Infectious disease Flashcards
(160 cards)
1
Q
Define mild asthma:
A
speak sentences, wheezing only on exhalation, POx >95%, PEFR >70%
2
Q
Define moderate asthma:
A
speak phrases, wheezing on exhalation and inhalation, POx 90-95%, PEFR 40-69%
3
Q
Define severe asthma:
A
speak only words, wheezing on exhalation/inhalation or quiet, POx <90%, PEFR <40%
4
Q
Indication for starting controller
A
2+ exacerbations in 6mo requiring oral CS
>4 episodes of wheezing/year that last at least 1 day, interfered with sleep, has positive asthma predictive index
5
Q
What are signs of atopic disease (positive asthma predictive index?
A
1 major - parenteral asthma, atopic dermatitis
2 minor - allergen sensitization, eosinophilia >4%, wheeze without URI
6
Q
Describe criteria for intermittent asthma
A
symptoms or use of SABA <2days/wk, nightime awakenings <2x/month in 5-11yr, no interference with activity, baseline FEV1 >80%, steroids 1x/year for exacerbation
7
Q
Rx for intermittent asthma
A
SABA
8
Q
Rx for mild persistent
A
Add low dose ICS or LTRA for 0-4
9
Q
Rx for moderate persistent
A
0-4y medium dose ICS
Older pt low-dose ICS and LABA or stay on low dose ICS+LTRA
10
Q
Escalation of therapy for moderate persistent
A
Medium dose ICS + LABA or LTRA
11
Q
Rx for severe persistent
A
High dose ICS + LABA/LTRA
12
Q
Escalation for severe persistent
A
HD ICS + LABA/LTRA and oral CS
13
Q
What are indications for oral steroid use?
A
Does not respond to initial albuterol, mod to severe exacerbation, hx of recent oral steroid use, optimal albuterol therapy at home, hx of life-threatening episode, anti-inflammatory 2-4hr, improve SABA in 1-2hr
14
Q
When do you have to taper steroid use?
A
if >10 days of usage
15
Q
What are indications of well-controlled asthma?
A
symptoms/SABA usage <2/week oral CS use <1/year night waking <1/mo FEV1 or PEFR normal activity normal
16
Q
Indication for long-acting B2-agonists
A
Poor control on low to moderate doses of ICS, control of nocturnal symptoms, exercise-induced asthma
17
Q
Can you develop antibody to LABA
A
yes
18
Q
What are SE of Mg sulfate
A
flushing, malaise, hypotension and bradycardia
19
Q
What is atrovent, SE, and function
A
ipratropim, smooth muscle relaxant, can cause pupillary dilation
20
Q
First choice Rx for allergic rhinitis in young kids
A
oral antihistamine
21
Q
First choice Rx for allergic rhinitis in older kids
A
intranasal CS
22
Q
Define anaphylaxis precisely
A
acute skin + respiratory/decreased BP
2 or more (skin/mucous membranes, respiratory, cardiac GI)
Decreased BP exposed to known allergen
23
Q
Pattern: IUGR, sepsis, sensorineural, periventricular calcification, pneumonitis, hepato-splenomegaly, thrombocytopenia, dental defects
A
CMV
24
Q
Pattern: rash, IUGR, senosrineural hearing loss, cataracts/microphthalmia, PDA, pulm stenosis, myocarditis, T cell dysfunction
A
Rubella
25
Which viral infection is less likely transmitted in 3rd trimester?
rubella
26
Which virus is more often periparum transmitted
HepB
27
When is highest infectivity for varicella?
