Infectious Disease 9 Flashcards
(15 cards)
Rocky Mountain Spotted Fever’s symptoms start 5 days after tick bite…other than constitutional symptom and thrombocytopenia, there is a classic rash. What does it look like and how does it spread?
DX?
TRX?
PETECHIAL RASH, that starts in extremities and spreads centrally to body.
DX = Clinical, serologic testing avail but not that good.
TRX = Doxycycline, start if suspected. Don’t wait for serology.
What is the classic presentation of Strep Throat/Strep pharyngitis?
How do you DX?
TRX?
What sequela are you trying to avoid with treatment?
Sore throat + FEVER NO cough, NO viral symptoms Tonsillar exudate Palatal petechiae Tender cervical lymphadenopathy.
DX = Rapid Strep Antigen Test, Throat culture if RSAT is negative (bc poorly sensitive)
TRX = 10 days of PCN or 5 days Amoxicillin.
Rheumatic Fever, not associated with post -strep GN.
What is the recommended screening for Syphilis in Pregnancy?
IF pregnant patient is +ve how do you TREAT?
- At first prenatal visit (RPR or VDRL)
- Repeat in 3rd trimester for HIGH RISK pts.
TRX = Penicillin (even if allergic, desensitize)
How long after STREP THROAT do you see Rheumatic Fever?
The Major JONES criteria for RF?
How do you TRX RF?
3 weeks after UNTREATED Strep pharyngitis.
JONES : Joints - Migratory arthritis Heart - Carditis Nodules - Sub q nodules Erythema marginatum (annular rash with central clearing, serpiginous border) Sydenham Chorea.
TRX = Chronic PCN to prevent further episodes of RF.
What is the Rabies PRE- Exposure ppx schedule?
Vaccine days 0, 7, 21 and 28
Four vaccines in 1 month
What is the RABIES POST-EXPOSURE ppx for pt with NO completed prior vaccination series?
RABIES Immunoglobulin
+
Rabies vaccine days 0, 3, 7, 14 (4 in 2 weeks)
What is the RABIES POST-EXPOSURE ppx for patient with prior completed vaccination series)
Rabies vaccine days 0 and 3.
Rhino-orbital MUCORMYCOSIS nearly always presents in what clinical setting?
Other than symptoms of HA, Sinus Pain, F, and purulent nasal drainage…What is the classic physical exam findings of MUCORMYCOSIS?
How do you dx and Treat?
DM with DKA –> bc rapid growth in high glucose and acidic environments.
Nasal eschar/necrosis
DX = sinus endoscopy with Biopsy/Culture
TRX = Surgical debridement during endoscopy AND IV AMPHOTERICIN B
In a DM foot ulcer with OSTEOMYELITIS, what is the best way to isolate organism for trx?
TRX involves ABX for 6 weeks, what serum marker can you follow to confirm response to trx?
BONE BX (wound swab not helpful bc contaminated)
ESR.
How does the presentation of Erysipelas and Cellulitis differ?
Erysipelas = sharply demarcated erythema (only involves superficial skin)
Cellulitis = diffuse erythema with deep skin involvement of dermis and fat.
What is the most common complication of Cat Scrath Disease?
Suppurative lymph nodes.
Normally Mononucleosis is supportive trx. BUT rarely you can get severe pharyngeal swelling that can threaten airway….how do you manage this?
(warning signs are inability to swallow, dyspnea, tachypnea)
IV Corticosteroids.
What are the 3 scenarios when you would use corticosteroids in treatment of mononucleosis (which normally would be treated supportively)
- Aplastic Anemia develops
- Thrombocytopenia develops
- Concern for airway obstruction.
What are the 4 components of CENTOR criteria for diagnosis of Strep throat?
- Tonsillar Exudate
- Tender cervical lymphadenopathy
- Fever
- NO cough
(1 point for each, if 3 points or higher, then do Rapid strep antigen test)
What is the Jarish- Herxheime RXN
IS there a way to prevent it?
How do you treat it?
Acute SELF- Limiting Febrile run that occurs within 24 hours of TRX of Sphirochete infections.
NO effective prevention.
TRX with Acetaminophen
