ID Flashcards Preview

PANCE review > ID > Flashcards

Flashcards in ID Deck (116):
1

What hematologic laboratory abnormality may be found in patients with infection by the organism Rickettsia ricketsii ?

This infection causes Rocky Mountain spotted fever, a disease which affects the vascular endothelium. Thrombocytopenia is a common lab abnormality found in these patient

2

what bug causes vomiting and diarrhea within hours of ingestion?

S. aureus can cause severe diarrhea and vomiting within hours of ingestion due to the toxin produced in the body as a consequence of ingesting this food.

3

what sexually transmitted dz would Intracytoplasmic inclusions be seen on dx testing?

found during diagnostic testing, would confirm the diagnosis of Chlamydia

4

Fungemia

yeast in the blood

5

tx of fungemia?

Amphotericin B, Flucytosine or Fluconazole

6

Cryptococcus Neoformans is found

soil from pigeon poop, pulmonary and CNS/visual symptoms, think immunocompromised

7

Cryptococcus Neoformans Dx

Crypotcoccal antigen in CSF or serum. India ink stain

8

Cryptococcus Neoformans tx

Amphotericin B or Fluconazole for 10 weeks

9

Histoplasmosis

Dimorphic fungus found in soil/bird poop/bat poop in mississippi and ohio

10

Histoplasmosis symptoms

Fever, cough, mouth ulcers, wt loss, retinal deposits
● Chronic progressive pulmonary and Calcified nodules

11

Histoplasmosis tx

Tx: Long term itraconazole, Amphotericin B

12

chest x ray for histoplasmosis will show?

CXR will show miliary infiltrates

13

Pneumocystis Jiroveci (PCP/PJP) x rays finding

diffuse interstitial infiltrates, “Bat wing pattern

14

Pneumocystis Jiroveci (PCP/PJP) dx

BAL or induced sputum

15

tx of Pneumocystis Jiroveci (PCP/PJP

TMP/SMX, steroids if PO2

16

Pneumocystis Jiroveci (PCP/PJP most common opportunistic infection of ______patients

HIV

17

Tx for Botulism

Botulinum antitoxin from CDC

18

rheumatic fever is caused by

Group A Streptococcus (S. pyogenes)

19

how long after strep hemolytic infection does rheumatic fever show up

2-3week

20

botulism symtoms Ds

double vision, droopy head, difficulty speaking, dilated pupils and dry mouth

21

Major Criteria Jones criteria

Polyarthritis, Carditis, Nodules, Chorea, Erythema
Marginatum

22

Minor Criteria:

Arthralgias, Fever, Leukocytosis, Elevated CRP/ESR,
prolonged PR interval

23

Risus sardonicus (spasm of the facial muscles causing a
“joker smile”) and Opisthotonus (spasm causing body to go into extreme hyperextension)

tentanus

24

hypersecretion of water & chloride → massive diarrhea →
hypovolemia and metabolic abnormalities

Vibrio cholerae

25

tx cholerae

Oral rehydration, antibiotics shorten course (Tetracycline, Ampicillin, TMP/SMX, Quinolones)

26

Corynebacterium diptheriae

Transmitted by respiratory secretions (trachea)
Deadly for infants

27

complications of Corynebacterium diptheriae

Exotoxin causes myocarditis/neuropathy

28

Enteric fever (typhoid fever) is caused by

salmonella (pea like diarrhea and will have fever)

29

systemic symptoms of enteric fever?

splenomegaly, abdominal distension/tenderness, paradoxical bradycardia (low HR even with fever), rash in week 2 (faint pink papular rash on trunk that fades with pressure)

30

tx of Enteric fever (typhoid fever)

Ceftriaxone or Quinolones for 2 wks

31

Salmonella Bacteremia differs b/c of prolonged fever and what else

osteomyelitis

32

Shigella dysenteriae

Sudden onset diarrhea, abdominal cramps, tenesmus (feeling as if you constantly need to evacuate bowels), fever, malaise, headache, loose stools with
blood and mucous

33

tx Shigella dysenteriae

TMP/SMX (Bactrim)

34

tx of Diphtheria

Horse serum antitoxin from CDC,Antibiotics: Penicillin or Erythromycin/Azithromycin and vaccine

35

pseudomembrane or corn flake membrane

Diphtheria

36

pertussis is caused by

Bordetella pertussis

37

what stage is the Catarrhal

the first stage: hacking
cough (mostly at night) most infectious stage

38

Paroxysmal is what stage of pertussis

2nd stage: coughing spasms followed by high-pitched inspirations (whoops, gasping for air)

39

final third stage of pertussis

Convalescent: happens about 4 wks after the onset of cough; paroxysms improves; lasts another 2-3 wks

40

jones ( must have two major criteria) use JONES for rheumatic fever what are they?

