NEED TO KNOW INFX Block I Flashcards by Demetré Harris

What is the standard definition of Fever of unknown orgrin

Greater than 100.9 on several occasions

Uncertain Dx after one week of study in the hosptial

3 or more outpatient visits

Duration of fever for at least 3 weeks

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What is the offending agent of Anthrax

Bacillus anthracis

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Where is anthrax commonly found

Livestock hides ( cattle, sheep, goats, camels)

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How is anthrax transmitted

Inhalation of spores

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Is anthrax trasmitted person to person

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What is the ABX for ANTHRAX

Ciprofloxacin

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What is the durration of Cutaneous Anthrax Tx

7-10 days of Cipro

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What is the offending agent of Plague

Yersinia pestis

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Where is plague still common in the US

NM, AZ, and CO (Hikers)

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What are the three types of Plague

Bubonic, Septicemic, Pneumonic

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Fleas carry what form of Plague

Bubonic

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What is the vector for plegue

Fleas and Flea bites

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A pt presents with a WBC count of 20,000 or more with increased bands, Low grade DIC, Elevated LFTs, and gram neg coccobacillus

Think

Plague

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What is the bacteria responible for small pox

Variola

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What is the herald S/s of Herpes

Tender regional lymphadenopathy

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How does Herpes apear on a Txank smear

MNG cells, Muclinucleated Giant Cells

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What is the Tx approach to Condyloma/ HPV

Prevention! With Gardisil

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What are two major complications of gonorrhea in women

PID and cervical motion tenderness

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A young pt presents with a swollen knee without truama and is sexually active… think

Disseminated gonoccocal infection!

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A culture presents as gram negative intracellular diplococci…
Think.

Gonorrhea

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What is the Tx approach for Gonorrhea

Ceftriaxone 500 mg IM

And DOxy 100 mg x 7 days to treat for chlamydia

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What is the Tx of Choice for Chalmydia

Azithromycin 1 GM po

Or Doxy 100 mg Po q 12 hours x 7 days

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An ulcer in the genitals that begins painless and then progresses to painful think…

Lymphogranuloma venerium

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What is the virus responcible for Syphillis

Treponema pallidum

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What is the onset of syphillis

Primary 3 weeks post exposure Secondary within 6 months Tertiary years

What is secondary syphillis

2-10 weeks after primary rash on the palms or soles of feet

What is the Tx for BV

Metronidazole (flagyl)

What is the Tx for Chanchroid

Ceftriaxzone or Azithromycin

What is the DOC for granuloma inguinale

Azithrymycin

What is the Tx for head lice

Permethrin 1 %

A pt presents with nighttime itching and tunneling think../.?

Scabies

What is the Tx for Scabies

Permethrin 5%

What Dz do Bedbugs commonly carry

Hep B

What is the common cause of Hep A in the US

Raw oysters, seafood

Hep E is usually benign except in what pt population

Pregnacy 25% mortality

What is the first marker of Hep B innfection and what is it followed by

1st serum marker is HBsAG ( surface antigen) Followed by IGM core AB Followed by IGG core AB Then 4-6 months later: Anti surface ABs (which signifies immunity)

What signifies immunnity or successful immunization to Hep B

Anti-HBs (surface ABs)

Persistant HBsAg or Anti-HBc signifies

Chronic Hep B infection

What is the median time to progression of cirrhosis in pts with Hep C

30 years

What factors speed up the development of cirrhosis in pts with hep C

``` Increased Alcohol intake Age > 40 HIV co infection Male gender Or Chronic HBv infection ```

What two year groups are at an increased risk of Hep C infection

Pts that received clotting fxs before 1987 And Pts that recieved blood or organs before july 1992

What is the prevention strategy for Hep D

HBv Vax

What is the cell type that we evaluate for HIV

CD4 count

What is the Screening test for HIV

HIV ELISA Then Western blot to confirm

What is the CD4 count for AIDs

Less than 200

What is the most common herpes virus that affects HIV/AIDs pts

HHV 8

A pt with recent onset of retrosternal pain and HIV Think

Candidiadis (esophagus)

A pt with HIV and retinal changes think

CMV retinitis

A pt with HIV and dyspnea on exertion, non productive cough, recent onset and a bad chest x ray Think

P jiroveci, pneumonias or mycobacterium

A pt with AIDs and violaceous plaque like lesions think

Kaposi sarcoma

A pt with HIV/ AIDs and a focal neuro deficit or mass effect in the brain think..

Toxoplasmosis (brain)

A pt with HIV/ AIDS with apical or miliary infiltrates, with a respose to TB think,..

What is the most common oppurtunisict infection assoc with AIDs

P jiroveci pneumonia

How often should you check CD4 count in AIDs pts

Every month until stable then every 3 months for life

What CD4 count is medboard criteria

Below 300

A pt with HIGH fever ( 104 for 4-5 days), chills, severe muslce aches, and severe headache Rapid onset.. think

Influenza

What is the Tx of choice for influenza

Zanamivir

What is the most common cause of post transplant pneumonia

CMV pneumonia ( with HIV/ AIDs)

Where is Hantavirus prevalent in the US

CO, AZ, NM, or UT Cabins, cabins, Camping (mice and rats)

How does Hantvirus present on CXray

Mild interstitial pulm edema that rapidly progresses to Basilar/ perihilar pattern

What is the Tx of choice for Hantavirus

Ribavirin

What is the most common community acquired pneumonia

Streptococcous aka pneumococcal

A pt that presents with bloody tinged sputum Think?

Streptococcus pneumonia ( CAP)

What is the DOC for pts with streptococcus with comorbidies

Augmentin ( amoxicillin and clauvanate)

What is the most common cause of CAP in healthy persons specifically

Mycoplasma pneumonia

A pt presents with bullous myringitis ( pustules on the tempanic membrane) and a non productive cough.. think

Mycoplama pneumonia

What is the Tx of choice for mycoplasma pneumonia

Typically self limitiing May use Doxy or Azithromycin

A pt presents with fever, hematuria, N/V/D, Headache and photophobia, HORDERS spots (pink blnaching maculopapular rash) and works around birds… think

Chlamydophila psittaci

A pt presents with a prior flu, with new onset of worsening fever or cough (Elderly pt) Think

Staph Aurues Pnuemo

A pt presents with blood stained (currant jelly) sputum Think

Klebsiella pneumonia

What is the Tx of choice for Klebsiella pneumonia

Piperacillin/ Tazobactam

What ABX can be used in Smockers with bronchitis

Amoxicillin

A child presents with a frenal ulcer, and a characteristic cough.. think

Pertussis

What is the Tx of choice for Pertussis

Azithromycin