IFNX III Flashcards
1
Q
What is the most common cause of cestode infx worldwide
A
H. Nana
2
Q
What is the TxOC for Hymenolepiasis
A
Praziquantel (biltricide) and Supportive Care
3
Q
What are the two types of Taneia
A
T. Solium (pork) and T. Saginata (cow)
4
Q
What is the most common feature of Taeniasis (Solium and Sagintata)
A
Passage of proglottids in the stool (passive and active BM)
Assoc with. Appendicitis and Cholangitis
5
Q
What is the TxOC for T. Solium and T. Saginata
A
Praziquantel
And surgical removal for clogged areas. (Appendicitis, Cholangitis, ect)
6
Q
What causes cysticercosis
A
T. Solium (pig)
Common from areas in asia, rising in SoCal (10% of all SZR in SoCal)
7
Q
What is the most common parasitic infection of the CNS
A
Cystiercosis from T. Solium
8
Q
A pt from SoCal recently traveled to asia presents with a SZR, think of what parasite
A
T. Solium, ( Cysticersosis )
9
Q
A pt presents with calcified intramusular nodules, think what parasite
A
T. Solium
10
Q
What shows up on stool sample for cystercercosis
A
The Taenia not the cystercosi
11
Q
What is the Tx approach to cystericosis
A
1st priorty is SZR treatment and possibel surgery
Albendazole and Praziquantel
+dexamathasone
12
Q
A pt presents from Russia after eating fresh water fish, what is the possible parasite
A
Diphyllobothriasis (fish worm/eggs)
13
Q
A pt presents with fatigue, diarrhea, dizzyness, low h/h, low b12 and folate (megoblastic anemia) , numbness of the extremities, all from eating fresh water fish
Think..
A
Diphyllobothrium
14
Q
What is the TxOC for diphyllobothrium
A
B12 and Folate supplementation + praziquantel
15
Q
Is eosinophilia presnt in protazoan infections?
A
NO!
16
Q
What are the three blood flukes
A
S. Haematobium (africa/ ME)
S. Japonicum (Far east)
S. Mansoni ( Africa, South/ Central America)
17
Q
S. Haematobium is a common cause of what cancer
A
Long term infx inplicated in bladder cancer, possible bue to anatomica relationship to vesicle plexus
18
Q
What is the TxOC for schistomiasis
A
Praziquantel
19
Q
What is the TxOC for fascioliasis
A
Triclabendazole
20
Q
A pt presents from eating crawfinsh, with uticaria, N/V/D, abdominal pain
Think
A
P. Westermani
21
Q
What is the TxOC for paragonimiasis (crawfish trematode)
A
Praziquantel
22
Q
A parent presents with thier child from running around barefoot down in the south, father found a worm in the childs diaper after two days of diarhhea
Think of what parasite
A
Strongloidiasis
23
Q
What is loefflers syndrome
A
A minifestation of strongyloidiasis
Pulm infections from the worms migration
24
Q
What is the TxOC for strogyloidisasis
A
Ivermectin and/or Abendendazole
25
What are the two hookworms
Ancylostoma duodenal
Necator americanus
26
A pt presents with iron deficiency, has a ground itch at site or parasite bite, Pt is a young child that was running around barefoot
Think
Hook worms
27
What is the TxOC for hookworms
Abendazole
| Mebendazole
28
What is the largest nematode and is the most common helmith worldwide
A. Lumbricoides
29
A pt presents coughing up a worm, think of what round worm
Ascariasis
30
What is the TxOC for a pt coughing up a worm
Aka ascariasis
Tx with abendazole or mebednazole
31
What is the only host for enterobius vermicularis
Humans
32
A pt presesnt with nocturnal anal puritis,
Think of what nematode
E. Vermicularis
33
What is the TxOC for Human Pin worms
Mebendazole
34
A pt presents with small tunneling on the feet and inbetween the toes…
Think what round worm
Ancylostoma caninum
| Cutaneous larva migrans
35
What is the TxOC for Cutaneous Larva Migrans
Albendazole
Ivermectin
And wear shoes!
