Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med > ID > Flashcards

ID Flashcards

1
Q

What are the signs/symptoms of early sepsis and septic shock?

A

Early sepsis: fever, vasodilation, warm flushed skin, +/- visible source of infection
Septic shock: organ hypoperfusion, pulmonary edema (ARDS), AMS, acute renal failure, GI bleeding, angina, DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When working a pt up for sepsis and running a blood culture, how many sites should you get blood from?

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you treat sepsis?

A

IV fluids
Vasoconstrictive agents
Broad spectrum abx (until culture comes back)
Insulin (BS 80-110)
Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you monitor in pts with sepsis?

A

Serum lactate, base deficit, & pH to evaluate progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Toxic shock syndrome is commonly seen in what population?

A

90% of cases are in women of childbearing age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common toxin that causes toxic shock syndrome?

A

TSST-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the signs/symptoms of toxic shock syndrome?

A

Fever
Macular rash
Systemic hypotension
Vomiting/diarrhea
Myalgias
Disorientation
Lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you treat toxic shock syndrome?

A

Supportive care
Abx: nafcillin or oxacillin (for staph), PenG + clindamycin (for strep)
Monitor cardiac, renal, & pulm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aside from menstruation products, what other things can cause toxic shock syndrome?

A

Diaphragm use
IV drug use
Osteomyelitis
Pilonidal abscess
Septic arthritis
Cellulitis
Burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the definition of a fever of unknown origin?

A

Fever that persists > 3 weeks without expected response to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What temp meets the criteria for fever of unknown origin along with the > 3 week duration?

A

100.9F (38.3C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

To be diagnosed with a fever of unknown origin, must the fever be consistent?

A

No, it can be intermittent, relapsing sustained, or temperature-pulse disparity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes lyme disease?

A

Spirochete borrelia burgdorferi carried by the blacklegged tick (deer tick)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the signs/symptoms of lyme disease?

A

Early (3-30 days post bite): fatigue, fever, chills, muscle/joint aches, erythema migrans (rash @ site of bite) “target like” or “bulls-eye” shape
Late (days - months post bite): severe HA, stiff neck, numbness/tingling of the face/hands/feet, rashes at sites other than initial bite, heart palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long after a tick bite can you test for lyme disease?

A

Lyme antibody testing 4-6 weeks after tick bite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you treat lyme disease?

A

Early: 7-14 days of PO doxy or amoxicillin or cefuroxime
Late w/neuro symptoms: 14-21 days of PO or IV doxy or ceftriaxone
Late w/carditis: 14-21 days of PO or IV doxy or amoxicillin or cefuroxime
Late w/arthritis: 28 days of PO doxy or amoxicillin or cefuroxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When can you provide prophylactic treatment for lyme disease?

A

Tick bite occurred in area w/high incidence
Tick was removed in last 72 hrs
Tick was engorged
Tick was blacklegged type
Pt has no contraindications to doxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes Rocky Mountain Spotted Fever?

A

Rickettsia rickettsii carried by american dog tick, rocky mountain wood tick, or the brown dog tick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the classic triad of symptoms of rocky mountain spotted fever?

A

Fever
Tick exposure
Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are symptoms of rocky mountain spotted fever?

A

Fever/chills/malaise
HA
Myalgias
Vomiting
Rash 2-4 days after fever (macules that transition to petechiae that moves from wrists/ankles to trunk to palms/soles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can occur in pts w/rocky mountain spotted fever later in the disease?

A

Amputations (2/2 vascular inflammation & damage)
Hearing loss
Paralysis
Mental disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the 1st line treatment for rocky mountain spotted fever?

A

Doxy (100mg q12 hrs for adults, 2.2mg/kg BID for kids) x 5-7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What mosquito carries malaria?

A

Female anopheles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you test for malaria?

A

Microscopic exam of thick & thin blood smears repeated every 12-24 hrs OR
Antigen detection test (BinaxNOW)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How many sets of negative blood smears are needed to rule out malaria?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the treatment for malaria?

A

Chloroquine OR
Hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the signs/symptoms of malaria?

A

High fever
Shaking chills
HA
N/V/D
Neuro complaints
Myalgias
Flu-like general appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is almost always fatal once signs/symptoms appear and only has < 20 documented cases of human survival?

A

Rabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are signs/symptoms of rabies?

A

Early: may be asymptomatic, fever, HA, prickling/itching at bite site
Late: delirium, abnormal behavior, hallucinations, hydrophobia, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the treatment for rabies?

A

Supportive if signs/symptoms present & confirmed diagnosis
Post-bite prophylaxis w/rabies immune globulin & vaccination in pts bitten by an animal known or assumed to have rabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What med is commonly used to prophylactically treat an animal bite?

A

Augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How is typhus fever typically spread?

A

Body lice, chiggers, or fleas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are common symptoms of typhus fever?

A

Fever
HA
Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How do you treat typhus fever?

A

Doxy (100mg BID for adults, 2.2mg/kg BID in kids) for at least 3 days after fever stops & evidence of improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Arboviral disease, West Nile virus, and yellow fever are all treated with what?

A

Supportive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the 1st & 2nd most common STI in the US?

