Infectious Disease 4 Flashcards
- Appearance of discharge with Bacterial Vaginosis?
- Is Vaginal inflammation present?
- What is the treatment for Bacterial Vaginosis?
- Thin, off white discharge with fishy odor.
- No
- TRX: Metronidazole or Clindamycin
- Appearance of discharge you see with Trichomoniasis?
- Is Vaginal inflammation present?
- What is the treatment for Trichomoniasis?
- Frothy, yellow-green, malodorous.
- YES
- TRX: Metronidazole. Treat Partner.
How do you treat Trichomoniasis in Pregnancy? Can you breast feed on trx?
Metronidazole 2g X 1
No. Stop breast feeding for 24 hrs and discard milk during that period.
- Appearance of discharge with Candida Vaginitis?
- Is Vaginal inflammation present?
- What is the Treatment for Candida Vaginitis?
- Cottage cheese like discharge
- Yes
- TRX: Fluconazole
- For Lyme disease, how does the time frame of attachment/feeding or the Ixodes Tick, effect transmission of Borrelia Burgdorferi?
How is tick engorgement a marker for transmission.
- At lest 36 hours of attachment is required to transmit Lyme Disease. Unlikely to get disease if <36 hours.
- Unengorged tick = unlikely to transmit Lyme disease (was not feeding long enough.)
A person gets Meningococcal Meningitis. What 5 groups of people around them should get chemo ppx to prevent the disease?
1) Household members
2) Roommates or Intimate contacts
3) Came into respiratory/oral secretion contact with infected person:
- Person intubating/ET tube care
- Kissing
- Mouth to mouth resuscitation
4) Airplane ride next to infected person >8 hours.
5) Childcare workers (infected person is a child at daycare)
What is chemoprophylaxis for those with high risk contact with an infected person with Neisseria Meningitidis (Meningococcal Meningitis?)
In what time frame should you give the ppx?
What two alternative abx can be used if first line drug is C/I?
First Line= RIFAMPIN 600 mg BID x 2 days.
(Give within 24 hours of contact)
IF Rifampin C/I bc on OCP (rifampin decreases OCP effectiveness), then give:
CIPROFLOXACIN 500mg X1
OR
CEFTRIAXONE 250mg X1
Treatment for Latent TB?
What do you do after finishing course of TRX?
Isoniazid x9mths
OR
Rifampin 4-6 mths (IF Isoniazid resistance suspected)
After finishing treatment no need to retest.
Treatment for Active TB?
Isoniazid (for full 6 months)
Rifampin (for full 6 months
Pyrazinamide (first 2 months)
Ethambutol (first 2 months)
What is the abx of choice for pediatric pneumonia in:
Preschool age children with focal lung finding?
vs
Older well appearing child with bilateral lung finding?
Preschool age children with focal lung finding: AMOXICILLIN
Older well appearing child with bilateral lung finding: AZITHROMYCIN
What is HIV-associated lipodystrophy?
Lipodystrophy higher rates of what 3 adverse pathology?
Seen in HIV +ve patient on anti-retroviral.
Loss of fat from extremities and face “skeleton face.”
Increased fat on the back of neck “buffalo hump” and increased belly fat.
Associated with dyslipidemia, insulin resistance and increase risk of CAD.
What is the most common SE of Isoniazid (trx for TB)?
Regarding this SE, what is the indication to Discontinue INH?
Hepatotoxicity.
Stop INH if:
LFTs > 5x upper limit normal
OR
LFTs >3x + Symptomatic
- What bug causes Mononucleosis?
- 4 classic Symptoms of MONO?
- Smear looks like in MONO?
- EBV
- Exudative Pharyngitis
- Ant/Post Cervical lymphadenopathy
- Prominent Lethargy/malaise + fever
- Hepatosplenomegaly
- Atypical lymphocytes - irregular nucleus and lots of cytoplasm.
Treatment of Mononucleosis?
Supportive.
Avoid contact sports for 4 weeks (splenic rupture).
What are the 4 absolute contraindications to the Varicella Zoster Vaccine (VZV, a live attenuated vaccine)?
1) Anaphylaxis to Neomycin
2) Anaphylaxis to gelatin
3) Pregnancy
4) Immunocompromised
- HIV CD4 <200
- Active Hematologic cancer
- Long term immunosuppressant therapy