if mom ets it 5 dys before delivery to unwith 48hrs after delivery
28
Pattern: encephalitis, low birth weight, paralysis with muscular atrophy limb, increased susceptibility to infection, rudimentary digits, chorioretinitis, microophthalmia, cataracts, clubfoot
varicella
29
Pattern: high fever, cough, coryza, conjunctivitis, Koplik spots 2 days after onset, rash last 7 days, appears 4 days, brawny-coppery appearance
measles
30
Pattern: parotitis with pain and fever, epididymo-orchitis, encephalities in males, deafness
Mumps
31
Complications of measles
reactivation of TB, bacterial PNA, severe otitis media, appendicitis, laryngotracheitis, stomatitis, fatal neuro subacute sclerosing panencephalitis
32
Pattern: generalized rash, HA, lympadenopathy, fever, polyarthralgia, and polyarthritis, encephalitis
rubella
33
Pattern: rash, papules, centrally and peripherally, high vaccine failure, can have associated superinfection of staph A or group A strep
Varicella
34
Pattern: mild 7-10 days of symptoms before rash appears
Erythema infectiosum - Parvo19
35
Rx for Parvo19 chronic
IVIg for chronic
36
Complications of Parvo19
polyarthropathy, transient aplastic crisis, myocarditis, acute fulminant hepatitis
37
Pattern: high fever, rapid deferevescence --> papular rash, high seizure risk because of fever curve
HHV-6
38
Pattern: fever, exudative pharyngitis, lymphadenopathy, hepatosplenomegaly
EBV
39
Rash appear with ampicillin or penicllin exposure
EBV (can see with CMV)
40
Traveler's diarrhea
Ecoli enterotoxigenic
41
Rice water diarrhea
vibrio
42
shellfish, and salad in winter
rotavirus
43
Summer, water in wilderness, foreign travel, day care centers, flatulence, foul-smelling stools, prolonged infection with soft stools, weight loss
giardia
44
Prolonged 1-2 weeks of diarrhea or longer
cryptosporidium
45
Crampy, watery diarrhea toxin producing in mexican food, meat, poultry
C. perfringens
46
Voluminous diarrhea
vibrio
47
Fever/pulse dissociation
typhoid fever
48
Petting zoo, farm animals
shiga-toxin producing, STEC, cryptosporidium
49
Swimming
shiga-toxin, cryptosporidium
50
Petting zoo, farm animals
shiga-toxin, cryptosporidium
51
Animals
cryptosporidium, campylobacter, yersinia, nontyphoid salmonella
52
Chicken
nontyphoid salmonella, campylobacter, c. perfringens
53
Hamburger
STEC +/- HUS
54
Pork
Yersinia
55
Shellfish/salad
Norovirus
56
Raw fruits/vegetables
STEC, nontyphoid
57
Unpasteurized milk
campylobacter, nontyphoid
58
Picnic, banquet
S aureus, b. cereus, clostridium perfringens
59
Travel
Enterotoxigenic, S. typhi, shigella, vibrio cholera, giardia, cryptosporidium, entamoeba histolytica
60
fall-winter
rota, noro
61
summer
giardia, crypto, STEC
62
Hemoglobinopathy
nontyphoid salmons
63
Iron overload
yersinia
64
HIV infection
cyrptosporidium, nontyphoid salmonella
65
Day-care center
Rota, crypto, giardia, campylobacter, STEC
66
Pattern: gradual onset, fever, HA, malaise, abdominal pain, HSM, rose spots, fever/pulse dissociation
salmonella typhi
67
Pattern: 7-10 days incubation
salmonella typhi
68
Pattern: from eggs, chicken, red meat, reptiles, unpasteurized milk, ice cream, raw fruits, vegetables
non-typhoid salmonella
69
Which bacterial infection has complication of bacteremia, osteomyeltis, meningitis, abscesses in infants, sickle-cell, asplenia, HIV-infected
non-typhoid salmonella
70
Pattern: from farm animals, day care centers, intestinal cramping
campylobacter
71
Pattern: mesenteric adenitis, pseudoappendicitis, arthritis, excessive iron storage, bactermia, meningist, osteomyelitis
yersinia
72
Pattern: hematochezia, severe abdominal pain that mimics intussception, fever, blood diarrhea
stec
73
Pattern: gradual onset, abdominal cramps, diarrhea, blood and mucus, tenesmus (mimic IBD) lower quad pain, liver abscess, brain abscess
entabmoeba histolytic
74
Pattern: bacteremia, osteomyelitis, meningitis
non-typhoid, yersinia
75
Pattern: arthritis
yersinia
76
liver abscess
