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Flashcards in infectious dz Deck (24):
1

candida

skin, mm, disseminated, GI, vulva, vagina, dentures, balanitis

tx: clinical or biopsy
KOH-pseudo

cutaneous: warm, moist, dark
chronic infections: defect in Tcell response
-possible endocrinopathies

contiguous spread: trauma, burns, surgery

disseminated- on blood culture, high morality rate

endocarditis- infectious drug users, prosthetic valves

chronic disseminated- leukemia

tx:
azoles, capsofungin, amphotericin B( amyphy terrible- a lot of side effects, terbinaine






2

cyrptococosis

-budding yeast in soil, pigeon feces, inhalation

pull infection: fever, though
dx: cx
tx: difulcan X 10 weeks

meningitis:
s/s: HA, N/V, confusion, lethargy, visual changes
dx: CSF ( inc protein, inc WBC, dec glucose)
CT/MRI-punched out lesions
tx: mild dz: diflucan,
severe dz: induction ( amphotericin B)
maintenance- diflucan- life long

3

histoplasmosis

social, bird, bat droppings

3 types:
chronic progressive pul dx- apical cavities

progressive disseminated dz- ( HIV CD$

4

histoplasmosis work up

labs: anemia of chronic dz

diagnostic: bronchoalveolar lavage
-blood cx


tx: mild dz: itraconazole
severe dz: amphotericin witch to itraconable for life

5

PCP

airborne, premature babies, immunodeficiency states

s//s: abrupt, fever, tachypnea, dyspnea, cough
dx: CXR: diffuse infiltrates
cysts, nodules, cavities
PFTS: dec VC, dec TLC
labs: sputum stains

tx: Bactrim, steroids
prophylaxis( CD4

6

botulism

- gram positive rod, seen in soil

- toxin A and B
transmitted food borne ( canned or smoked), infant botulisms ( honey)

s/s: 12-26--> eyes ( double vision, dry mouth, n/v, dying of respirator paralysis)

tx: report to CDC with botulinum antitoxin
manage respiratory failure

7

cholera

seen after earthquakes, breaks in sewage

-hypersecretion of watery diarrhea ( rice water)
-pt dye of dehydration
-soil cultures
-diangosed clinical

tx: fluids, abx ( tetracycline, ampicillin, bacterium)

prevention: vaccine, short lived, limited

8

diphtheria

respiratory droplets

- s/s: nasal d/d
laryngitis
pharyngeal- thick gray membrane

tx: reportable dz
anti-toxicin
remove membrane

abx: pen, erythromycin, zithromax

case: till 3 neg BC

prevention: Dtap, Tdap, Td

9

pertussis

- respiratory droplets
s/s:
catarrhal- coryza, cold-like sxs, hacking cough
paroxysmal- burts of coughing
convalescent- 4 weeks after set

tx: erythromycin X 7d yas

prevention: Dtap, infants

Trap: adolscents

10

tetanus

soil, local
elderly, migrant workers, IV drug users

s/s: pain and tingling at site, stiffness of jaw/neck, irritability, painful tonic convulsions
-remains conscious

tx: tetanus immun globulin and start immunizations
- sedation, induced paralysis

PCN- eradicate any left o

11

wound management for tetanus

clean wound

unknown vaccine hx:
dirt wound
- 1 vaccine and immune globulin

clean wound- vaccine and no immune globulin

12

salmonella

-gram negative

Gastro enteriis s/s: crampy abd pain, diarrhea
tx: fluids

bacteremia: prolonged fever, bacteria go to distant areas

tx: fluids, cipo

enteric fever: malaise, fever, sore throat, pea soup diarrhea,

tx: fluids, cipro

vaccine: poorly effective

13

shigella

fecal -oral route

diarrhea with blood
tenesmus
30% - reactive arthritis

dx: stool cx ( WBC and RBC) and BC

tx: hydration, bactrim, cipro

14

lyme

borellia burgdorferi

most common tick born illness
must feed 24-36 hours
drops off in 2-4 hours

stage 1: erythema migrant, flue-like sxs

stage 2: fatigue, malaise, small, multiple, h/a neck pain, migratory arthritis

cardiac: pericarditis
focal : aseptic meningitis

stage 3: months--> years
MSK- variable arthritis synovitis
- encephalopathy

dx: early- should not get lyme titers ( testing wrong)
-diagnosed clinically

tx: doxy 2-3 weeks
peds/pregnancy- amor

prevention: avoid ticks

chemoprevention tx: doxy 200 mg once

15

rockey mountain spotted fever

wood tick and dog tick
-prevention: avoid ticks
-no chemoprophylaxis

- 1 week ; f/c/n/myalagia
pneumonitis cough
delirium, lethary
rash over ankles and spread to center

