MKSAP-5 Flashcards
(36 cards)
how is MAC diagnosed?
bone marrow biopsy or blood culture
How is brucellosis acquired
Drinking Raw, unpasteurized milk of goat, cattle
Erlichia chafensis lab findings
Thrombocytopenia
Leukopenia
Elevated LFTs
What is another name for heartland virus,
and what other bug and manifestation does it appear similar to?
How do you tell them apart?
Bandavirus
It is similar to erlichiosis
Give them Doxy, Heartland virus will not respond to Doxy but erlichia will!
A patient in___demographic should be hospitalized if you see shingles rash
(We are’s most patients with Shingles can be managed outpatient with p.o. antiviral)
___This is a treatment
Immunocompromised i.e. pregnant, transplant recipient
Acyclovir IV…!
What is the clinical course of the shingles rash, as and how does it present typically?
If for starts with pain and paresthesias in the skin area, in a few days rash Erupts Afterwards
When you have a shingles outbreak, what is the p.o. antiviral treatment due to benefit the rash?
How soon after shingles outbreak should you take it?
If shortens a duration of symptoms, also decreases the severity of symptoms
Taken within 72 hours after rash onset
Which fluoroquinolone is not a good respiratory fluoroquinolone
Which fluoroquinolone is not good for Pseudomonas coverage
Ciprofloxacin sucks for strep pneumo coverage
Moxifloxacin sucks for Pseudomonas
Curb 65, what does it include?
Pneumonia severity index
C-confusion
U-uremia i.e. BUN >20
R-respiratory rate ie RR >30
B-blood pressure <90/<60
65-age 65 and over
1 point for all
1: Treat outpatient
2: Moderate risk, consider inpatient treatment or outpatient with close follow-up
3 or MORE: Severe risk going patient! Maybe even ICU
Describe the complication of shingles AKA herpes zoster infection
As send what is the clinical presentation?
Ramsay Hunt syndrome
SYMPTOMS
-Zoster oticus:Erythematous vesicular rash on the ear,
Similar looking lesion in the mouth(HALF OF THE TONGUE!!!)
-Cranial nerve VIII involvement: Symptoms with hearing loss, tinnitus, nausea vertigo, nystagmus
-Cranial nerve VII involvement: Facial nerve palsy one-sided face Paralyzed involving forehead
Pathophysiology of invasive pulmonary aspergillosis
Aspergillus initially invade pulmonary blood vessels->they cause distal infarct in the tissue->hemoptysis at presentation
What is the differential diagnosis of infection induced facial nerve palsy?
Bell’s palsy from Lyme disease i.e. Borrelia
VZV i.e. shingles i.e. Ramsay Hunt syndrome
HSV-1
In a patient who is being treated for CHF exacerbation, what will be an indication to place a urinary catheter?
To monitor intake and output in a critically illpatient
Do not place 1 in a not critically ill patient!
To prevent CAUTI
Lab findings and Babesia
Thrombocytopenia
Hemolytic anemia
Jaundice, elevated LFT, Hepatomegaly
Splenomegaly
BLOOD SMEAR will NOT HAVE SHISTOCYTES
Blood smear: Intra erythrocytic rings
Positive galactomannan in a patient with pneumonia, think this bug
Invasive aspergillosis
Which 2 Candida bugs can actually cause invasive candidiasis?
Candida auris
Candida glabrata
Not not not not not Candida albicans! Normal respiratory flora it is!
A patient who is immunosuppressed, has very very prolonged neutropenia, what bug are the added risk of getting?
Invasive aspergillosis
What will you see on CT chest thorax for invasive pulmonary aspergillosis
Pulmonary infiltrates
Nodules with groundglass appearing around the nodule: The halo sign!
Wedge-shaped density-it is the infarct!
Definitive diagnosis of invasive aspergillosis, how was it done?
Bronchoalveolar lavage and biopsy, either are very effective
Also very excellent is the serum galactomannan assay
Babesia can be caused by this mode
Black Legged tic
Even transfusion reaction!
What kind of immunocompromised patients are at a risk for invasive aspergillosis?
Why?
Receiving chemotherapy
Hematopoietic stem cell transplant
Both of these conditions can cause prolonged neutropenia
To the patient with IBD i.e. Crohn’s or ulcerative colitis need prophylaxis when they are traveling overseas?
Yes!
Give them rifaximin for prophylaxis for traveler’s diarrhea
(Otherwise if the patient does not have a disease complication–Another one being CKD– that puts him at a high risk, do not give antibiotics just like that!)
Most frequently acquired infection in international travelers?
And what Bugs does not involve?
Traveler’s diarrhea
ED tech E. coli
Campylobacter
Shigella
Salmonella
These above make up 80 to 90% of cases
Viruses i.e. rotavirus, norovirus
Some protozoal parasites i.e. Giardia
Clinical presentation speaking, how you distinguish meningitis from encephalitis?
Patient with meningitis will be sick and uncomfortable, but normal brain function, will be awake and talking and alert oriented
With encephalitis they will be altered, may be obtunded, personality change, flaccid paralysis or focal paralysis, some kind of movement disorder
