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Infectious disease 3 Flashcards

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1
Q

Clinical features of fusariosis

A
  • immunocompromised patient
  • inoculated from tap water or soil
  • skin nodules + pulmonary disease + persistent fever
  • mold
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2
Q

Treatment of fusariosis

A

amphotericin

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3
Q

Diagnosis of anaplasmosis

A

serology + peripheral blood smear examination showing intraleukocytic morale

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4
Q

Specific features of anaplasmosis

A
  • leukopenia + high fever
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5
Q

Ehrlichiosis vector + location

A
  • Lone star tick

- Southeast and south central US

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6
Q

Typhoid fever clinical features + lab features

A
  • high fevers + abdominal pain + characteristic erythematous macular rash (rose spots)
  • can have elevated LFTS
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7
Q

Lemierre’s disease other term

A

septic thrombophlebitis of the internal jugular vein

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8
Q

Lemierre’s disease clinical features

A

patient with hx of recent pharyngitis + then develops sepsis + neck pain/swelling/persistent fever (infection may extend to lateral pharyngeal space or involve carotid sheath) + cavitary lung lesions

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9
Q

Typical cause of lemierre’s disease

A
  • anaerobic organism fusobacterium necrophorum
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10
Q

imaging of pulmonary aspergillosis

A
  • nodules with or without cavitation + ground-glass infiltrates
  • *halo sign (“nodules surrounded by ground-glass infiltrates)
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11
Q

other clinical feature of cdiff

A

right lower quadrant or lower quadrant abdominal pain

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12
Q

How to reduce VAP risk

A
  • semi recumbent positioning
  • oral antiseptics
  • avoid PPIs
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13
Q

Necrotizing fasciitis clinical features

A
  • commonly after surgery in a diabetic or immunocompromised patient
  • *exquisite tenderness to palpation
  • crepitus
  • hemorrhagic blisters
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14
Q

First step in management of suspected nec fasc

A

surgery consult for debridement

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15
Q

Indication for PCP pox

A

CD4 greater than 200

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16
Q

Indication for toxo ppx

A

CD4 less than 100

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17
Q

Initial therapy of neutropenic fever

A
  • anti-pseudomonal beta-lactam (cefepime OR zosyn)
  • Addition of vancomycin IF
  • Hemodynamic instability
  • severe sepsis
  • pneumonia
  • positive blood cultures for a gram-positive organism
  • suspected catheter-related infection
  • skin or soft-tissue infection
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18
Q

Presentation of acute HIV

A
  • mono-like syndrome (fever, lymphadenopathy, sore throat, athralgias)
  • generalized macular rash
  • GI symptoms
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19
Q

Management of acute HIV

A
  • combination antiretroviral therapy
  • notify partner and consider secondary ppx
  • don’t wait until resistance and genotype testing is done because people are highly infectious and the regimen can be modified as needed after it comes back
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20
Q

Treatment of leptospirosis

A

Doxy or penicillin

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21
Q

Additional intervention needed after culture with streptococcus bovis

A

colonoscopy (anaerobe)

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22
Q

Additional intervention needed after culture with clostridium septicum

A

colonoscopy (anaerobe)