A

1st: chlamydia
2nd: gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Both chlamydia and gonorrhea may have what type of symptoms?

A

Asymptomatic
Abdominal/pelvic pain
Dyspareunia
Dysuria
Urinary urgency
Penile/vaginal discharge
Breakthrough vaginal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which STI (gonorrhea or chlamydia) has an unremarkable physical exam in 90% of men and 70-95% of women?

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Where do you obtain a sample for the nucleic acid amplification test when working a pt up for gonorrhea or chlamydia?

A

Sample must come from symptomatic area (urine, oropharyngeal, vaginal, rectal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the treatment of choice for gonorrhea?

A

Ceftriaxone 500mg IM (if pt < 150kg) (100mg if pt > 150kg) x 1 dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the treatment of choice for chlamydia?

A

Doxy 100mg PO BID x 7 days

42
Q

What is a primary sign of pelvic inflammatory disease (PID)?

A

Cervical motion tenderness (chandelier sign)

43
Q

What can having a PID affect in the future?

A

Fertility

44
Q

What is the treatment of choice for PID?

A

Ceftriaxone 1g IV q24 hrs PLUS doxy 100mg PO or IV q12 hrs PLUS metronidazole 500mg PO or IV q12 hrs

45
Q

What are the signs/symptoms of trichomoniasis?

A

Thin, frothy, malodorous vaginal discharge
Strawberry cervix

46
Q

What test is used to diagnose trichomoniasis?

A

Wet mount/prep

47
Q

What is the treatment for trichomoniasis?

A

Metronidazole 2g x 1 dose OR
Tinidazole 2g x 1 dose OR
Metronidazole 500mg BID x 7 days

48
Q

What should you caution pts about when prescribing Metronidazole?

A

Cannot take with alcohol

49
Q

What are the signs/symptoms of primary syphilis?

A

Primary (10-90 days post exposure): painless/indurated ulcer

50
Q

What bug causes syphilis?

A

T. pallidum

51
Q

What are the signs/symptoms of secondary and tertiary syphilis?

A

Secondary (2-8 weeks after chancre disappears w/concurrent multiple systemic manifestations): condyloma lata, alopecia, papulosquamous rash
Tertiary (months-year post infx): cardiovascular syphilis, neurosyphilis, gummatous syphilis

52
Q

What is the first test that is performed when diagnosing syphilis?

A

Rapid plasma reagin (RPR)

53
Q

What is the treatment for primary/secondary syphilis?

A

Benzathine penicillin G 2.4 million units IM x 1 dose

54
Q

What is the treatment for neurosyphilis and tertiary syphilis in pts with HIV?

A

Neuro: Pen G aqueous 18-24 million units IV QD x 14 days
Tertiary w/HIV: benzathine pen G 2.4 million units IM weekly x 3 weeks

55
Q

What are common signs/symptoms of Hep B & C?

A

Anorexia
N/V
Abdominal pain
Jaundice
Signs of liver damage

56
Q

What is the treatment for Hep B?

A

Virus usually clears on its own
No cure if it doesn’t clear
Vaccine for prevention

57
Q

What does the CDC recommend for screening for Hep B?

A

Once per lifetime in any adult over 18 yo with no known risk factors

58
Q

What is the treatment for Hep C?

A

Can clear on its own or lead to chronic infection
Oral direct acting antivirals (DAA) x 12 weeks

59
Q

Who does Medicare require screening for Hep C?

A

Pts > 60 yo

60
Q

What are the signs/symptoms of herpes simplex virus?

A

Painful oral or genital ulcer (herpes hurt)
Pruritus
Dysuria
Fever
HA
Localized lymphadenopathy

61
Q

What test is used when diagnosing HSV?

A

Nucleic acid amplification test (NAAT) from ulcer (if recently ruptured vesicle)

62
Q

What is the initial treatment for the first episode of HSV?

A

Acyclovir 400mg TID x 7-10 days OR
Valacyclovir 1g BID x 7-10 days

63
Q

What is the treatment for an acute flair/recurrent episode of HSV?

A

Acyclovir or valacyclovir at higher doses & shorter durations

64
Q

What is the suppressive treatment for HSV?

A

Acyclovir 400mg BID OR
Valacyclovir 500mg - 1g QD

65
Q

What is the difference between HSV-1 and HSV-2?

A

HSV-1: classically associated with orolabial (now leading cause of genital herpes in young/homosexual pts)
HSV-2: classically associated with genital infections
(1 mouth, 2 balls)

66
Q

What are most cases of HPV caused by?

A

HPV 6, 11, 16, & 18

67
Q

What are the signs/symptoms of HPV?

A

Genital/anogenital warts
Cauliflower-like growth (condylomata acuminata) to external genital region, perineum, or perianal region

68
Q

What is the treatment for HPV that presents w/an anogenital wart w/o malignancy?

A

Surgical removal
Cryotherapy
Laser vaporization
Topicals (imiquimod, podofilox)

69
Q

What is the treatment for HPV that presents w/high-grade/persistent cervical dysplasia?

