ID pt 2 Flashcards
(84 cards)
1
Q
COVID dx
A
PCR/ NAAT
2
Q
COVID tx
A
paxlovid
3
Q
what are 4 types of polio?
A
- abortive
- nonparalytic
- paralytic
- post-poliomyelitis syndrome
4
Q
s/s of abortive polio
A
nonspecific illness
- fever
- HA
- constipation
- sore throat
- n/v/d
5
Q
s/s of nonparalytic polio
A
- nonspecific illness
- meningeal irritation and muscle spasms
- no paralysis
6
Q
s/s of paralytic polio
A
- flaccid asymmtric paralysis affecting proximal muscles of lower extremities
- sensory loss is rare
- spinal- impacts spinal nerves
- bulbar- impacts CNs and can lead to respiratory paralysis
7
Q
s/s of post-polio syndrome
A
- progressive muscle paresis and atrophy
- fasiculations and fibrillation
- restless leg syndrome
8
Q
dx of poliomyelitis
A
PCR of washings, stools, CSF
9
Q
tx of polio
A
suportive
10
Q
polio vaccination schedule for children
A
4 doses
- 2 mo, 4 mo, 6-18 mo, 4-6 yrs old
11
Q
polio adult vaccination scheudle
A
3 doses
- 1st dose, 2nd dose 1-2 mo later, 3rd dose 6-12 mo after 2nd
12
Q
s/s of active TB
A
- fever
- night sweats
- weight loss
- hemoptysis
- productive cough
13
Q
a primary TB infection can progress to what 3 stages?
A
- active/ primary progression
- latent TB
- termination
14
Q
list a few s/s of disseminated TB/ miliary TB
A
- meningitis
- Addison’s disease
- Pott’s disease
- erythema nodosum
- hepatitis
15
Q
CXR of primary or latent TB would show what finding?
A
Ghon focus/ complex
16
Q
CXR or CT findings in active TB
A
cavitary lesions in lung apices
17
Q
active TB tx
A
PIER
- pyrazinamide (PZA)
- isoniazid (INH)
- ethambutol (EMB)
- rifampin (RIF)
18
Q
latent TB tx
A
INH or RIF
19
Q
s/s of atypical tuberculosis
A
- skin and soft tissue findings: abscesses, arthritis
- lymphadenitis: MAC in children
- eyes: keratitis and retinal lesions
20
Q
dx of atypical mycobacterial disease
A
culture of sputum, blood or urine
21
Q
tx of MAC
A
azithromycin or clarithromycin
and
ethambutol
and
rifampin or rifabutin
22
Q
syphilis cause
A
treponema pallidum
23
Q
s/s of primary early/ infectious syphilis
A
painless chancre
non-tender regional lymphadenopathy
24
Q
s/s of secondary early/ infectious syphilis
A
systemic symptoms- generalized lymphadenopathy
rash- non-pruritic, includes palms and soles
condyloma lata
lesions distant from site of inoculation
*most infectious stage
25
this stage of syphilis is highly infectious and lasts up to 1 yrear after initial infection. Infectious lesions may recur.
early latent stage
26
this stage of syphilis is noninfectious except transplacentally and occurs more than 1 yr after initial infection.
late latent
27
what are 2 types of late syphilis?
tertiary or neurosyphilis
28
major findings of tertiary late syphilis
**gumma**- infiltrative tumor with rapid onset
**cardiac** syphilis- aortitis and other heart findings
29
neurosyphilis findings
- meningitis, dementia, HL, psychosis
- tabes dorsalis--> loss of virbration and proprioception
- general paresis
- argyll robertson pupil
30
# argyll robertson pupil
constricts with _______ but not to _____
accommodation
light
31
tx of syphilis
IM PCN G
neurosyphilis- IV PCN
32
lyme disease stage 1 (early localized) s/s
erythema migrans
viral like illness- myalgias, fatigue, HA
33
lyme disease stage 2 (early disseminated) s/s
aseptic meningitis
bilateral CN7 palsy
cardiac issues- AV block
34
lyme disease stage 3 (late persistent) s/s
MSK- joint pain/ swelling
neuro findings
AMS, mood changes, ect
35
diagnostic standards for lyme disease
1- exposure to endemic area
2- documented erythema migrans within 30 days OR one late manifestation
3- lab confirmation
36
lab confirmation of lyme disease
ELISA and western blot
elevated ESR and liver enzymes
37
tx of lyme disease
doxycycline
38
4 requirements for lyme disease prophylaxis
1- attached for 36 hrs or more
2- started within 72 hrs of removal
3- more than 20% of ticks in area infected
4- no doxy contradictions
39
relapsing fever s/s
abrupt onset fever, chills, tachy, severe HA, ect for 3-10 days, then relapse occurs 1-2 wks later
40
dx of relapsing fever
blood smear with wright or giemsa stains
PCR
41
tx of relapsing fever
IV PCN G or ceftriaxone
42
how long must the tick be attached for lyme disease to be transmitted?
24-36 hrs
43
how long does the tick need to be attached for rocky mountain spotted fever to be transmitted?
