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Q Set A Flashcards

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1
Q

Rickettsia akari

A
  • rickettsialpox
  • NYC, house mouse mite, mild
  • eschar then papular/vesicular lesions
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2
Q

Endocarditis with nutritionally variant Strep tx

A

Granulicatella + Abiotrophia

  • harder to treat than Strep viridans
  • tx: 4 wks pcn or ctx PLUS 2 wks gent
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3
Q

Rickettsia rickettsii

A

RMSF

  • severe, no eschar; south central + SE US (also SW adobe homes); rash can be delayed (wrists/ankles)
  • low or high WBC, thrombocytopenia
  • Dermacentor tick (dog tick)
  • more severe than Ehrlichiosis
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4
Q

Borrelia hermsii

A

Tick-borne relapsing fever

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5
Q

Borrelia recurrentis

A

Louse-borne relapsing fever

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6
Q

Orientia tsutsugamushi

A

SCRUB typhus

  • chiggers
  • SE Asia, Russia, Australia
  • rural
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7
Q

Rickettsia typhi

A

ENDemic typhus

  • cat/rat fleas
  • temperate, usually tropical - Calif, TX, HI
  • RF homeless
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8
Q

Rickettsia prowazekki

A

EPIdemic typhus

  • body louse
  • homeless, refugees, war, famine
  • flying squirrels
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9
Q

Rickettsia conorii

A
  • one eschar

- Southern Europe/Mediterranean

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10
Q

Rickettsia africae

A
  • South Africa, tall grasses, safari
  • multiple eschars
  • Amblyomma tick
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11
Q

HTLV-1

A
  • Caribbean, Japan
  • recurrent persistent strongy
  • rare: spastic paraparesis
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12
Q

Herpes B infection

A
  • macaques

- deep wounds –> valacyclovir asap

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13
Q

Chronic granulomatous disease (CGD)

A
  • aspergillus, Staph aureus, Nocardia, Serratia
  • outside US: BCG, salmonella, Burkholderia
  • dx: dihydrorhodamine 123 oxidation test
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14
Q

Adult Still’s disease

A
  • high F, arthritis/arthralgias, evanescent rash (salmon pink on trunk/extremities)
  • elevated inflammatory markers
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15
Q

Mycobacterium bovis

A
  • unpasteurized milk products, Mexico
  • typically PZA resistant
  • abd lymphadenitis, peritonitis
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16
Q

Peripheral Outer Retinal Necrosis (PORN)

A

VZV&raquo_space; HSV

-very low CD4 counts, poor prognosis

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17
Q

Tularemia

A
  • Francisella tularensis (GN)
  • exposure to aerosols (lawn mower infected animals), ticks/flies/tissue, wild game/beavers/rabbits/squirrels
  • suppurative LAD, pulmonary (infiltrates, elevated LFTs, F)
  • tx: streptomycin or gent
  • martha’s vineyard / east coast
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18
Q

Plague

A
  • Yersinia pestis (GN)
  • rodent fleas, infected cats; NM, CO, AZ
  • droplet precautions
  • Bubonic- pustules, eschars, painful LAD
  • Septicemic
  • Pneumonic- bloody sputum, rapidly fatal, focal necrotizing infiltrates
  • tx: streptomycin or gentamicin
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19
Q

Hantavirus pulmonary syndrome

A
  • MCC: sin nombre virus
  • hemoconcentration, thrombocytopenia, elevated LFTs, prolonged PT
  • pna + rodent exposure
  • biphasic
  • SW US
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20
Q

Rabies PEP

A
  • a healthy dog, cat, or ferret that bites someone should be monitored for 10 days prior to giving rabies PEP to the victim
  • if no animal –> given rabies IG (at site of bite and remainder in butt) followed by the vaccine at a different site, and again on days 3, 7, and 14
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21
Q

Chaga’s disease

A

Trypanosoma cruzi; reduviid bugs

  • Central and South America
  • congestive cardiomyopathy, conduction abnormalities
  • megacolon, megaesophagus
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22
Q

