Review Flashcards
(169 cards)
1
Q
What causative agent of malaria has the worst prognosis?
A
Plasmodium Falciparum
2
Q
How is malaria transmitted?
A
Bite of infected female anopheles mosquito
3
Q
What are some S/Sx of poor prognostic factors of malaria?
A
- Marked agitation
- Hyperventilation
- Hypothermia
- Bleeding
- Deep coma
- Anuria
- Shock
4
Q
What is the causative agent for the Plague?
A
Yersinia pestis
5
Q
What is the vector for the plague?
A
Rat flea
6
Q
What is the MC form of the plague?
A
Bubonic plague
7
Q
What are some s/sx of the plague?
A
- F/C
- HA
- HypoTN
- Shock
- DIC
- Blood clots leading to arterial obstruction and acral gangrene = black death
8
Q
What is the reservoir for ebola hemorrhage fever?
A
Fruit bats
9
Q
How is ebola hemorrhage fever transmitted?
A
Consuming bushmeat
bats, gorilla, chimpanzees, shrews, and duikers
10
Q
What are some clinical manifestations of ebola hemorrhagic fever?
A
Hemorrhage:
- Hematochezia
- Petechiae
- Ecchymosis
- Mucosal bleeding
- Hematemesis
11
Q
How is schistosomiasis transmitted?
A
Blood flukes enter the skin from contaminated water (walking barefoot on the beach)
12
Q
A clinical manifestations of schistosomiasis is Katayama fever, what species does that primarily occur with?
A
Schistosoma mansoni and Schistosoma japonicum
13
Q
What are some s/sx of Katayama fever?
A
- Chest pain
- Hematochezia
- Hepatosplenomegaly
- F/C
14
Q
What is a tx for schistosomiasis?
A
Praziquantel
15
Q
What is the causative agent for toxoplasmosis?
A
Toxoplasma gondii
16
Q
How is toxoplasmosis transmitted?
A
- Inhalation of oocysts from cat feces
- Vertical transmission from mother to fetus
- Ingestion of oocysts in raw pork
17
Q
What is a manifestation of Toxoplasmosis transmitted congenitally?
A
Retinochoroiditis
18
Q
What is the tx for Toxoplasmosis?
A
Pyrimethamine and sulfadiazine w/ Leucovorin
19
Q
What is a clinical finding in a pt who has contracted scabies?
A
Linear burrows in interdigital web spaces
20
Q
What is the hallmark sx in some with scabies?
A
Intense pruritus
21
Q
What is the tx for scabies?
A
Permethrin cream
22
Q
What is the MC bedbug in the US?
A
Cimex Lectularis
23
Q
How is bedbugs transmitted?
A
Fomite contact: mattress, cushions, pillows, wooden bed crevices
24
Q
S/sx of someone who has been bitten by bedbugs?
A
Urticaria and itching
25
What is tx for bedbugs?
- Malathion
- Lindane
- Calamine lotion
26
What is the causative agent for body lice?
Pediculus humanus corporis
27
Body lice is a human vector for what disease?
Rickettsia prowazekii - causative agent for epidemic typhus
28
What is the difference between flea bites and scabies bites?
Flea bites are more spread out lesions while scabies bites are more of a cluster and closer together.
29
What is the tx for ascariasis?
- Mebendazole
- Albendazole
- Ivermectin
30
What is the tx for Enterobiasis (pinworms)?
- Albendazole
- Mebendazole
- Pyrantel pamoate
31
What is the tx for Necatorisais (hookworm)?
- Mebendazole
- Albendazole
- Pyrantel pamoate
- AND Iron supplementation
32
What is the tx for Pork tapeworms?
Praziquantel
33
What is the tx for pork tapeworm if cystericosis occurs?
- Albendazole + Praziquantel + Steroids
| - or Albendazole +/- steroids
34
What is the tx for beef tapeworms?
Praziquantel
35
What is the causative agent for Necatoriasis (hookworms)?
Necator americanus
36
What is the causative agent for enterobiasis (pinworms)?
Enterobius Vermicularis
37
What is the causative agent for pork tapeworms?
Taenia Solium
38
What is the causative agent for beef tapeworms?
Taenia saginata
39
What is the causative agent that caused a group of Mexican immigrants to get sick when they ate pickled pork?
Taenia Solium ---> pork tapeworms
40
What lab work must be done in a pt with Necatoriasis?
Iron panel d/t iron deficiency anemia
41
How is Trichinellosis/Trichinosis transmitted?
Ingestion of encysted larvae in uncooked pork
42
What is the MC cause of death associated with Trichinellosis/Trichinosis?
Myocarditis
43
What is the tx for Trichinellosis/Trichinosis?
- Mebendazole or Albendazole
| - and Prednisone
44
What is the causative agent for Lyme disease?
Borrelia Burgdorferi
45
What are the vectors for lyme disease?
Deer tick, sheep tick, taiga tick, black-legged tick
46
What is the rash called in someone who has lyme disease?
Erythema migrans
47
What is the tx for lyme disease?
Doxy
| - alt: amox and cefuroxime
48
What is the causative agent of Rocky Mountain fever?
Rickettsia Tickettsii
49
What is the vector for Rocky Mountain fever?
Dog tick or rocky mountain wood tick
50
What clinical presentation would you see in someone who has been infected with Rocky Mountain fever?
Centripetal; "inward" macular rash, palms and soles involved
51
What is the tx for Rocky Mountain fever?
Doxy
| - alt: chloraphenicol
52
What mosquito born disease will have a positive tourniquet test?
Dengue: febrile phase
53
What clinical manifestation can occur if a pregnant women is bitten by a mosquito carrying the Zika virus?
Microcephaly
54
What mosquito born disease has a vaccine available?
Japanese Encephalitis
55
What is the highest mortality/most severe mosquito born illness in the US?
Eastern equine Encephalitis
56
Where is Hantavirus Pulmonary Syndrome found?
All 4 corners
57
Where are rabies found?
Worldwide
58
What is the MC rabies vector in the US and Africa and Asia?
US: bats
| Africa and Asia: Dogs
59
What laboratory diagnostic finding would you see in someone who is infected with rabies?
Negri bodies histologically
60
Mother brings pt in with poss. conjuctivitis, reports they just got back from Costa Rica, what disease do you suspect pt has?
Chagas disease
61
What is the causative agent for chagas disease?
Trypanosoma cruzi
62
Pt comes in with photophobia nonproductive cough, and acute fever you ask if he has around any birds and he reports he loves to play with birds especially parrots what do you suspect the pt has?
Psittacosis
63
What is the causative agent for Psittacosis?
Chlamydia psittaci
64
What is the tx for Psittacosis
Doxycycline or Tetracycline
65
HIV is a member of what virus group?
Retroviridae group of viruses
66
HIV attacks what specific immune cell?
CD4
67
What is the MC way HIV is transmitted?
Sexual contact
68
What is the MC way healthcare workers contract HIV?
Needle stick
69
What is the HIV post prophylaxis medication regimen?
Emtricitabine, Raltegravir, and Tenofovir
70
What is the HIV pre prophylaxis medication regimen?
Truvada: Emtricitabine/ Tenofovir DF
71
How often should you check the HIV antibody?
Every 3 mos
72
Crystal-induced nephropathy associated with what drug?
Indinavir (Protease inhibitor)
73
CNS sxs associated with what drug?
Efavirenz (NNRTI)
74
What is the prophlyaxis tx for pneumocystis pneumonia?
TMP/SMZ (bactrim)
75
What is the tx for thrush?
Nystatin: swish and swallow
76
What is the difference between Cryptosporidiosis and Cryptococcosis?
Cryptosporidiosis: causes diarrhea- infection affecting small bowel mucosa
Cryptococcosis: causes meningitis
77
Why are older pts at risk for HIV?
- Divorces and death of a spouse
- Erectile dysfunction meds
- Contraception no longer a concern
- postmenopausal
- Vaginal atrophy = small cuts/tears = increased blood exposure
- Less discussion during encounters with PCP
78
Why are women at risk for HIV?
- Irregular mensuration
- Recurrent vulvovaginal candidiasis
- HPV related cervical dysplasia
- Invasive cervical cancer
79
Why are children at risk for HIV?
Perinatal transmission- transplacental (MC)
| In utero, during childbirth, breast-feeding
80
Pt recently had an organ transplant and is now being diagnosed with a fungal infection, what do you suspect she has?
Aspergillosis: Aspergillus fumigatus
81
What fungal infection will you see a halo on CT scan?
Invasive Aspergillosis
82
What fungal infection will you see a reverse halo on CT scan?
Mucormycosis
83
Pt reports he just got back from Michigan after digging lots of ditches and its presenting with flu-like sxs, what do you suspect?
Blastomycosis
84
What is the tx for Blastomycosis?
Mild to moderate: Itraconazole
Severe: Amphotericin B then Itraconazole
85
What fungal infection is most commonly associated with getting pricked by a rose thorn?
Sporotrichosis
86
What is the causative agent for Sporotrichosis?
Sporothrix shenckii
87
What is the tx for Sporotrichosis?
Itraconazole
88
What fungal infection would you suspect if pt reports he was crawling/ spelunking through caves near the Ohio river this past weekend?
Histoplasmosis
89
What is the causative agent for Histoplasmosis?
Histoplasma capsulatum
90
What is the tx for Histoplasmosis?