36
What is the cause of Visceral and Ocular larva migrans
Toxocariasis from the larva of T. Canis and T. Gati
37
A pt presetns with fever, visceral larva migrans, anorexia, wt loss, heptaosplnomegaly, with ophtamlic lesions, and visual disturbances, and cataract appearnace
Think of what round worm
Toxocariasis
38
What is the TxOC from toxocariasis (visceral and ocular larva mirgans)
Albendazole and/or Mebendazole
39
A pt states he is an avid hunter, and loves to eat bear, pigs, and deer, he hunts mainly in the US
Presents with signifigant pain, perirobital and facial edema, and a very HIGH fever, conjunctivitis, and SPLINTER hemorrhages
Think what parasite
Trichinellosis
40
What is the Tx of Choice for Trichnellosis
Albendazole and/or mebendazole
41
What is the test of choice to find amebias
EPP PCR ( enteric parasite panel)
42
What is the TxOC for amebiasis
Metronidazole
Tinidazole
Iodoquinol Luminal Agent
Paromomycin Luminal agent
For fulminant- SRGRY
43
A pt presents with fever, wt loss, diffuse abd tenderness, may be in the RUQ
Hem pos stools
+/- jaundince
Think
Amediasis
| Or liver abscess amebiasis
44
What is the most common parasite ID’d in stool specimins
Giardia Lamblia
45
A pt presents after camping in the western US ( can also be in day cares)
Mode of transmission often fecal oral from contaminated water ingestion
S/s: diarrhea, abd distention , cramps, Nausea, with foul greasy, frothy stools, flactulence,
Think giardiasis
46
What is the DxOC for Giardias
EPP PCR
Finding trophozites or cysts
47
What is the TxOF
Tinidazole
Or metronidazole
There are no surgical options as it may resolve spont.
48
What are the two types of leishmaniasis
Cutaneous and visceral
49
Where are the promiment regions for visceral leishmaniasis
India, bangladesh, Napal, Sudan, Brazil
50
What is the zector for leishmaniasis
Sand flys (L. longipalpis)
51
A pt presents with lesions exposed skin, with a raised edge and a central crater
Current deployed to the M/E
Think
Lieshaniasis from a sand fly bite
52
What are the S/s of Black fever
Aka visceral lieshmaniasis
Recurrent high fever, Wt loss, signifigiant splenomegaly / hepatomegaly , post kala-azar dermal lesions
Can coexist with HIV
53
A pt presents with recurrent fevers, darkening of the skin, with hepatosplenomegaly, on CBC has pancytopenia
Think
Visceral leishmaniasis
54
A pt presents (may be a child or HIV comp)
With watery diarrhia, with wt loss, low grade fever, and pancreatic involvment , RUQ/epigastric pain, with hyperactive bowl sounds
From swimming in contaminated or recreational water like water parks (not common in the south)
Think
Cryptosporidiosis
55
Cryptospordosis likes to infect HIV at what CD4 count
200
Esp. Less than 50
56
What is the TxOC for Immuncomp vs Comp Cryptosporidiosis
Immunocomp is HAART Tx
COmp: No tx ind, may use nitazoxanide , S/s care
57
A pt presesnts after hiking in the appalachians, says they were bitten by a tick
Has fever, chills, diaphoresis, and then prostration, malaria like illness
Think
Babesiosis from B. Microti (Tick)
58
What is the progression of S/s of babesiosis
Looks almost exactly like malaria
But didnt travel
Starts as chills to fever, to diaphoresis, to prostration
59
What is the TxOC for Babesiosis
Clindamycin +quinine
60
Where is malaria most common
90 percent of cases are from africa
61
What is the vector for malaria
Anopheles mosquito
62
What is the most widespread malaria type
P. Vivax
63
What is the pathophys of malaria
Sporozoites migrate into hepatocytes (liver phase) within minutes emerge into the bloodstream after a few weeks
Rupture of infected erythrocytes lead to fever and merozoite release
64
What is the time frame for fever for P. Knowlesi
24 hrs
65
What is the time frame of fever for P. Faliparum, Vivax and Ovale
48 hrs, can be sporadic
66
What is the time frame for fever for P. Malariae
72 hrs
67
What is the most severe type of malaria
P. falciparum
68
A pt presents with fever, HA< mild anemia
May be immune/partially immune/non-sterile/innate immunity
Recently travelled from africa
Think
Malaria
69
Why is P. falciparum so bad
Targets all RBCs causing severe anemia
70
A pt presents with splenic rupture, may ben in a coman, with severe anemia and renal failure
Malaria
71
Chronic P. malariae leads to
Nephrotic syndrome
72
On labs, a pt presents with no eosinophilia, with acute renal fialure, elevated bilirubin, and hypo glycemia
Think
Malaria
73
What is the Dx OC for malaria
Thick and thin smears
Three smears apart seperated by 12-24 hours
74
When should prevention for malaria be started
1-2 weeks before
Doxy every day
Atovaquone/proguanil every day (only 7 days post)
Primaquine everyday (14 days post)
Chloroquine every week (has resistance)
Mefloquine every week ( causes sleep d/o)
75
What is the TxOC for severe malaria (P. falciparum 14 day incubation)
IV artesunate
76
Should steroids be used for malaria
No, can make cerebral s/s worse
77
What is the infx rate of animal bites
80%
78
What is the DOC for dog bites
Augmentin ( Amoxicillin with clauvanate acid)
79
What is the most common pathogen of cat bits
Pastruella multocida
80
What is the most common pathogen in dog bites
Capnocytophaga canimorsus
But 2nd is P. Multocida
81
How are dog/ cat bites treated on the face vs hands
Facial wounds rarely become infected and can be closed right away
Wound on the hands should be left open, as well as hands older than 6 hours (primary closure)
82
What is the agent of cat scratches
Bartonella henselae
83
What is the most common S/s of cat scrathes
Adenopathy in children
84
How does cat scratch fever present
Hx of contact with a cat
Rash (along lymph path)
Lymhpadenitis
FUO
Parinaud oculoglandular syndrome in 2-3% of pts
85
What is the TxOC for Cat strach dz/ Fever
Immunocompenten with class s/s
Azithromycin
86
Who is the risk to (mother or fetus) with toxoplasmosis
Fetus!