ent histolytica
77
prominent cramping
campylobactor, clostridium perfringens
78
pseudoappendicitis
yersinia
79
IBD like presentation
entabmoeba histolyica
80
bacterial culture
salmonella, shigella, campylobacter
81
Toxin detection
STEC, C. difficile
82
Antigen detection
rotavirus, campylobacter, c. difficile
83
PCR
norovirus, c. difficile
84
Rx E.coli
azith, ceftriaxone, cipro
85
Rx vibrio cholera
azith, doxycycline
86
Rx giardia
metronidazole, mitazoxanide, tinidazole
87
Rx crytosporidium
nitazoxanide
88
Rx shigella
azithro, ceftriaxone, cipro,
89
Rx salmonella typhi
ceftriaxone, azithro, quinolone
90
Rx non-typhoid salmonlla
Rx is not indicated if uncomplicated
91
Antibiotics may prolong carrier state
non-typhoid salmonella
92
Rx campylobacter
azithro
93
Rx ent histolytica
metronidazole
94
rose spots
typhoid fever or enteric
95
petechiae/purpura
meningococcal disease
96
ecthymus grangrenosum
pseudomonas in immunocompromised pt
97
pustule and skin abscess
s aureus
98
macular --> petechiae --> necrosis
RMSF
99
With which maternal infection would you need to stop breastfeeding period?
HIV, brucellosis, HTLV-1, 2, HepC
100
With which maternal infection can you breastfeed, but most pump
Varicella, CMV, untreated TB, active HSV lesions on breast
101
Malnutrition impairs what arm of immune system?
Both innate and adaptive
102
Malnutrition puts you at risk particularly of which disease?
Higher risk for TB
103
How do you test for congenital CMV?
Stool, urine, respiratory tract or CSF within 2-4 weeks of birth or PCR
104
How is CMV transmitted beyond neonatal period?
urine, respiratory secretions, blood, organ or hematopoietic stem cell transplantation
105
Pattern: blueberry muffin, thrombocytopenia, IUGR, microcephaly, cerebral atrophy, periventricular intracerebral calcification, hepatosplenomegaly, jaundice, chorioretinitis, sensorineural hearing loss
CMV
106
What cause oral hairy leukoplakia as early manifestion of HIV?
EBV
107
What is EBV associated with?
X-linked lymphoproliferative syndromes, Burkitt lymphoa, nasopharyngeal carcinoma in southeast Asia
108
What is the incubation period for EBV?
1-2 months
109
Pattern: <4yo, rash, hepatosplenomegaly, prolonged fever
EBV
110
What are the compliciations of EBV infection?
Airway obstruction, neurologic complications, severe hepatitis, myocarditis or hemolytic anemia
111
What antibiotic can cuase rash in mono patients?
ampicillin
112
What is the management for mono?
supportive care
113
Pattern: transplant recipient, fever, rash, hepatitis, bone marrow suppression, PNA, encephalitis and graft rejection
HHV-6
114
Most sensitive test and most commonly used test for rotavirus
PCR - most sensitive
| ELISA most commonly used
115
Reservoir for west nile virus
avian-mosquito-avian
116
Season for west nile
summer or early fall
117
Risk factors for HepC virus
Infected mother, recipients of blood before 1992, international adoptees and refugees, HIV-infected children, adolescnts with IV drug use, multiple sex prtners, victims of sexual assault, unintentional needle stick
118
Whenshould you evaluate newborn suspected of HCV?
RNA between 2 and 6 months, antibodies after 15 months
119
Agent: brain abscesses, oral nd dental infections, deep neck, intra-abdominal, pelvic, necrotizing soft tissue
anaerobic
120
Two bacteria most common causes of pharyngitis
Strept and arcanobacterium haemolyticum
121
Difference in testing for strept and a. hemolyticum
A hemolyticum - grows on sheep blood agar, colonies are smll, have narrow hemolysis
122
Rx for Arcanobacterium
erythromycin
123
What must you think of with FUO >8 days
Brucella
124
How can you get Brucella?
unpasteurized dairy products, inoculation of infected animal fluids, inhalation
125
What are symptoms of brucella?
fever, sweating, osteoarticular, hepatosplenomegaly, transaminitis, arthritis (monoarticular) affecting knee and hip, bone marrow suppression
126
What is unique about treatment of brucella?
