Infectious Disease Flashcards by Isaac Morrise

Bartonella

Cat scratch disease
Gram negative
Granuloma or pyeogenic abcess
Manage with Azithromycin, Cipro, Aminoglycosides

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Paralysis of botulism

Descending symmetric paralysis

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Campylobacter

Bloody diarrhea with abdominal pain
Gram negative
Poultry, Dairy and Petting Zoos
Fluids and Cipro

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GI bug NOT to use cipro for

E coli H157:07

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Chancroid

Very rare STI
Haemophylus Ducreyi - gram negative
Multiple painful lesions
Z-max, rocephin, cipro

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Management of chalmydial pneumonia

Tetracycline MC

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Cholera

Most people die of electrolyte imbalance
Rice water stool - Dark field microscopy
FLuids and electrolytes
Tetracycline od macrolide

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Diptheria

Gram positive bacillus
Pseudomembrane with bleeding
Severe lymphadenopathy
Antitoxin with PCN of erythromycin

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E coli O157:H7

Produces shiga toxin
Hamburger or raw vegetables
Hemolytic uremic syndrome
NO ABX - look for renal failure and thrombocytipenia to rule in

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5 drugs that can treat MRSA

Vancomycin
Linezolid
TMP/SMX
Daptomycin
Ceftaroline

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5 Major Jones criteria

Carditis
Polyarthritis
CHorea
Erythema Marginatum
SQ nodules

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5 minor jones criteria

Arthralgia
Fever
Elevated ESR
Increased CRP
Prolonged PR interval

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Titer indicating possible rheumatic fever

ASO titer

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Rocky Mountain Spotted Fever

Influenza prodrome followed by a rash
Peripheral to central spread
Manage with doxycycline

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Salmanellosis

Reptiles!!
High volume pea soup diarrhea NO BLOOD
Salmon colored maculopapular rash (may look like pityriasis rosacea but with diarrhea)

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Shigellosis

Bloody diarrhea
Raw vegetables and cold salads
LLQ cramping and abd pain
Cipro to treat

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Significance of fecal WBCs

Inflammation
Can be infection, radiation, or IBD

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Tetanus immunization prophylaxis protocol for wounds

Unknown or under 3 doses - Td and TIG IF not a clean minor wound - pretty much all wounds
3+ doses - None needed

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Management for mucocutaneous, vulvovaginal and disseminated candidiasis

MC - Clotrimazole; FLuconazole in AIDS
Vulvovaginitis - Micoconazole or Clotrimazole
Disseminated - FLuconazole, AMph B

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Cryptococcus

Fungal meningitis with increased lymphcytes - seen with india ink or latex agglutination titers
Western US in pigeon excrement
Amphotericin and flucytosine for CNS
Fluconazole for pulmonary

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Histoplasmosis

Ohio river and Mississippi river valleys
Pneumonia and miliary pattern
Itraconazole - may need amphotericin

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Coccidiodmycosis

Southern Cal to texas
FLuconazole or Itraconazole
May use amphotericin B
Soil

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Blastomycosis

Northwestern
Decaying wood
Itraconazole or amphotericin B

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Pneumocystis

HIV with CD-4 under 200
Infiltrates with spared apices
Elevated LDH and silver stain
Bactrim or pentamidine
Clinda plus primaquine in mild cases

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When to use prednisone for pneumocystis

Prednisone if paO2 NOT spO2 under 70!!

