, chills, malaise, muscle aches, substernal CP, HA, nasal stuffiness

fever lasts 1-7 days accompanied by coryza, nonproductive cough, photophobia, eye pain, sore throat, pharyngeal injection and flushed facies

A

influenza

53
Q

Reye syndrome (fatty liver with encephalopathy) is a potential complication

A

influenza

54
Q

Tx of influenza

A

supportive care

55
Q

member of herpesvirus family

  • highly contagious, especially the day before the rash appears
  • incubation period is 10-20 days

benign in children, can be life threaetning in elderly or immunocompromised

A

Varicella(chicken pox)

56
Q

lesions begin as erythematous eruption that follows a centripetal pattern

  • lesions appear in crops
  • mucous membranes may be involved
A

Varicella (chicken pox)

57
Q

painful eruptions along dermatomal pattern
thoracic and lumbar regions!

trigeminal eruptions that include the tip of the nose (Hutchinsons sign) risk corneal involvement

A

Zoster (shingles)

58
Q

Rhabdovirus is transmitted via infection from an animal bite or an open wound

*vectors= bats, dogs, foxes, raccoons, coyotes,

A

Rabies

59
Q

incubation pd between bite and onset of symptoms in from 10 days-years (typically 3-7 weeks)

typically pain and prosthesis at site; skin is sensitive to changes in temp and wind

A

rabies

60
Q

pts are restless, with muscle spasms and extreme excitability
Bizarre behavior, convulsions, paralysis
*THICK, tenacious saliva
*hydrophobia (painful spasms caused by drinking water)

A

Rabies

61
Q

Suspect animals: brains tested for virus using fluorescent antibody markers

*CSF may show rabies revere transcriptase by PCR

A

Rabies

62
Q

Is there a cure for rabies?

A

NO! prevention is key!!

63
Q

Post exposure immunization includes rabies immunoglobulin (in wound and IM at a distant site)

A

Rabies

if pt has receives active immunization in past, immunoglobulin is NOT given

64
Q

Pre exposure vaccination of persons at high risk

A

rabies

65
Q

infects all cells containing the T4 antigen, primarily the CD4 helper inducer lymphocytes

*transmitted thru bodily fluids

A

HIV

66
Q

CD4 count below 200

A

AIDS

67
Q

the measure of actively replicating virus

A

viral load

68
Q

if possibly exposed to HIV, post exposure prophylaxis should be started within…

A

72 hours

69
Q

secondary prevention efforts include anti-retrovirals and chemoprophylaxis

A

HIV treatment

70
Q

Spread via… Sex, breast milk, blood transfusions, respiratory droplets

  • *owl eyes in biopsy
  • *pizza pie retinopathy
A

Cytomegalovirus (herpes virus 5)

71
Q

Dimorphic fungus found in soil infested with bird and bat droppings

A

Histoplasmosis

72
Q

Urine assay can be used to confirm dx

DOC= itraconazole

A

Histoplasmosis

73
Q

Encapsulated budding yeast found in soil with dried pigeon dung

Pulmonary dz can develop
Fever,cough dyspnea

Dx= CSF. Tx=Fluconazole

A

Cryptococcus

74
Q

India ink stain or serology with latex agglutination used in dx of

A

Cryptococcus

75
Q

Fungus found in lungs of humans and animals
**MOST COMMON HIV OPPORTUNISTIC INFECTIONS

SOB, nonproductive cough
Diffuse interstitial infiltrates

DOC: TMP-SMX

A

Pneumocystis jiroveci pneumonia

76
Q

Enterobius vermicularis (humans only host)
Perianal itching
Scotch tape test
DOC= albendazole for whole house

A

Pinworms

Infectious Disease (9 decks)

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