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Infectious Disease Flashcards

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1
Q

Gram positive bacteria

A 
Streptococcus (Group A, B, C, D, F, G)
Staph aureus (MSSA and MRSA)
Listeria
Bacillus
Pneumococcus
Tuberculosis and nocardia
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2
Q 
Gram positive (anaerobes)
Gut and skin and soft tissue
A

Peptococcus

Peptostreptococcus

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3
Q

Gram negative (enteric)

A

E. coli
Klebsiella
Proteus
Pseudomonas aeruginosa

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4
Q

Gram negative (respiratory)

A

Hemophilus spp.

Neisseria

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5
Q 
Gram negative (anaerobes)
GI tracts and environmental infections
A

Anaerobic Gram negative rods (Bacteroides fragilis)

Anaerobic Gram positive rods (Clostridium spp.)

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6
Q

Spirochetes

A

Syphilis

Borelia spp. (Lyme disease and others)

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7
Q

What to consider when thinking about medications

A

Always ask the question, “What am I trying to treat?”
FQs (Levo, Cipro, Moxi) esp if given with steroids have a black box warning for tendon rupture
Bactrim (TMP-SMX) is a great drug for staph, strep coverage is poor
Keflex is good for non-specific skin infections when MRSA is NOT suspected
For facial swelling, think clindamycin

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8
Q

Lab for Candidiasis

A

KOH prep

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9
Q

Tx for oral candidiasis

A

Clotrimazole troches, nystatin swish and spit. HIV usually need oral and/or prophylaxis

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10
Q

Tx for vulvovaginitis candidiasis

A

Uncomplicated may be treated with single Diflucan (fluconazole), 3-5 days of tx with terconazole, miconazole
Pregnant must use topical azole

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11
Q

Tx for cutaneous candidiasis

A

Topical nystatin or iconazole creme

Topical nystatin creme AND nystatin powder

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12
Q

What is found mostly in soil and pigeon droppings?

A

Cryptococcus neoformans

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13
Q

What is found in soil contaminated with bat or bird droppings?

A

Histoplasma capsulatum

Sx mimic influenza

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14
Q

Tx for Histoplasmosis

A

Itraconazole 200 mg/day divided in 3 doses for mild to moderate forms (sx < 1 mo). Oral solution is best

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15
Q

What type of population commonly has Pneumocystis jiroveci?

A

HIV pts, among others

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16
Q

Tx for Pneumocystis jiroveci?

A

TMP-SMX, steroids, Dapsone goold alternative tx
Alternative: Clinda + Primaquin
Pts often get worse at the start of tx
All pts with CD-4 count below 200 cells/microL need prophylactic, TMP-SMX drug of choice

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17
Q

Pneumocystis

A

Caused by a fungus commonly found in the lungs of people and many animals. Airborne, lies latent in alveoli.

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18
Q

Sx of pneumocystis

A

Fever
SOB
Non-productive cough

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19
Q

CXR of pneumocystis

A

Diffuse, patchy, miliary infiltrates. May develop spontaneous pneumothorax, fatigue, weakness, weight loss

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20
Q

Cause of acute rheumatic fever

A

Group A Beta-hemolytic strep pyogenes

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21
Q

Sx of acute rheumatic fever

A 
Fever
Sore throat
Body aches
Joint pain
Tachycardia
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22
Q

Chorea

A

Also known as Syndenham’s chorea, or St. Vitus dance. There are abrupt, purposeless movements. This may be the only manifestation of acute rheumatic fever and its presence is diagnostic. May also include emotional disturbances and inappropriate behavior.

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23
Q

Pathophysiology of botulism

A

Clostridium botulinum. Prevents the release of acetylcholine at neuromuscular junctions and autonomic synapses.

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24
Q

Pharmacological tx of botulism

A

Trivalent antitoxin

Potassium channel antagonists (Ibutilide, Dofetilide, sotalol) may provide symptomatic relief