A

Cryotherapy
Loop electrosurgical excision
Cold knife cone resection

70
Q

Is HPV an STI that gets reported to the health department?

A

No

71
Q

How are hookworms transmitted/make people sick?

A

Infested soil through skin
Skin penetration –> migrate to vascular system –> migrate to R side of heart & pulm circulation –> migrate to pharynx –> migrate to GI tract

72
Q

What are signs/symptoms of a hookworm infection?

A

Pulm: cough, sneezing, wheezing, hemoptysis
GI: abd. pain & distention, diarrhea, maybe melena
May have keloids from hookworm tract

73
Q

What diagnostic test is done to test for hookworms?

A

Stool sample microscopy

74
Q

How do you treat a hookworm infection?

A

Single-dose albendazole OR
Multi-dose mebendazole

75
Q

What presents with perianal itching that gets worse at night?

A

Pinworms

76
Q

What test is done in suspected pinworm infection?

A

Tape test

77
Q

What is the treatment for pinworms?

A

Vermox OR
Mebendazole

78
Q

What is commonly seen in people who live in tropical areas w/decreased sanitation & increased fecal contamination of water supplies, and can present with GI symptoms?

A

Amebiasis

79
Q

What is the treatment for amebiasis?

A

Metronidazole 500mg PO q6-8 hrs x 7-14 days OR
Tinidazole 2g PO QD x 3 days

80
Q

What is a common protozoan infection in the US that is spread via a fecal-oral route that peaks from early summer to early fall?

A

Giardia

81
Q

What are the signs/symptoms of giardia?

A

Foul-smelling diarrhea
Greasy stools
Abdominal bloating/cramping
Increased flatulence

82
Q

What is the gold standard test for giardia?

A

Microscopic identification of pathogen in stool sample collected over several days

83
Q

What other tests for giardia may be used in place of the stool sample collection?

A

Direct fluorescence immunoassay (DFA)
Enzyme immunoassay (EIA)
Duodenal aspirate

84
Q

What is the treatment for giardia?

A

Current 1st line for pts > 3 yo: tinidazole
Classic 1st line: metronidazole

85
Q

What is a common opportunistic infection that can cause significant disease in immunocompromised pts?

A

Toxoplasmosis

86
Q

What is seen on a brain CT or MRI in a pt with toxoplasmosis?

A

Multiple hypodense areas with ring-enhancing lesions

87
Q

What is the treatment for toxoplasmosis?

A

Empirical therapy if suspected & waiting on test results
Pyrimethamine & sulfadiazine combo for 4-6 weeks beyond resolution of symptoms, prolonged course (6 months) for immunocompromised pts

88
Q

How long do AIDS pts usually have to be on a pyrimethamine & sulfadiazine combo for toxoplasmosis treatment?

A

Lifelong

89
Q

What commonly presents with pts saying they “feel like I’ve been hit by a truck”, fever, chills, & fatigue?

A

Influenza

90
Q

What is the general treatment for influenza?

A

Prevent w/annual vaccine
Supportive care

91
Q

What pts can get anti-viral treatment for the flu?

A

High risk groups if within 48 hours of symptom onset

92
Q

What antivirals are used to treat influenza?

A

Flu A & B: neuraminidase inhibitors (oseltamivir, zanamivir, peramivir)
Flu A only: adamantane antivirals (amantadine, rimantadine)

93
Q

What are the stages of HIV?

A

Acute HIV infection
Chronic HIV w/o AIDS: CD4 count > 200 w/goal > 500
Chronic HIV w/AIDS: CD4 count < 200 or AIDS defining illness
Advanced HIV: CD4 count < 50

94
Q

What is the gold standard treatment for HIV?

A

Highly active retroviral therapy (HAART) regardless of CD4 count
May include: NRTI, NRTI fixed-dose combo, integrase inhibitors, NNRTIs, or protease inhibitors

95
Q

What CD4 count gets a prophylactic treatment and what agent is used?

A

CD4 < 200 prophylaxis w/Bactrim

96
Q

If a healthcare provider is exposed to HIV infection, what is the treatment?

A

PEP within 72 hrs of exposure

97
Q

What is used as prophylactic treatment for people who have a partner that is HIV positive?

A

PrEP

98
Q

What is the criteria for diagnosing AIDS?

A

CD4 count < 200 AND
1 or more of the following:
TB, CMV, candidiasis, cryptococcal meningitis, toxoplasmosis, kaposi sarcoma, kidney disease, neuro complications (AIDS dementia)

99
Q

What is the classic triad for TB?

A

Fever
Night sweats
Hemoptysis

100
Q

What may be seen on CXR in a pt with TB?

A

Perihilar infiltrates

101
Q

What is the treatment for TB?

A

6 month RIPE regimen: 2 months w/4 drugs (rifampin, isoniazid, pyrazinamide, ethambutol) & 4 months w/2 drugs (rifampin, isoniazid) OR 4 months rifapentine-moxifloxican

102
Q

What constitutes a positive skin TB test?

A

Healthy pt: > 15mm induration
Healthcare or high-risk setting: > 10mm
HIV, close contact w/known TB, or immunosuppressed: > 5mm

Clin Med (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions