ID Flashcards
1
Q
What hematologic laboratory abnormality may be found in patients with infection by the organism Rickettsia ricketsii ?
A
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
Q
what bug causes vomiting and diarrhea within hours of ingestion?
A
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
Q
what sexually transmitted dz would Intracytoplasmic inclusions be seen on dx testing?
A
found during diagnostic testing, would confirm the diagnosis of Chlamydia
4
Q
Fungemia
A
yeast in the blood
5
Q
tx of fungemia?
A
Amphotericin B, Flucytosine or Fluconazole
6
Q
Cryptococcus Neoformans is found
A
soil from pigeon poop, pulmonary and CNS/visual symptoms, think immunocompromised
7
Q
Cryptococcus Neoformans Dx
A
Crypotcoccal antigen in CSF or serum. India ink stain
8
Q
Cryptococcus Neoformans tx
A
Amphotericin B or Fluconazole for 10 weeks
9
Q
Histoplasmosis
A
Dimorphic fungus found in soil/bird poop/bat poop in mississippi and ohio
10
Q
Histoplasmosis symptoms
A
Fever, cough, mouth ulcers, wt loss, retinal deposits
● Chronic progressive pulmonary and Calcified nodules
11
Q
Histoplasmosis tx
A
Tx: Long term itraconazole, Amphotericin B
12
Q
chest x ray for histoplasmosis will show?
A
CXR will show miliary infiltrates
13
Q
Pneumocystis Jiroveci (PCP/PJP) x rays finding
A
diffuse interstitial infiltrates, “Bat wing pattern
14
Q
Pneumocystis Jiroveci (PCP/PJP) dx
A
BAL or induced sputum
15
Q
tx of Pneumocystis Jiroveci (PCP/PJP
A
TMP/SMX, steroids if PO2
16
Q
Pneumocystis Jiroveci (PCP/PJP most common opportunistic infection of ______patients
A
HIV
17
Q
Tx for Botulism
A
Botulinum antitoxin from CDC
18
Q
rheumatic fever is caused by
A
Group A Streptococcus (S. pyogenes)
19
Q
how long after strep hemolytic infection does rheumatic fever show up
A
2-3week
20
Q
botulism symtoms Ds
A
double vision, droopy head, difficulty speaking, dilated pupils and dry mouth
21
Q
Major Criteria Jones criteria
A
Polyarthritis, Carditis, Nodules, Chorea, Erythema
Marginatum
22
Q
Minor Criteria:
A
Arthralgias, Fever, Leukocytosis, Elevated CRP/ESR,
prolonged PR interval
23
Q
Risus sardonicus (spasm of the facial muscles causing a “joker smile”) and Opisthotonus (spasm causing body to go into extreme hyperextension)
A
tentanus
24
Q
hypersecretion of water & chloride → massive diarrhea →
hypovolemia and metabolic abnormalities
A
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.