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25
Interventions for chlamydia
Doxycycline 100 mg BID x 7 days or Azithromycin 1 gm PO x 1 Pregnancy: Azith or Amzx 500 mg PO BID x 7 days Trachoma conjunctivitis: Azith 1 gm PO x 1 Alternate: Tetracycline 250 mg QID x 14 days
26
Hx and physical exam of cholera
Sudden severe frequent watery diarrhea liquid stool is gray, without odor, blood, or pus "rice water stool"
27
Interventions for cholera
Fluids! Fluids! Fluids!
28
Etiology of shigellosis
Gram negative facultative non-motile rod | Enterotoxin
29
Pharmacological tx for shigellosis
Cipro Levo Azithromycin
30
Hx and physical exam for diphtheria
Nasal infection produces few sx aothan than a nasal d/c. Laryngeal infection may lead to upper airway and bronchial obstruction. In pharyngeal diphtheria, the most common form, a tenacious gray membrane covers the tonsils and pharynx. Mild sore throat, fever, and malaise are followed by toxemia and prostration
31
Pharmacological tx of diphtheria
``` Antitoxin, which is prepared from horse serum, must be given in all cases when diphtheria is suspected. PCN Erytho Azithro Clarithro ```
32
Etiology of gonococcal infections
N. gonorrhoeae, a gram-negative diplococcus
33
Hx and physical exam of gonococcal infections
Urethritis and cervicitis Disseminated disease- Purulent arthritis or the triad of rash, tenosynovitis, and arthralgias Conjunctivitis
34
Pharmacological tx of gonococcal infections
250 mg dose of intramuscular ceftriaxone in combination with a second drug (azithromycin or doxycycline)
35
Pathophysiology of tetanus
Tetanospasmin acts at the spinal inhibitory neurons, where it plays a protein needed for release of neurotransmitters
36
Hx and physical exam of tetanus
Stiffness of the jaw, neck stiffness, spasms of the jaw muscles (trismus) or facial muscles and rigidity and spasm of the muscles of the abdomen, neck, and back
37
Pharmacological tx of tetanus
Tetanus immune globulin, 500 units IM within first 24 hrs of presentation PCN, 20 million units IV daily in divided doses
38
Prevention/maintenance for tetanus
Primary immunization of adults, Td as two doses 4-6 weeks apart, with a third dose 6-12 mos later. For one of the doses, Tdap (tetanus toxoid, reduced-dose diphtheria toxoid, acellular pertussis vaccine) should be substituted for Td
39
Lab and diagnostic imaging for helminth/pinworm infestations
"Scotch tape" test (90% sensitivity when performed x3)
40
Pharmacologic tx for helminth/pinworm infestations
Ivermectin | Mebendazole (pinworms)
41
Etiology of malaria
Plasmodium vivax is about as common as P. falciparum
42
Prevention/maintenance of malaria
``` Prior to travel: Chloroquine Doxycycline Mefloquine Primaquine Hydroxychloroquine Prevention of mosquito bites DEET ```
43
Central sx of malaria
HA
44
Systemic sx of malaria
Fever
45
Muscular sx of malaria
Fatigue | Pain
46
Back sx of malaria
Pain
47
Skin sx of malaria
Chills | Sweating
48
Resp sx of malaria
Dry cough
49
Spleen sx of malaria
Enlargement
50
Stomach sx of malaria
N/V
51
Hx and physical exam of malaria
Recent travel to endemic area. Classic paroxysm includes chills, high fever, and then sweats Fevers become regular (with 48 hrs P. vivax and P. ovale or 72 hrs with P. malariae)
52
Pathophysiology of salmonellosis
Fecal-oral route (eggs, undercooked chicken, dairy products)
53
Interventions for salmonellosis
Fluids and electrolyte replacement mainstay of therapy
54
Etiology of toxoplasmosis
Toxoplasma gondii is an obligate intracellular protozoan parasite
55
Lab and diagnostic imaging for toxoplasmosis
ELISA most commonly used
56
Pharmacological tx of toxoplalsmosis
Initial regimen of choice is pyrimethamine plus sulfadiazine, clindamycin for those allergic to sulfadiazine Alternative: Pyrimethamine + atovaquone or azithromycin
57
Hx and physical exam of Lyme disease
Regional adenopathy, low-grade intermittent fever, HA, myalgia, arthalgias, fatigue, malaise, classic "bulls-eye" rash (erythema migrans)
58
Pharmacological tx of Lyme disease
Doxycycline 100 mg BID x 10 days, 2nd line amoxicillin. For cardiac, CNS, meningitis, see Sanford. Amoxicillin recommended for treating pregnant pts
59
Hx and physical exam of Rocky Mountain spotted fever
Most cases late spring and summer American dog tick int he east Rocky mountain wood tick in the west
60
Etiology of syphilis
Treponema pallidum (spirochete)
61
Hx and physical exam of syphilis
Primary: single chancre: indurated, firm PAINLESS with raised borders Secondary: enters the bloodstream, generalized maculopapular rash, fever, diffuse adenopathy, thinning of lateral 1/3 of eyebrows
62
Hx and physical exam of infectious mono
``` Sore throat Fever Malaise Tender splenomegaly Tender posterior cervical lymphadenopathy ```
63
Oncogenic types of HPV
``` 16 18 31 33 35 ```
64
Genital condyloma types of HPV
6 | 11
65
Prevention/maintenance for HPV
Regular PAP smears | Quadrivalent HPV vaccine 9-26 yo
66
Hx and physical exam of measles (rubeola)
Erythematous maculopapular rash Begins at hairline, spreads to face, neck Prodrome with fever, coryza, Koplik spots
67
Hx and physical exam of rubella (German measles)
Pink, maculopapular rash, confluent on trunk, begins at the forehead, spreads to the trunk
68
Etiology of rabies
Single-stranded RNA virus of rhabdovirus group
69
Intervention for rabies
Quarantine asymptomatic animal for 10 days, sick animals MUST be tested by state health department Clean and scrub wound thoroughly
70
Pharmacological tx for rabies
If animal cannot be quarantined, begin vaccination and IG tx
71
Rabies vaccination schedule
20 iu/kg as much as possible infiltrated in and around the wound. Balance IM into glute Immunocompetent: 4 doses Human diploid cell vaccine, Day 0, 3, 7, 14
72
Dog bites tx
Pasturella canis most common organism Augmentin tx of choice Alternative: Clinda + TMP-SMX (peds) OR clinda + cipro (adults)
73
Cat bites tx
80% get infected < 24 hrs Pasturella multocida most common organism Culture Agumentin tx of choice Alternative: Cefuroxime axetile OR doxycycline If cx is + for multocida, PenG or Pen VK
74
Human bites tx
Multiple pathogens Augmentin is tx of choice Alternative: Clindamycin

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