Mild to moderate: Itraconazole
Severe: Amphotericin B
91
What fungal infection is associated to disruption of soil during dust storm?
Coccidioidomycosis
92
What is the causative agent for Coccidioidomycosis?
Coccidioides immitis
93
Where is Coccidioidomycosis most likely to be found?
Desert region: Mexico, AZ, CA
94
What is the causative agent for cat scratch disease?
Bartonella Henselae
95
What is the drug of choice for cat scratch disease?
Azithromycin
96
What is the causative agent for infections in wounds (cellulitis) related to dogs and cats (ie cat bites)?
Pasteurella multocida
97
What is the treatment of choice for pasteurella multocida?
Amoxicillin-clavulanate (Augmentin)
98
What is the causative agent for Tularemia?
Francisella Tularenis
99
What is the hallmark clinical manifestation for Oculograndular Tularemia?
Painful auricular LAD
100
What are the hallmark clinical manifestations for Ulceroglandular Tularemia?
Ulcerated skin, regional LAD
101
Why are NSAIDS contraindicated in a pt with dengue hemorrhagic fever?
Thrombocytopenia
102
What is the AIDS defining cancer caused by human herpes virus 8?
Kaposi Sacroma
103
What is the toxicity associated with integrate strand transferase inhibitors?
Hypercholesterolemia
104
Localized erythema and edema at the site of parasitic entry into the body associated with T. cruzi is called what?
Chagoma
105
Clinical presentation of a pt who crawled through caves enriched with bird or bat guano and developed progressive disseminated histoplasmosis?
Oral mucosa ulcerations, erythema multiform/nodosum
Adrenal insufficiency
106
What fungal disease is caused by encapsulated budding yeast associated w/exposure to contaminated soil and dried pigeon stool?
Cryptococcosis
107
What is the MC first manifestation of Cryptococcosis?
Headache
108
Scotch-tape test helps diagnose what?
Pinworms (Enterobiasis)
109
What is the causative agent of Scabies?
Scaroptes scabiei var. hominis
110
How are respiratory sxs caused by Ascarias?
Ingestion of infectious eggs from fecal contaminated soil, water or vegetables then is carried into the circulation to the lungs resulting in SOB, cough and Loefflers syndrome
111
What is Loefflers syndrome?
Eosinophilic pneumonia
112
CD4 count is used to monitor HIV what does it measure?
Measures the status of the immune system and disease progression
- shows risk of opportunistic factors
113
Viral count is used to monitor HIV what does it measure?
Measures the response to and efficacy of HAART and gives correspond info to the CD4 count
114
What needs to be done if viral load is >50 after 4 mos of treatment?
Regimen modifications may need to be done
| below 50 = undetected stage
115
What is the MC presentation of cytomegalovirus?
CMV retinitis
116
What is one other presentation of cytomegalovirus?
CMV Esophagitis
117
What are s/sx of CMV retinitis?
Unilateral (usually)
- Vision changes, loss of peripheral vision, scotoma, and/or floaters
118
What are s/sx of CMV esophagitis?
- Chest pain, odynophagia and nausea
| - EGD: ulceration in distal esophagus, biopsies to confirm dx
119
Where is malaria most prevalent?
Sub-Saharan Africa and New Guinea
| US: southern states
120
What topical medication would you use to treat tinea unguium?
- Ciclopirox (nail lacquer)
121
What systemic medication would you use to treat tinea unguium
- Terbinadine x 3 mos (1st line)
| - Itraconazole x 3 mos
122
What medication would not be used to treat tinea unguium?
Nystatin
123
What is 1st line tx for SEVERE fungal infections?
Amphotericin B
124
What necessary steps need to be taken if a pt is having infusion related ASEs with Amphotericin B?
- Reduce infusion rate
| - If rigors occurs give Meperidine
125
What should be done prior to infusions of Amphotericin B to avoid ASEs?
```
Test dose (required for deoxycholate formulation)
- 1 mg IV over 20-30 minutes
```
Pre-meds 30 minutes prior
- Antipyretics: acetaminophen or NSAIDs
- Antihistamine: diphenhydramine
- Steroids: Hydrocortisone
126
How is Fluconazole excreted?
Renal
| - need to dose adjust
127
How is Flucytosine excreted?
Renal (>90%)
| - need to dose adjust
128
How is Voriconazole excreted?
Liver
| - need to dose adjust
129
What is a core element for good antibiotic stewardship?
- Effective communication
| - Managing pt and family expectation for antibiotic during a clinical visit
ie viral vs bacterial
130
What is the 1st line tx for Hep C?
Ledipasvir/sofosbuvir x 12 wks
131
What is an advantage of Hep C tx?
99% curable!
132
If CD4 count is <200 how would you treat?