87
A pt presents with cervical lymphadenopthay
Fever, malasie, night sweats, HA, myalgias, pharyngitis
Has either been around cats or hunters who ate uncooked deer meat
Think
Toxoplasmosis
88
A pt with aids that has toxoplasmosis will present how
Toxoplasmosis encephalitis
89
What is the Tx for Tocoplasmosis in aids pts
(LOOK UP ANSWER, Pet assoc dz)
90
A pt presents with skin truama around an aquarium/ or coral Salt water,
Has a papulue that has ulcerated, with localized pain and induration, may have tendon or septic arthritis
Think
M. Marinum
91
What is the Tx for M. Marinum
Clarithromycin
Ethambutol
+ rifamipin
X 1 moth
92
A pt presents from a trip to africa, was playing with horses, possumsm and dogs,
Has a scratch on the leg, that has become infected and has large ulcers and plaques,
( look up the MYCOBAT that fits this, after M. Miranum)
93
Leprosy is common from contact with what animal>?
Armadillos
94
Skin lesions with deminished sensations with peripheral neuropathy suggestive of
Bilateral ulnar neuropathy is suggestive of
Leprosy
95
What are the DOC for leprosy
Rifampin, dapsone and clor(something?)
96
M. Chelonae is associted with what animals
soil, frogs
97
A pt just got a new tattoo, what mycobacterium could they have gotten
M. Chelonae
98
A pt presents from a tropcal area, swimming in the water, is possible infected with the most common zoonosis in the world
S/s: Icterus (severe),
leptospirosis ( look up other s/s)
99
What are the classic S/s of leptospirosis
( look at pet associated Dz, lecture 3)
100
What is the Tx for severe vs outpt leptospirosis
Severe: IV Pen G
( Look Up outpt) lectue before encephalitis
101
A pt presents with exterme lethargy, flaccid paralysis, leukopenia from being bit by a mosquito
Think
West nile/ Encephalitis
102
A pt presents with fever, nuchal rigidity, and AMS
Think
Meningitis
103
Look at meningitis Diffferential slide and know it
Lecture 3 slides (meningitis)
104
What is the #1 cuase of bacterial menigits
N. Meningitidis
105
What is the most common meningitis in neonates
Group B
| Look up others and add
106
What is the tx for strep pneumo
Cefotaxaine or Ceftriaxone + ( one other drug, look up to add in meningitis lecture )
107
Know the listeria monocytogens slide
108
A pt presents wtih parasethisa/ pain at a bite with tingling, or itchy feeling at a site of a bite even after healing…
Think
Rabies
109
What is the most reliable test of infection during the first week of rabies
Nuchal skin biopsy with Negri Bodies ( eosinophilic cytoplasmic inclusions)
110
What is the tyopical test for clinical Dx of rabies
Serum rapid fluorescent focus inhibition test (RFFIT)
111
What is the Tx approach to rabies
Optimal results require the following:
1. Immediate vigorous wound cleansing
—Solution of 1 part soap and 4 parts water
2. Passive and active immunizations
Prevent progression to full-blown rabies
3. Vaccines commonly available
—Human diploid cell vaccine (HDCV)
—Purified Chick Embryo vaccine (PCEC)
112
What is the pre exposure immunization for rabies
Primary IMM on days 0, 7, 21, 28
And A booster in the deltoid
113
What is post exposure IMM for rabies
Vax on days 0, 3, 7, and 14 if no prior IM
Or On days 0 and 3 if prior IM