Mycobacterium Avium Complex

Disseminated disease with pulm disease Z-max

Leprosy

Skin lesions and peripheral nreve involvement Foot pads of armadillos Dapsone, rifampin, clofazimine

TB PE finding

Post tussive rales

Indication to treat TB for 9 months

Cavitary lesion present on CXR All others 6 months

Indication to switch TB tx to INH and rifampin

Cultures negative after 2 months of tx

Management of latent TB

9 months INH with B6 Positive PPD with no evidence of active disease

TB Quad THerapy

RIfampin (Red) red orange secretions and urine) Isoniazid (Ice) Periferal neuropathy Pyrozinamide (Pedal) Gout, also hepatotoxic Ethambutol (Eyes) Visual problems

AMebiasis

Colitis, abd pain, bloody diarrhea Liver abscess Metronidazole or Iodoquinol

3 parasites treated with Metronidazole (GET)

GIardia Entomoeba Trichomonas

Giardiasis

Hiking or camping FOul smelling non-bloody diarrhea, no WBCs Metronidazole

Trichamoniasis

Hookworm Ground itch, Cough, Abd symptoms Feet to Lungs to GI life cycle Albendazole to tx

Ascariasis

Gotten by ingesting eggs Roundworm Albendazole

Parasite causing vitamin B deficiency

Diflobotrin latam - fish tapeworm

Dx for malaria

thick and thin blood smears

Management of malaria

Blood and liver stages - need different tx Chloriquine and hydroxychloroquine MC

Pinworms

Enterobiasis Perianal itching with scotch tape test - oval shaped ALbendazole no eosinophilia Prophylax family

Toxoplasmosis

Cat litter or raw meat COng. transmission possible CT scan with ring enhancing organisms Pyrimethamine, FOlinic acid, sulfadiazene or clinda

Trichamoniasis

Rancid odor and green discharge Strawberry cervix Metronidazole

Zika virus

Most asymptomatic Congenital defects - have to limit exposure Carribean islands

Dx of septic shock

Fluid bolus does not improve MAP

Dx of sepsis

Look for multiple system issues

Approach to selecting abx for septic patients

Cover gram negatives, gram positives, and anaerobes

Management of lyme disease

Doxycycline, AMoxicillin, or Cefuroxime

Tests for lyme disease

Dark field exam Rapid Plasma Reagin and Venereal Disease research Lab - not specific Treponeamal Elisa - Specific FTA ABS - Confirmatory test PCN - can use doxy

Late syphillis

Finds its way to blood vessels Can get neuro at any time

Argyll RObinson pupils

Small irregular pupils reactive to accommodation but not to light

Cytomegalovirus

Herpes family Mono-like illness without pharyngitis Gancyclovir or foscarnet

Test for mono

Heterophile antibody test

Erythema infectiosum

Parvo B-19 Slapped cheek appearance Usually not a problem

Management of Herpes

Acyclovir (IV for enchepalitis). Famcyclovir, Valcyclovir (second two for proph)

Opportunistic HIV infections at 100-200 CD4

PCP, Histoplasmosis

Opportunistic infection for HIV at CD4 of 50-100

Toxoplasmosis and cryptococcus

Opportunistic HIV infections for CD4 under 50

MAC CMV retinitis PML

Opportunistic infections for HIV with CD4 of 200-500

TB, THrush, Zoster, Lymphoma, Kaposi

HPV pathology

Prickle cells

HPV types

1-4 Skin warts 6 and 11 - Genital warts Cervical dysplasia - 16 and 18

HPV vaccination schedule

start at 11-12 3 doses if starting older than 15

Measles

Resp transmission Fever, cough coryza - rash days later with continued fever koplick spots Head to trunk rash

Mumps

Swollen glands, testicles, etc. Supportive

Rabies

Multiplies at site of bite and spreads Everone gets the vaccine, IG for those who have never gotten the vaccine

Roseola

Herpes virus 6&7 High fever that breaks into a rash Febrile seizures Support

Rubella

Prodrome with rash after fever Face to trunk to extremities THrombocytopenia - can cause catartacts and PDA congenitally

Management of post herpetic neuralgia

Gabapentin Amytriptiline - old tx

Gram positive cocci

Staph and strep (S. pneumo are diplococci) Enterococci

Gram positive rods

Corneybacterium Listeria Lactobacillus Propionibacterium

Gram negative cocci

Neisseria

Gram negative rods

E coli Klebsiella Enterobacter Pseudomonas

Infectious Disease Flashcards

(72 cards)