6-10 hrs
44
rocky mountain spotted fever s/s
abrupt onset fever and HA
rash- small blanching pink macules that spread into petechiae-> involvement of palms and soles
chills, malaise, hard palate lesions, conjunctival injection
45
dx of rocky mountain spotted fever
skin biopsy with immunohistology or PCR
46
tx of rocky mountain spotted fever
doxycycline
pregnancy- chloramphenicol
47
ehrlichisosis s/s
high fever
rigors
pleomorphic rash- many stages at once
48
tx of ehrlichiosis
doxycycline
pregnancy- rifampin
49
amebiasis s/s
dysentery- **bloody diarrhea**, colitis, abd pain
necrotizing colitis- hemorrhage, perforation
extraintestinal- **liver abscess**, hepatomegaly,** RUQ pain,** weight loss, high fever
50
amebiasis tx
metronidazole or tinidazole + luminal agent
- luminal agents: diloxanide, idoquinol, paromomycin
51
this protozoan disease is common in healthy pts who recently went swimming in lakes or heated swimming pools
naegleria fowleri
52
naegleria fowleri s/s
primary amebic meningoencephalitis (PAM)
- fever, neck stiffness, HA
- photophobia, 3, 4, and 6 CN palsies, AMS
- coma and death
53
tx of naegleria fowleri
amphotericin B
rifampin
miltegosine
azithromycin
steroids
| probably won't be on exam via Wil
54
this protozoan disease is common in pts with history of camping and lake water exposure
giardiasis
55
s/s of giardiasis
explosive, foul smelling nonbloody diarrhea
- stools are frothy/ greasy
- weight loss, malabsorption, vitamin deficiencies
56
dx of giardiasis
stool wet mount
stool antigen assays
57
tx of giardiasis
metronidazole or tinidazole
pregnancy- paromomycin
treat contacts
58
s/s of malaria
HA and fatigue
irregular paroxysms of fever and diaphoresis (sweats)
59
dx of malaria
**giemsa stained blood smears**
rapid antigen tests
60
tx of malaria
non-falciparum- **chloroquine**
* vivax or ovale- add primaquine
falciparum- **ACTs: artemether-lumefantrin**
severe-** IV artesunate**
61
toxoplasmosis s/s in healthy pts
asymptomatic
mono-like illness
* non-tender bilateral lymphadenopathy
* sore throat
62
toxoplasmosis s/s in immunocompromised
encephalitis
pneumonitis
chorioretinitis
necrotizing brain lesions
63
congenital infection of toxoplasmosis s/s
1. chorioretinitis
2. hydrocephalus
3. intracranial calficiations
blueberry muffin rash
seizures
spontaneous abortion
64
this is the late manifestation of toxoplasmosis that may present years after congenital infection
retinochoroiditis
* eye pain
* photophobia
* glaucoma or blindness
65
what does CT scan show for toxoplasmosis
ring-enhancing lesions
66
toxoplasmosis tx
immunocompetent- self limited
immunocompromised/ congenital/ pregnancy >14 wks- **pyrimethamine + sulfadiazine w/ folinic acid**
pregnancy <14 wks- **spiramycin**
67
trichomoniasis s/s
copious, purulent malodorous frothy discharge
hemorrhages in vaginal walls
strawberry cervix
dysparenunia
males- minimal discharge
68
trichomoniasis dx
wet mount
NAAT
69
tx of trichomoniasis
metronidazole
2nd line- tinidazole
70
s/s of hookworm/ round worm
rash- pruritic at site of penetration, serpiginous tracts
lungs- cough, wheezing, low fever
GI- epigastric pain, diarrhea
nutritional def- iron deficiency (anemia) and protein loss (hypoalbuminemia, edema, ascites)
71
dx of hookworm/ roundworm
stool microscopy
CBC- eosinophilia, anemia, hypoalbuminemia
iron def
72
tx of hookworm/ roundworm
albendazole
iron supplements and vitamins
73
this type of tapeworm infection may lead to neurocysticercosis
pork- taenia solium
74
this type of tapeworm may lead to megoblastic anemia due to B12 def
fish- diphyllobothrium latum
75
this type of tapeworm may lead to pruritis ani, anorexia, weight loss and crampy abd pain and seizures
dwarf- hymenolepis nana
76
dx of non-invasive tapeworms
proglottids in stool
77
tx of non-invasive tapeworms
praziquantel
dwarf requires more than 1 dose
78
s/s of invasive taenia solium
neurocysticerosis
* increased ICP
* seizures
* AMS
* psych disease
extraneural cysticerosis- muscle and subcutaneous invovlement
79
dx of invasive taenia solium
imaging- CT and MRI
* parenchymal cysts and calcifications
lab
* CSF
* serology
80
tx cysticercosis
viable or degenerating parenchymal cysts- albendazole + corticosteroids
| if more than 2- add praziquantel
81
echinococcosis s/s
abd pain, biliary obstruction, **cholangitis**, portal HTN, cirrhosis
CP and bronchial obstruction
82
tx of echinococcosis
albendazole
83
pinworm s/s
**nocturnal pruritis ani**
insomnia and restlessness
enuresis
severe- abd pain and n/v
84
tx of pinworms
albendazole, mebendazole or pyrantel
pregnancy- only treat if severe w/ pyrantel