labs: low plts and low salt
tx: doxy- all ages
pregnancy- cholaremphenicol

16

syphili

transmission only by sexual contact

testing:
non-treponema tests- regular screening

high risk: treponemal tests

primary: painless shanker, adenopathy

secondary: weeks to months and very infectious stage. fever, adenopathy, rash over palms and soles

tertiary:gummatous reactions
inflammation every where
eyes- blindness
prostitue pupils

tx: PCN, allergic-tetracycline
Jarish-herzheimer rx- reaction to PCN

pregnancy- screening all prenatal its

congenital syphillis- rash
isolate and tx with PCN

17

CMV cytomegalovirus

virus remains latent
sexual, congenital, person and person

perinatal dz: jaundice, metal retardation

immunocompetent host:
fever, malaise, mon-like
complicaitons: GI

reactive dz: CD4

18

Epstein Barr virus

human herpes 5

10-35

s/sx: fever, ST,
posterior chain nodes, enlarge spleen
hepatic
ampicillin - may get a rash

labs; cbc, hemolytic anemia, monspot

tx: symptomatic, supportive
acyclovir
steroids for impending airway obstruction
avoid contact sports for large spleen

19

rabies

raccoons, bats, coyotes

s/s: pain at site, fever, malaise n/v
CNS stage: furious encephalitis

labs: skin bx
CSF,MRI

tx: prevention: immunization for domestic animals

post exposure: rabies immune globulin IM to wound plus distant site

human diploid cell rabies vaccine 5 injections 0,3,7, and 15
pre-exposure - 0.7, 21, 28

tx: fatal

20

HIV/AIDS

human retrovirus
targets all cells with t4 antigen , primarily CD4 helper lymphocyte
perinatal transmission, sexual, blood born products

screening: ELISA confirmed with Western blot
viral load: actively replicating virus

CD4 count: decrease with illness progression
other labs: anemia, leukopenia, thrombocytopenia

acute syndrome: flu-like syndrome, persistent adenopathy

HIV dz- weight loss, fever,

AIDS indication conditions: have it

prevention: safer sex, universal precautions, drug rehab


secondary: screening programs

post exposure: counseling, testing now 6 wks, 3 dos, 6 month , risk 0.03%

perinatal: antiretroviral during pregnancy , L and D and to newborn, avoid breast feeding

tx: antiretroviral, HAART
goal: suppression load
combination therapy
much have an expert

categories: NRTI- SE: bone marrow problems

NNRT;s- rash and neuro issues

fusion inhibitors: pain with injections, allergic run

CCRS- cough, fatigue

protest inhibiors- lipid issues

INSTI- headache, dizziness

combination therapy:

21

helminths

rounds worms, flukes, tapers

intestinal infections
mild to sever

-skin signs: hook worm

renal dz, splenic infarction

tx: albendazole

deworming programs- stop transmission

22

malaria

-endemic to tropics
-most cases to US are imported
-mosquitos inoculare liver
-releaes into blood cels

-s/s: shaking chill, fever, diaphoreses
malaise, n/v, diarrhea

P falciparum-severe dx

labs: peripheral smear- number of parasite tells you how much disease
- check cbc, hemolytic anemias

tx: chloroquine
okay in pregnancy
add doxy with resistance

prevention: chemoprophyasis , chloroquine, malorone, eduction, mosquito control

23

toxoplasmosis

cats and birds

transmission: ingest cysts- raw or uncooked meat

primary infection: acute, mild, febrile
congenital: cause of stillbirth/ abortion

AIDS/chemo pt: local infections in brain

dx: histology, serology
CT scan

tx:pyrimethamins
clean litter box

24

pin worms

female worms come out in butt cheeks
tx: albendazole
- tx every one in the house now and in 2 weeks