Yaws

A

ulcerated or papillomatous lesions

Treponema pallidum sbsp pertenue

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23
Q

Pinta

A
  • Western hemisphere, south of US

- Treponema carateum

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24
Q

Leprosy

A

M leprae

-hypopigmented skin lesions with decreased/absent sensation

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25
Serotonin syndrome
- <1 day onset; serotonin agonists - hyper-reactivity, tremor, clonus (often has prodrome of N, V) - tx: benzos
26
Neuroleptic Malignant syndrome
- 1st dose to wks onset - RIGIDITY, bradyreflexia - antipsychotics - dantrolene
27
Meningitis vaccines
- ACYW: all age 11-18 - B: crowded situations, ages 10-25 or asplenic - PEP: direct contact to oral secretions or within 3 feet for 8 hrs
28
Lyme disease heart block
tx: CTX (over doxy) if needs hospitalization | - resolves in days to wks, no permanent pacemaker needed
29
Hepatitis E
- risk in 3rd trimester for fulminant hepatitis with necrosis - India, Africa, SE asia
30
Hep A PEP
- within 2 weeks of exposure and uncertain vaccine history, given hep A vaccine for people ages 1-40 - if someone is unlikely to respond to vaccine, can give immune serum globulin
31
Saddle nose deformity
syphilis granulomatosis with polyangiitis relapsing polychondritis
32
Relapsing polychondritis
- inflammatory condition of cartilage - floppy ears, saddle nose deformities - if on ear --> spares lobe!
33
Hyperammonemia syndrome
Ureaplasma | Mycloplasma hominis
34
African sleeping sickness
-tsetse fly; can have 'chancre' that resolves East: Trypanosoma brucei rhodesiense- more severe West: T brucei gambiense
35
severe malaria complications
cerebral edema, pulm edema, HYPOglycemia, hemolytic anemia, renal failure, thrombocytopenia, bacterial infection -tx: IV quinidine (hard to get), IV artesunate
36
Rhinosporidiosis
- fleshy pedunculated lesions in conjunctiva or nasal mucosa in normal host - tropical areas - protozoa; stagnant water exposure
37
Encephalitozoon hellem
keratoconjunctivitis + sinusitis in IC
38
LTBI 15mm
no known risk factors
39
LTBI 10mm
-recent immigrants, IDU, healthcare workers / high risk employees, lab personnel, children <4
40
LTBI 5mm
PWH, recent contact, old TB on cxr, SOT, immunosuppressed
41
Hepatitis during secondary syphilis
- high AP and bili relative to AST/ALT (similar to lepto) | - indolent
42
Rheumatic fever ppx
- monthly IM pcn or daily pen VK - RF WITHOUT carditis: 5 yrs or age 21 - RF with carditis: 10 yrs - RF with residual heart disease: until age 40 or 10 yr after RF (whichever is longer)
43
CVID
- recurrent bac resp infections - low IgG - dx: measure specific Ab titers before and after immunization
44
Monosodium glutamate (MSG) sydnrome
=chinese restaurant syndrome - bronhospasm - very short incubation
45
PTLD
- EBV - F, LAD, lymphomatous infiltrates in lymph nodes, spleen, liver, bm, kidney, lung - reduce immunosuppression for tx +/- rituximab
46
Madura foot
=mycetoma - slowly progressive painless destruction of subcutaneous tissue - assoc w/ picking up firewood - bac (nocardia, strep, actinomadura) or fungal (scedo, madurella, fusarium) - dx: examine grains from drainage
47
Buruli ulcer
Mycobacterium ulcerans chronic ulcer progresses over years -tropical countries
48
US300 strain
community acquired MRSA | -with SCCmec IV gene
49
Toxoplasmosis
- acute: febrile cervical adenopathy (mono without sore throat) - reactivation: cerebral lesions or dissem + pulm infiltrates
50
Parvovirus B19 = Erythrovirus B19
- red cell aplasia, arthritis - slapped cheeks in kids - giant abnromal pronormoblasts on bm bx - can cause hydrops in pregnancy
51
Inherent resistance to Ampho B
Aspergillus terreus Scedosporium/Lomentospora Candida lusitaniae
52
Malaria ppx in pregnancy
Avoid travel! | Mefloquine
53
Secondary adrenal insufficiency associated infections
Disseminated TB or histo, meningococcus | HIV, itraconazole
54
Sulfur granules
Actinomyces
55
Pertussis PEP
-household members and close contacts: azithro x 5 days or quarantine x 21 days
56
Allergic fungal sinusitis
- often hx of allergic rhinitis +/- nasal polyps - eosinophils, Charcot-Leyden crystals on path, and NO tissue invasion by the mold - surgical excision
57
Mycobacterial lymphadenitis
- mostly MTB | - M scrofulaceum - kids <5
58
Bloody diarrhea
STEC (shigatoxin producing E coli) Campylobacter Shigella Salmonella
59
Norovirus
- nursing homes, cruises | - vomiting is key sx; can have watery diarrhea
60
Klebsiella oxytoca
-can cause antibiotic-related hemorrhagic colitis
61
HIV-2
``` West Africa ALL NNRTIS (ex. efavirenz) have NO activity against HIV-2 ```
62
Hep B treatment drugs
Emtricitabine, Lamivudine, Tenofovir | Entecavir, Adefovir, Telbivudine
63
FAST growing NTM
FAC Fortuitum Abscessus Chelonae
64
Hemorrhagic cystitis ddx
adenovirus, BK virus, cyclophosphamide, radiation
65
Dirofilaria
- dog heartworm | - can cause solitary (granulomatous) nodule in humans, worm seen on histology
66
acute flexor tenosynovitis
- symmetrical swelling, finger in slight flexion, pain with passive extension, tenderness along flexor tender sheath - needs surgical debridement
67
TTP
anemia, renal, & CNS damage
68
Adenovirus common presentations
non-purulent conjunctivitis, pna, hepatitis, rarely myocarditis
69
Chronic genital HSV not responsive to acyclovir
``` thymidine kinase (tk) deficient HSV --> acyclovir resistance -tx: foscarnet ```
70
Parvovirus B19 = Erythrovirus B19
- red cell aplasia, arthritis - slapped cheeks in kids - giant abnromal pronormoblasts on bm bx - can cause hydrops in pregnancy
71
Mycobacterium ulcerans
Buruli ulcer chronic ulcer progresses over years -tropical countries
72
Mycobacterium ulcerans
Buruli ulcer chronic ulcer progresses over years -tropical countries
73
Louse-borne relapsing fever
74
Louse-borne relapsing fever
Louse-borne relapsing fever
75
Rickettsia parkeri
- Amblyomma tick - SE US - "American boutonnesue F"

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