Prophylaxis Bactrim PCP (pneumocystis pneumonia)
133
If CD4 count is <100 how would you treat?
Bactrim prophylaxis TE (toxoplasma gondii encephalitis)
134
What additional antibiotic therapy would you start in a pt whos CD4 was at 150 but now 50?
Azithromycin/Clarithromycin MAC (mycobacterium avium complex)
135
A healthcare worker was stuck by a needle how would you treat and for how long?
Tenofovir DF 300mg/Emtricitabine 200mg (Truvada) once daily
PLUS
Raltegravir 400mg BID or Dolutegravir 50 mg qd
x 28 days
136
What is the treatment for Influenza?
- Oseltamivir (Tamiflu) - dose adjust for renal function
137
What is 1st line initial tx for HIV infection?
Intergrase Strand Transfer Inhibitor based regimens
| -gravir
138
What is 1st line tx for HBV?
Tenofovir
| - monitor for HBV reactivation after d/c
139
What is the medication regimen for a pt co-infected with HBV + HIV?
```
Tenofovir
+
Lamivudine (or emtricitaine)
+
Efavirenz
```
140
What medications are used to boost therapeutic levels of other antiviral?
Protease inhibitors (ie. Ritonavir)
141
What is the tx for HSV encephalitis?
Acyclovir
| 10mg/kg (IBW)/dose IV q 8 hrs x 14-21 days
142
Primaquine is a medication that is used to manage Malaria, what can it cause?
Hemolytic Anemia in G6PD deficiency
143
Pt is in the hospital, they have used IV and multi-system resistance Malaria what is the most appropriate combo regimen?
Artemisinin + Lumefantrine
144
When taking antihelminth drug (ie Praziquantel) what do you want to avoid doing when taking these drugs?
Chewing tablets
| - induces retching and vomiting, very bitter
145
When you take Albendazole for luminal agent what do you want to make sure you do?
Take on empty stomach
146
When you take Albendazole for systemic agent what do you want to make sure you do?
Take with food to get absorbed
| - fatty meal is best
147
What is first line tx for pinworms?
Pyrantel Pamoate
| - only effective for helminths in the GI tract (luminal)
148
What malaria medication and dose do you take only 1 tablet a week and is good for longer duration?
Mefloquine
| - 250mg/wk 1-2wks before/4 wks after
149
What ASEs do you want to be cautious of when taking Mefloquine?
Neuropsychiatric ASES
| - seizures and psych disorders
150
Malarone is an antimalaria prophylaxis that is made up of what two medications and what dose?
Atovaquone + proguanil
| - 100mg-250mg/day 2 days before/7 days after
151
What malaria prophylaxis is used for mission trips to Haiti and what is the dose?
Chloroquine
| - 500mg/wk 1-2wks before/4wks after
152
What is 1st line tx for HSV and shingles?
Valacyclovir
153
What is 1st line tx for CMV?
Valganciclovir or Ganciclovir
154
How would you tx a symptomatic pt who gets entamoeba histolytica?
Metronidazole + Paromomycin (luminal agent)
| - combo used when needing to treat luminal infection
155
How would you treat an asymptomatic pt who gets entamoeba histolytica?
Only need to be treated with luminal agent: paromomycin
156
How would you treat a pt who is returning in from a trip from India, states he has a "tough GI system did not care about what food or water he consumed" you are concerned about flagellated protozoa how would you treat?
Metronidazole
157
What causes ASEs of Mebendazole?
Dying helminths may cause inflammation/immunologic/allergic response to proteins released from dying helminths.
158
How do you avoid the ASEs of antihelminths?
Take in combo with glucocorticoids (prednisone or dexamethasone) to reduce inflammatory response.
- ie: Praziquantel + prednisone to prevent inflammation
159
What is the dose for Doxycycline for malaria prophylaxis?
100mg/day 2 days before/4 wks after
160
What is the tx for Toxoplasmosis?
Pyrimethamine + sulfadiazine (w/ folinic acid )
161
What Biomarker that is usually elevated in systemic bacterial infections but not viral?
Procalcitonin
162
How is crack cocaine use associated with increased prevalence for HIV infxn?
Cocain for sex bartering
163
What is amebiasis mode of movement?
Pseudopods
164
What is Giardias mode of movement?
Flagella
165
What drug is used to treat influenza resistant to neuraminidase inhibitors?
- Baloxavir Marboxil - out patient labeling
166
What is the first line treatment of roundworms (AKA ascariasis)?
Albendazole
167
What is the first line treatment for hookworms (AKA necator americanus)?
Albendazole
168
What is the first line treatment of lymphatic filariasis?
Diethylcarbamazine
OR
Albendazole + Ivermectin
169
What is the first line treatment for strongyloidiasis and onchocerciasis?
Ivermectin