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23
Q

Additional intervention needed after culture with nontyphoidal salmonella

A

HIV test

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24
Q

Additional intervention needed after diagnosis of candidemia

A

ophthalmologic examination

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25
CMV esophagitis EGD + biopsy features
EGD: sharply demarcated, linear ulcers in distal one third of esophagus Bx: intranuclear inclusions
26
HSV EGD features
EGD: well circumscribed shallow ulcers
27
CMV esophagitis treatment
IV ganciclovir
28
legionella PNA clinical features
- relative bradycardia (would expect higher for degree of fever) * no response to beta lactam abx or aminoglycoside abx **outbreaks in nursing homes
29
legionella PNA treatment
ONLY quinolone or macrolides
30
RMSF vs. ehrlichiosis
- Ehrlichiosis = leukopenia + rash starting on trunk + southeeastern and south central US RMSF = rash starting on extremities
31
Centor criteria
*tender* anterior cervical LAD *fever tonsillar exudates absence of cough
32
Infectious mono vs. Group A strep
mono = younger patient, fatigue, splenomegaly, posterior LAD
33
Epiglottitis clinical features
- SEVERE sore throat (out of proportion to findings on exam) + dysphagia - may or may not have drooling and stridor
34
Work up of epiglottitis
IF stable (no stridor) -- lateral neck x-ray
35
treatment of epiglottitis
CTX + vancomycin
36
disseminated gonorrhea presentation
- asymmetric migratory joint pain | - pustular lesions
37
cervicofacial actinomycosis clinical features
- mandibular swelling + can form abscesses, fistulas, and sinus tracts - sulfur granules
38
treatment of cervicofacial actinomycosis
IV penicillin initially then oral penicillin for 6-12 months
39
Abx associated with a high risk of Cdiff
* quinolones - clinda - cephalosporins - penicillins
40
treatment of complicated cystitis
quinolones
41
Problem with NAAT for chlamydia
- high rate of false-positive results within 3 weeks of treatment so you shouldn't retest within this time period (it's amplifying the dead organism)
42
Treatment of chlamydia in women
azithro OR doxycycline
43
Follow up of PNA
1) **IF high risk characteristics (age over 50, smoking history) -- follow up CXR 7-12 weeks after treatment is recommended to document resolution and exclude underlying malignancy 2) smoking cessation counseling 3) PNA vaccination
44
Best way to reduce transmission of HSV between partners
- chronic antiviral suppression therapy (transmission can occur with asymptomatic shedding and during prodromal phases)
45
Schistosomiasis presentation
1) Urinary -- hematuria, dysuria, frequent urination 2) Intestinal -- diarrhea, abdominal pain 3) Hepatic -- hepatomegaly, splenomegaly
46
Nocardia clinical features
- immunocompromised patients | - lung and brain abscesses
47
treatment of nocardiosis
bactrim
48
Mycoplasma pneumonia isolation precaution order
droplet
49
RSV isolation precaution order
contact
50
Heamophilus influenza isolation precaution order
droplet
51
Measles isolation precaution order
airborne
52
Medical term for genital warps from HPV
condyloma acuminata
53
What are condyloma lata?
manifestation of secondary syphilis
54
treatment of condyloma acuminata
topical therapy (trichloroacetic acid, podophyllotoxin)
55
clostridium perfringens gastrointestinal illness clinical features
- watery diarrhea + undercooked or unrefrigerated food
56
antibiotics for meningococcemia
3rd generation cephalosporin (CTX or cefotaxime) + vancomycin (added for pneumococcal infection until final culture results are available
57
what are the encapsulated organisms?
- neisseria meningitidis - strep pneumo - h influenza
58
Management of candida from respiratory culture
- no anti fungal treatment (rarely indicates invasive candidiasis, typically just bronchial tree colonization), no need to repeat respiratory culture
59
Treatment of histoplasmosis presenting as an asymptomatic nodule
- no treatment (anti fungal therapy has no effect on nodule)
60
histoplasmosis treatment
IF mild --> itraconazole | IF moderate or severe --> amphotericin
61
Management of patient with partner testing positive for syphilis
Treat empirically with single dose of penicillin
62
meaning of life
?
63
Common lab abnormalities of dengue fever
- leukopenia + thrombocytopeia
64
Treatment of symptomatic zenker divertiuclum
surgery
65
common cause of PNA in immunocompromised patients following prolonged hospitalization in early transplant period
- nosocomial infection from VRE, pseudomonas, staph, candida | * pseudomonas commonly colonizes hospital equipment
66
Yersinia pestis clinical features
- swollen and painful lymph nodules (bubo) - high grade fever - rapid progression to sepsis with PNA, meningitis, shock
67
Yersinia pestis (bubonic plague) treatment
- tetracyclines or streptomycin
68
Management of patient with exposure to bubonic plague patient
doxycycline
69
Management of asymptomatic candiduria (candida in urine culture) in patient with chronic indwelling catheter
- don't treat, remove or exchange catheter
70
gram-positive bacilli in CSF + treatment
- listeria | - ampicillin or penicillin g
71
strep pneumo microbiologic classification
gram positive cocci
72
core features of fibromyalgia
diffuse MSK pain + tenderness on exam
73
Clinical features of chancre of primary syphilis
- recent intercourse - develops at inoculation site (*can also be mouth or pharynx, anus) - painless + indurated + nontender lymphadenopathy
74
Clinical features of septic pulmonary emboli
- multiple bilateral cavitary lesions | - typically due to right-sided infective endocarditis
75
Clinical features of AIDS-related lymphomas
- low Cd4 count + long standing HIV + class NHL presentation -- B symptoms, extra nodal disease * AIDS-related lymphomas are common in advanced HIV
76
Most common AIDS-related lymphomas
DLBCL and Burkitt lymphoma
77
Time it takes for tic to be attached prior to borrelia transmission
- 48 hours
78
CD4 count at which patients are at increased risk of pneumocystis infection
CD4 less than 200
79
Immune reconstitution inflammatory syndrome (IRIS) clinical features
- Patient diagnosed with HIV, started on HAART, then presents with infectious symptoms (due to unmasking of underlying infection)
80
Management of IRIS
- continue HAART | - Rule out underlying infection (sputum cultures, etc.)
81
Intertrigo clinical features
- erythematous plaques and erosions in skin folds of intertiginous areas (fungal infection)
82
DRESS presentation
- fever, generalized LAD, facial edema, diffuse morbilliform skin rash
83
Chikungunya virus clinical features
- fevers | - severe polyarthralgias
84
Malaria clinical features
- GI (vomiting, diarrhea) + anemia + thrombocytopenia + *cyclical fevers
85
Treatment of latent syphilis
- benzathine penicillin weekly x 3 weeks
86
First line for neurosyphilis
Penicillin G IV x 10-14 days | *CTX is second line
87
First line for tertiary syphilis
Penicillin G IM x 3 doses
88
First line for primary and secondary syphilis
Penicillin G IM x 1 dose
89
who needs prophylaxis for contacts of meningococcal disease
- close contacts + healthier workers with prolonged duration or exposure to respiratory secretions * regardless of vaccination status

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