JONES (major criteria): Joints (polyarthritis), O (imagine “O” is heart shaped for Carditis), Nodules (subcutaneous nodules on extensor surfaces), Erythema
Marginatum, Sydenham chorea (choreiform movements)

41

minor criteria for jones criteria (PEACE) or you can have one major and two minor to make dx

PEACE: PR, ESR, Arthralgias, CRP, Elevated temperature

42

LGV (lymphgranuloma venereum)
○ vesicular lesions or ulcers spreading to lymph nodes (inguinal buboes) and anorectal involvement possible

Chlamydia

43

dx Chlamydia

ELISA/DNA test to confirm (cervical or urethral swab, or urine sample)

44

tx for Chlamydia

Azithromycin (1gram PO x 1) or Doxycycline course
○ Erythromycin in pregnancy

45

more painful than Chlamydia
○ milky discharge and dysuria initially then days later have worsening
symptoms with profuse, yellow discharge

Gonorrhea

46

Conjunctivitis via direct inoculation
○ copious purulent discharge (pus pouring out of eye)

Gonorrhea

47

Bacteremia
○ skin lesions (small pustules, gun metal gray, hemorrhagic component and septic arthritis

Gonorrhea

48

dx of gonorrhea

Culture from infected area
● Infant gonococcus: gram stain of discharge (will see gram negative intracellular diplococci)

49

Name the other Mycobacterium that is not TB?

Mycobacterium avium intracellulare (MAC)
● Affects AIDS patients and immunosuppressed
● Causes lung disease and bone marrow suppression
Mycobacterium marinum
● Affects fish handlers
● Causes skin infections
Mycobacterium kansii
● lung disease
Mycobacterium ulcerans

50

inhaled droplet to get TB everyone gets primary, how many will become latent?

95%

51

most common symptoms of TB

cough

52

Toxoplasmosis in the brain

brain lesions in patients with AIDS (ring enhancing
lesions on CT)

53

Toxoplasmosis tx

Pyrimethamine

54

Rickettsia Rickettsii

rocky mountain spotted fever

55

Borrelia Burgdorferi

lymes

56

Transmission by the Ixodes Tick

lyme dz

57

lyme dx

Dx by antibodies (ELISA – 50% are false negative so mostly a clinical diagnosis

58

lyme tx

Tx: Doxycylcine

59

Erythema Migrans

first stage of lyme (target lesion)

60

what MS, CNS and Cardiac complications does lyme dz have?

Musculoskeletal (arthralgias), CNS (bells palsy – can be bilateral), Cardiac (heart
block)

61

Transmitted by Wood Tick

rocky mountain spotted fever

62

Rash to wrists and ankles which
spreads to the trunk, hepatosplenomegally, ARDS, increased WBC’s,
thrombocytompenia, hyponatremia, hematuria

rocky mountain spotted fever

63

tx for rocky mountain fever

Treatment: Doxycycline

64

Treponema Pallidum

Syphilis

65

Syphilis test dx

RPR/VDRL confirm with FTA –ABS

66

Chancre – ulcer to inoculated site with raised edges, round, smooth base, painless, and lymphadenopathy

Syphilis

67

Gummatous lesions: skin/bones/viscera/cardiovascular/ aorta

syphillis

68

Neruosyphilis

Tabes Dorsalis - demyelination of dorsal columns→ impaired
proprioception/ loss of vibratory sense

69

Argyll Robertson Pupil (like prostitutes)

accommodation but don't react (constrict with accommodation but not light)

70

tx syphilis

Tx: Benzathine Penicillin G 2.4million units in a single dose – if diagnosed late
give 3 doses 1 week apart

71

name 3 spirochetes

lyme, rocky mountain and syphillis

72

worse type of malaria

Falciparum is the worst

73

Anopheles mosquito

transmits malaria

74

dx malaria

Dx. by blood smear stains (not easy)

