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First Aid Step 2 > Infectious disease > Flashcards

Infectious disease Flashcards

(179 cards)

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1
Q

Gram stain : positive vs negative

A

Positive: blue purple
Negative: red

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2
Q

Chains

A

Strepotococci

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3
Q

Clusters

A

Staphylococci

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4
Q

Gram + Diplococci example

A

Strep pneumo

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5
Q

Gram - coccobacilli example

A

Haemophilus

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6
Q

Gram - diplococci

A

Neisseria

Morazella

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7
Q

Gram - rod, plump, thick mucoid capsule

A

Klebseilla

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8
Q

Gram + rods that forms spores

A

Clostridium

Bacillus

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9
Q

Pseudophyphae

A

Candida

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10
Q

Acid fast

A

Mycobacterium tuberculosis

Nocardia

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11
Q

Gram + sulfur granules

A

Actinomyces (PID w/ IUD, neck mass, cervical adenitits)

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12
Q

Silver stain

A

PCP and cat scratch

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13
Q

Positive India ink - think capsule

A

Cryptococcus

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14
Q

Spirochete

A

Treponema - dark field
Leptospira - dark field
Borrelia- light microscope

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15
Q

Catalase positive

A

Staph aureus
Serratia
Klebsiella
Aspergillus

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16
Q

Pt stuck with thorn:
Bug
Tx

A

Sporothrix schenckii

Tx: Itraconaozle, fluconazole, oral potassium iodine

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17
Q

Aplastic crisis in sickle cell or other hemoglobinopathy

A

Parvovirus B19

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18
Q

Sepsis after splenectomy or autosplenectomy in sickle cell

A

S pneumo
H flu
N meningitidis
ENCAPSULATED!!