Prolonged treatment because of intracellular pathogen
127
Pattern: microabscesses in hepatosplenic cat scratch
bartonell
128
Rx for mild to mod c difficile
metronidazole
129
Rx for severe c difficile
oral vancomyocin
130
How is severity measured for c difficile infection?
presence of ileus, megacolon or shock
131
Pattern: cericovaginal discharge, intermenstrual bleeding, lower abdominal pain, cervical friability
gonorrhoeae
132
Rx for N gono
Ceftriaxone x 1 shot and 1 dose of azithromycin or doxy for 7 days BID
133
Pattern: viral from URI, mouth sores, respiratory then goes to bones
kingella kingae
134
Rx for kingella
penicillins and cephalosporins
135
Who should receive ppx for individuals exposed to N meningitidis
rifampin, ceftriaxone, ciprofloxacin for household members, daycare, childcare center , contact occurred at any time during 7 days before symptom onset, direct exposure to oral secretions
136
Cat bite
pasteurella
137
Rx pasteurella
Penicillin or azithro
138
Pattern: fever, chills, malaise, headache, myalgias, vomiting/diarrhea, rash, DIC, respiratorydistress syndrome, renal failure and encephalopathy
Rocky Mountain spotted fever
139
Pattern: cellulitis, impetigo, uruncles, abscesses, lymphadenitis, more invasive (bacteremia, pneumonia, pyomyositis, osteo)
staph aureus
140
Rx for staph aureus
mild, incision/drainage, obtain specimen for culture and oral antibiotics
Severe - empiric vancomycin+nafcillin
141
Suspect what bacteria with IV cath in place for >3 days
S epi
142
Pattern: acute pharyngotonsillitis and impetigo develops 7 to 10 days after
GAS (pyogenes)
143
Pattern: hepatosplen, snuffles, cutaneous lesions, edema lymphadenopathy, steochondritis, PNA, pseudoparalysis, hemolytic anemia, thrombocytopenia
congenital syphilis
144
Pattern: 8th CN deafness, interstitial keratitis, peg-shaped incisors, mulberry molars, frontal bossing, saddle nose, tibial bowing, swelling of knees, ulceration, desquamation, palpable lesions
syphillis
145
Syphillis treatment
IV penicillin
146
Pattern: malaise, fever, cough, chest pain, headache, and myalgias (Valley fever) unilateral pulmonary infiltrate, hilar adenopathy or pleural effusion, erythema nodosum, erythema multiforme, erythematous maculopapular rash
coccidioides
147
Dx for coccidiodes
CXR
148
Pattern: hydrocephalus, cerebral calcifications, and chorioretinitis
Toxo
149
Pattern: sequelae learning disability, mental retardation, hearing loss or vision impairment later in life
Toxo
150
Rx for tox
pyrimehtamine plus sulfadiazine
151
Which plasmodium?
| Indian and subcontinent and central america
P vivax
152
Which plasmodium?
| AFrica, Papua New Guinea, Haiti, DR
P falciparum
153
Which plasmodium? West Africa
P ovale
154
Which plasmodium?
| worldwide
malariae
155
Pattern: fever, chills, rigors, HA, paroxysmal, nausea, vomiting, diarrhea, abdominal pain, arthralgias, myalgias, and respiratory symptoms can occur, H/P
malari
156
Which plasmodium? hepatic infection
vivax and ovale
157
Which plasmodium? nephrotic
malariae
158
Pattern: blood stools, severe abdominal pain and fever
entabmoeba histolytica
159
rx for e histolytica
metronizdazole or tinidazole
160
Pattern: chlorine tolerant associated with contaminated drinking and recreational water, nonbloody diarrhea but watery lasting 1 to 2 weeks
crypto