75

tx of malaria

Tx: chloroquine

76

HS family 1-8

1. herpes 1
2. herpes 2
3. chicken poxes
4 Eb Barr
5. CMV
6&7 Roseola
8. Karposi

77

herpes cause what brain disorder

encephalitis

78

Varicella Zoster complications

Can involve lungs (PNA or superinfection PNA) or brain (encephalitis)

79

Herpes Ophthalmicus

Trigeminal nerve – may see Hutchinson’s sign:
herpetic lesion to tip of nose

80

Post-herpetic neuralgia

can't be dx until months after zoster occurred months before, tx with chronic pain drugs

81

Pharyngitis, Lymphadenopathy, fever

Epstein Barr Virus

82

Epstein Barr Virus associated with

Burkitt’s lymphoma and nasopharyngeal carcinoma

83

difference between small poxes and chicken poxes

small poxes are all the same stage

84

Sudden high fevers then days later rash starts as the child is getting better

roseola (spread from truck to head)

85

Rash starts on Face and spreads to trunk and limbs

rubella

86

Congenital CMV

Primary CMV in pregnancy: 10% of babies will have low birth wt, microcephally, seizures, rash, hepatosplenomegally, jaundice,
pneumonia, retinal damage

87

symptoms of mono

Posterior lymphadenopathy, rash

88

what happens if you give amoxicillin and pt has mono

macularpapular/petechial rash

89

Dx

atypical lymphocytes on smear, hemolytic anemia,
thrombocytopenia, increased LFT’s, false + RPR/VDRL b/c of heterophilic antibodies

90

can you give aspirin for mono?

no Reyes symptoms

91

mono dx can give you a false positive for RPR- which is for

syphillis

92

CMV in AIDS below 50 CD count

Retinitis in AIDS pt’s with CD4

93

tx for CMV

Ganciclovir, Foscarnet

94

“Sixth disease” “Exanthem subitum” are other names for

roseola

95

why is rubella horrible

BAD in Pregnancy! – Congenital Rubella syndrome
a. Microcephaly
b. PDA (patent ductus arteriosum)
c. Cataracts

96

slapped cheeks 5th dz is caused by

parvovirus

97

most common flu

A

98

bigger mutation is shift or drift

shift

99

flu symptoms

FEVER, muscle aches, sore throat,

100

What signs or symptoms would you expect to find at the bite site of a patient infected with Rabies?

These symptoms have classically been described with a rabies infection and occur at the site of inoculation.

101

Which of the following organisms would appear red or pink upon application of a Gram stain?

Neisseria gonorrheae

102

Salmonellosis incubation peroid

8-48 hours after eating bad food

103

Which of the following is the most common vaginal infection?

BV

104

test for Gon and Chal

Nucleic acid amplification

105

pasteurella multocida organism is transfered in

dog bites

106

if the CD4 count is below 200 then HIV becomes AIDS or if

you have a AID related illness

107

if CD4 count is below 500

samonella or cdiff, herpes, zoster, TB

108

if CD4 count is below 200

PJP, treat with TMP-SMX

109

if CD4 count is below 100

toxo, tx with TMP-SMX and histo, tx with itraconazole

110

if CD4 count is below 50

CMV (retinitis =) and MAC (mycobacterium avium complex) tx with azthriomycin

111

A 10-year-old girl is brought to the office by her mother for human papilloma virus vaccination. The mother is concerned about what she reads on the internet linking causation between vaccines and medical conditions. The vaccine that her daughter is to receive contains an adjuvant, and the mother asks you to explain the purpose of this ingredient. Which of the following best describes the mechanism of adjuvant function?

It boosts the body's immune response to a given antigen dose

112

Which of the following is a recommended therapy in the treatment of Hepatitis C?

Ribavirin & alpha-interferon

113

patient’s cellulitis and abscess are suspected to be caused by MRSA, which of the following is the best oral antibiotic choice?

bactrim

114

This is the chief pathogen of interest in dog bites.

Pasteurella multocida

115

Zidovudine is a medicine that treats HIV what are the SE

peripheral neuropathy and pancreatitis

116

What is the therapy of choice for a patient diagnosed with Coccidioidomycosis?

The first line drug of choice for Valley Fever is fluconazole.