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19
Q

Pneumo in SW

Bug and Tx

A

Cocci

Tx: itraconazole, fluconazole, amphotericin B if severe

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20
Q

Pneumo after cave exploring or bat droppings in Ohio and Mississippi River

Tx

A

Histoplasma capsulatum - acute pulm Sx

Tx: IV amphotericin B, lifelong itraconazole if HIV positiive

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21
Q

Pneumo after bird

A

Chlamydia psittaci

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22
Q

Fungus ball or hemoptysis after TB induced cavitary disease

Tx

A

Aspergillus - halo sign on CT

Tx: voriconazole

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23
Q

Pneumo with silicosis

A

Tb

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24
Q

Diarrhea after hiking or drinking from stream
Bug
Dx
Tx

A

Giardia lamblia

Dx: cyst in stool

Tx: metronidazole

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25
Pregnant woman with cats | Bug Tx
Toxoplasmosis gondii Tx: spiramycin
26
Vit B 12 def and ABD sx
Diphyllobothrium latum
27
Seizures with ring enhancing lesions on CT | Tx
Taenia solium - cysticercosis OR Toxoplasmosis Tx: albendazole or praziquantel, steroids, consider anticonvulsants
28
Bladder cancer squamous cell in MIddle East and Africa
Schistosoma haematobium
29
Worm infection kids | Tx
Enterobius - positive tape test, perianal itching worse at night Tx: mebendazole, albendazole
30
Fever, mm pain, eosinophilia, periorbital edema after eating raw meat
Trichinella spiralis - trichinosis
31
Food poisoning after creams or dairy
S aureus from preformed toxin
32
Gastroenteritis in young kids
Rotavirus | Norwalk
33
Food poisoning after reheated rice
Bacillus cereus by preformed toxin- no help with abx
34
Food poisoning seagood
Virbio parahaemolytcius
35
Diarrhea after Mexico | Tx
E coli Tx: ciprofloxacin
36
Diarrhea after abc | Tx
C diff Oral metronidaozole or vancomycin
37
Infant paralyzed after honey
C botulinum - toxin bloch Ach release = hypotnia, poor feeding, neurogenic bladder, constipation
38
Genital lesions kids without sexual abuse
Molluscum contagiosum
39
Cellulitis after cat or dog bite | Tx
Pasteurella multocida- amoxicillin clauvulanate
40
Slaugterhouse worker with fever
Brucella
41
Empiric abx and bugs: bronchitis
No abx shown to be good | Virus, H flu, Moraxella
42
Empiric abx and bugs: Cellulitis
Cephalexin or dicloxacillin, Clindamycin or TMP-SMX if suspect MRSA Staph/strep
43
Empiric abx and bugs: Endocarditis
Antisaph pen or vanc + aminoglycoside | Staph/strep
44
Empiric abx and bugs:meningitis - kid or adulte
Cefotaxime or ceftriaxone + vanc | Strep pneumo, N meningitidis
45
Empiric abx and bugs: ostemyelitis
Oxacilli, cefazolin, vanc | Staph aureus, Salmonella
46
Empiric abx and bugs: atypical pneumo
Macrolide, doxy | Mycoplasma, Chlamydia
47
Empiric abx and bugs: classic pneumo
3rd ceph, azithromycin | S pneumo, H flu
48
Empiric abx and bugs: Septic arthritis
Antistaph pen, vanc = S aureus Ceftazidine or ceftriazone or cefotaxime = Gram N bacilli 3rd pen or ceph + aminoglycoside, imipenem = Gram N bugs, strep, staph
49
Empiric abx and bugs: UTI
TMP-SMX, nitrofurantoin, amoxicilli, quinolones | E coli
50
DOC bacteroidies
Metronidazole | Alt: clindamycin
51
DOC Borrelia
Doxy (not < 8 yrs or pregnant or lactating), amox, cefuroxime Alt: Erythromycin
52
DOC chlamydia
Azithromycin, doxy | Alt: erythromycin, oflaxacin, levafloxacin
53
DOC E coli
3rd gen ceph, fluoroquinolones | Alt: Aminoglycoside
54
DOC Enterococci
Pen or amp + amino glycoside | Alt: Vanc + aminoglycoside
55
DOC GC
Ceftriaxone plus doxy or azithromycin
56
DOC haeomophilus
2/3 ceph | Alt: ampicillin
57
DOC Klebsiella
3rd ceph, fluoroquinolone | Alt: 3rd pen + aminoglycoside
58
DOC meningococcus
Cefotaxime or ceftriaxone | Alt: Pen G if susceptible
59
DOC TB
RIPE
60
DOC mycoplasma
Macrolide | Alt: doxy, fluoroquinolone
61
DOC Pseudomonas
Ticardcillin or piperacillin + aminoglycoside | Alt: Ceftazidine, cefepime, aztreonam, imipenem, cipro
62
DOC strep A or B
Pen or cephazolin | Alt: eryhtromycin
63
DOC Treponema
Pen | Alt: doxy
64
DOC strep pneumo
3rd ceph | Alt: fluoroquinolone
65
DOC staph
Antisraph pen | Alt: Vanc if MRSA
66
Pneumo hotel, air conditioner, water tower | Bug and Tx
Legionella HA, GI Sx Tx: azithromycin or levofloxacin
67
BUrn wound infection with blue green color
Pseudomonas
68
Gold standard to dx pneumo
sputum culture
69
Common causes pneumo
``` Strep pneumo H flu Staph aureus Gram N - Pseudomonas, Klebsiella, E coli Mycoplasma Chlam pneumo Viral PCP ```
70
Most common cause pneumo
Strep pneumo
71
Uncommon due to vaccination
H flu
72
Hospital acquired pneumo
Staph aureus
73
CF, IVDU, chonic granulomatous disease pneumo cause | Tx
Pseudomonas | Ticarcillin or pipercillin
74
alcoholics and homeless pneumo, currant jelly sputum
Klebsiella
75
Enteric gram N, aspiration pneumo, neutropenia, hospital acquired, abscesses common, high mortality
E coli
76
Rapid onset shaking chills after URI, fever, pleurisy, productive cough, lobar consildation on CXR, leukocytosis, neutrophilia,
Strep pneumo
77
Tx h flu
Ampicillin or amoxicillin or 2/3 ceph | GRAM - Coccobacilli
78
Empyema and lung abscesses common
Staph aureus
79
When to give vaccine for strep penumo
``` older than 65 Splenectomy Sickel cell All kids Chronic disease - DM, cardiac, pulm, renal, liver Immunocompromised ```
80
Tx strep pneumo
Macrolide, doxy, 3 ceph with macrolide or doxy, fluoroquinolone (levofloxacin or moxifloxacin)
81
College student who lives in dorm and has sick contacts
Mycoplasma pneumo
82
Negative cold agglutinin Ab titer | Tx
Chlam pneumo Tx: macrolide or broad fluoro
83
Viral causes pneumo
RSV influenza Parainfluenza Adenovirus
84
Silver stain
PCP
85
TPositive vold agglutinin Ab | Tx
Mycoplasma pneumo | Macrolide or broad fluoro
86
If + RPR or VDRL, what to confirm
FTA-ABS or MHA-TPA | can see on dark field and not light microscope
87
Tx syphilis
Pen or doxy if allergic
88
Primary vs secondary vs tertiary
Primary: painless chancre resolve 8 wks Secondary: condyloma lata 6- 18 wks after infection, maculopapular rash (palms and soles), lymphadenopathy Tertiary: after latent phase, gummas (granulomas in different organs), neuro (Argyll Robertson pupil, dementia, paresis, tabes dorsalis, Charcot joints), thoracic aortic aneurysm
89
False positive RPR or VDRL
SLE
90
Congential syphilis presentation
ASx--> cutaneous lesion palm and soles, anemia, rhinorrhea --> frontal bossing, Hutchinson teeth, saddle nose
91
2 types endocarditisi
Acute (S aureus) | Subacute (Strep viridians)
92
Presentation endocarditis
Signs of infection + new heart murmur, emboli (stroke or infarct) ,Osler nodes (painful tip of finger), Roth spot (retinal hemorrhages), splinter hemorrhages, septic shock
93
Tx endocarditis
Empiric: 3rd pen or ceph + aminoglycoside
94
Right sided lesions more common
IVDU, left most common in gen population
95
Most common sequelae meningitis
Hearing loss
96
Common causes menignitis
S pneumo, Ne menigitidis
97
Asepetic meningitis causes
Mumps and measles
98
Temporal lobe abnormalities | Tx
HSV meningitis | Acyclovir
99
Contacts Tx if Neisseria meningitis
Rifampin, cipro, ceftriaxone, or azithromycin
100
Incubation period rabies
1-2 months
101
Classic Sx rabies
Hydrophobia- painful swallowing | CNS - paralysis
102
Tx after bite for rabies
1. local wound - amoxicillin clauvulante for prophy cellulitis 2. Observe animal 3. Prophy rabies Ig and vaccine (US - only give Tx if animal attaclkd unprovoked or if acting weird)
103
Normal bowel flora that can cause endocarditis, UTI, sepsis Tx endocarditis Tx VRE
Enterococcus faecalis Endocarditis - cell wall actie agent like amp or vanc and amino glycoside like gentamicin VRE: linezolid
104
Most common cause neonatal meningitis and sepsis Acquired birth canal - normal vag flora Prophy for mom
Strep agalactiae - GBS Pen or ampicilliin
105
Most common cause pneumo, otitis media, meningitis, sinusitis, sepsis
Strep pneumo
106
FEVER, PHARYNGEAL EDEMA, TONSILLAR EXUDATE, LACK OF COUGH, Sore throat, ,enlarged tender cervical LN, leukocytosis Tx, what to avoid
Strep pyogenes pharyngitis - GAS | Tx pen to avoid rheumatic fever and scarlet fever
107
Jones criteria for rheumatic fever
``` Joints- migratory polyarthritis O- carditis N- nodules E- erythema marginatum S- sydenham chorea ``` ``` Minor CRiteria Inflammatory cells (leukocytosis) Temperature (fever) ESR/CRP elevated Raised PR interval Itself (previous Hx of Rheumatic fever) Arthralgia ``` Need hx strep pharyngitis + at elast 1 major
108
Tx rheumatic fever
ASA, steroids if severe carditis
109
Cause of scarlet fever
STrep produces erythrogenic toxin
110
Classic skin presentation scarlet fever
Red flush in skin usually perioral that blances with pressure, truncal rash, strawberry tongue and late desquamation KAWASAKI CAN ALSO CAUSE THESE SX
111
Abrupt onset hematuria, proteinuria, RBC casts, HTN, edema (periorbital), elevated BUN and Cr
PSGN | Cannot prevent with abx!!!!!
112
Strep pyogenes causes
Pharyngitis- rheumatic fever, scarlet fever, PSGN | Impetigo, erysipelas, cellulitis, necrotizing fascitis, endomtritis or puerperal fever
113
Honey colored crusted lesions
Impetigo - staph >>> strep Staph if furuncle or carbuncle Strep if glomerulonephritis
114
Superficial cellulitis
Erysipelas
115
Most common cause cellulitis
Strep
116
Cellulitis in fisherman
Vibrio vulnificus - tetracycline
117
Cellulitis progresses to necrosis and gangrene with crepitus and systemic toxicity
Necrotizing fascitis
118
Endometritis Tx
Clindamycin + gentamicin after culturing
119
Subacute endocarditis and dental caries
Strep viridans (caries - Stre mutans)
120
S aureus commonly causes....
``` Abscess - furuncle or breastfeeding Cellultis Endocarditis esp drug user Food poisoning 2/2 preformed toxin Furuncle or carbuncle Impetigo Osteomyelitis - most common except in sickle cell Pneumo- form abscess or empyema Scalded skin syndrome- preformed toxin-->impetigo then desquamates Septic arthritis TSS- preformed toxin, hypotension, fever, rash that desquamates Wound infection Stap epidermidis: IV cath, proesthetics Staph saprophyticus: UTI ```
121
Exposed adult with neg PPD -Tx or no
No
122
Exposed child < 5 yrs with - PPD - Tx or no
Tx with INH for 3 months then repeat
123
Prophy for PPD conversion from neg to positive
INH 9 months and repeat PPD
124
Active disease or positive culture TX
RIPE 2 months then INH and rifampin 4 months
125
What to give with INH to prevent neuropathy, confusion, angular cheilitis, seborrheic dermatitis
B6/ pyridoxine
126
3 most common causes fever of unknown origin
Infection Cancer AI disease
127
Most common predisposing factor acute sinusitis
Viral URI
128
Asplenic pts predisposed to infections by
Encapsulated- pneumococcus, meningococcus, H flu, Kleb
129
Number bacteria in urine to Dx UTI
10^5
130
Healthy population susceptible to UTI
Preggers
131
Tx cocci
Amphotericin B
132
Blueberry muffin rash - congenital infection
Rubella
133
Meningitis neonates Causes Tx
GBS, E coli, Listeria, | Tx: gentamicin and ampicillin
134
Meningitis in infants Causes Tx
Pneumococcus Meningococcus H flu Tx: cefotaxime and vanc
135
CSF: low glc and PMN
bacterial meningitis
136
CSF: normal glc w/ lymphs
Viral meningitis
137
Numerous RBC in CSF samples
SAH
138
Inc gamma globulins in CSF
MS
139
Pruritic papule with regional LNopathy-->blak eschar after 7-10 d Tx
Cutanoues anthrax | Tx Pen G or ciprfloxacin
140
2nd lyme findings
Arthralgias, migratory polyarthropathies, Bell's palsy, myocarditis
141
+ cold agglutinins
Mycoplasma
142
Neutropenic nadir postchemo
7-10 d
143
Findings endocarditis
Fever, heart murmur, osler's nodes, splinter hemorrhages, Janeway lesions, Roth's spots
144
Branching rods oral infection
actinomyces israelii
145
Weakly gram + partially acid fast in lung infection
Nocardia asteroides
146
Painful chancroid
Haemophilus ducreyi
147
Dog or cat bite
Pasteurella multocida
148
Gardner
sporothric schenckii
149
Raw pork and skeletal mm cysts
Trichinella spiralis
150
Speepherders with liver cysts
Echinococcus granulosus
151
Perianal ithcing
Enterobius vermicularis
152
pregnant women with pets
Toxoplasma gondii
153
Meningitis adults
N meningitidis
154
Meningitis elderly
Strep pneumo
155
Meningoencephalitis AIDS
Crypto neoformans
156
Malignant otitis externa
Pseudomonas
157
Burn infections
Pseudomonas
158
Oteomyelitis foot puncture
Pseduomonas
159
Osteomyelitis sickel cell
Salmonella
160
45 yo heavy smoker and drinker wihth new cough and flulike Sx, Gram stain shows no bugs, silver stain gram - rods
Legionella pneumo
161
middle aged man acute onset monoarticular oint pain and bilat Bells palsy Tx
Lyme -Ixodes | Doxy
162
Endocarditis 3 wks after prosthetic valves
S aureus or S epidermidis
163
Endocarditis in native valve after dental cleaning
Strep viridans
164
Turns body fluids orange - Rx
Rifamptin
165
Antigenic drift vs antigenic shift
Drift: small, gradual changes in surface proteins through point mutations, virus can escape immune recognition, why can be infected with flu multiple times Shift: acute, major change in the influenza A subtype (genetic reassortment) circulating among humans, leads to pandemics
166
Common causes encephalitis
HSV and arbovirus
167
India ink stain
Cryptococcus
168
Temporal lobe + encephalitis
HSV Tx acyclovir CMV - ganciclovir +/- foscarnet
169
HA, fever, focal neuro deficit
Brain abscess
170
Complications of CMV
Retinitis: retinal detachment, floaters and changes in visual field GI and hepatobiliary: nonspecific Pneumonitis: cough fever, sparse sputum CNS: polyradiculopathy, transverse myelinitis, encephalitis
171
Complications chlamydia
Arthritis, neonatal conjuctivits, pneumo, urethritis / PID, lymphogranuloma venereum
172
HIV, CD4<25, anemia, hypoalbuminemia, inc ALP
MAC Tx - prophy azithromycin
173
Tx syphilis can result in
Jarisch Herxheimer rxn - acute flulike illness
174
Common UTI causes
``` SEEKS PP Serratia E coli Enterobacter Klebsiella pneumo Staph saprophyticus Pseudomonas Proteus mirabilis ```
175
Tick RMSF
Dermacentor variabilis
176
Bacterial conjuctivitis that is an emergency
GC
177
Conjunctivitis - recurrent epithelial keratitis in childhood, leading cuase of preventable blindness worldwide
C trachomatis A-C
178
Watery discharge conjuctivitis
Viral - usu adenovirus
179
FB sensation w/ purulent discharge
Staph, strep Haemophilus, Pseudomonas, Moraxella

First Aid Step 2 (22 decks)

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