Food disease (non GI) 1. Descending paralysis 2. Flush / Urtricaria 3. Paresthesia 4. Neurologic 5. Meningitis 6. Cellulitis / Sepsis 7. Jaundice 8. Fever / Arthralgia

1. Botulism 2. Scombroid 3. Ciguatera 4. Pufferfish 5. Listeria 6. Vibrio 7. Hep A 8. Brucellosis

UW3 (04 ID) Flashcards by M S

TB
Transmission duration?
If ppd negative?

Transmission –> upto 3m

If PPD ⊝ –> repeat @ w8-10

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Norovirus

Common symptom?
Risk factor? 3

Vomit&raquo_space; Diarrhea

Restaurant
Travel
Healthcare

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Food disease (non GI)

Descending paralysis
Flush / Urtricaria
Paresthesia
Neurologic
Meningitis
Cellulitis / Sepsis
Jaundice
Fever / Arthralgia

Botulism
Scombroid
Ciguatera
Pufferfish
Listeria
Vibrio
Hep A
Brucellosis

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Flushing
Throbbing headache
Palpitation
Abdominal cramp
Diarrhea
Oral burning
Onset <30m after eating seafood

Diagnosis?
Treatment?

Scomboid

Self limit

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Acute Rheumatic Fever

Symptoms / Manifest ? 7
EKG?
Lab? 2
Complication?
Prevention?

Migratory Arthritis
Carditis
Subcutaneous Nodules
Erythema Marginatum
Sydenham Chorea
Fever
Arthralgia

Prolong QR

ESR / CRP

Mitral regurg/stenosis

Penicillin (Prevention @ GAS)

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Labile emotion
Irregular rapid movement
Face / Hand / Feet
Onset after post infection

Diagnosis?
Cause?
Treatment?

Sydenham Chorea

Rheumatic fever

Penicillin

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HIV

co-infection screen? 5

TB
Hep B+C
Syphilis
Gonorrhea
Chlamydia

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Cryptococcus CNS infection

Rash description?
At what CD4 level infection occur?
CSF results? 4
Treatment 2
Follow up?

Molluscum like rash

Infection @ CD4 < 100

CSF
Open P > 280
Lymphocyte ↑
Leukocyte ↓
India Ink ⊕

Amphoteracin B + Flucytosine (2w)
Fluconazone (8w-1y)

Serial LP @ ↑ ICP

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Marine / Oyster / Water wound
Rapid progression
Septicemia / Shock
Hemorrhagic bullae / Nec fasc

Diagnosis / Microbe?
Risk? 2
Treatment? 3

Vibrio Vulnificus

DM / Liver disease

Ceftriaxone / Doxycycline / FQ

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Painless pustule @ distal extremities
Pain + Swelling @ passive extension

Diagnosis?
Lab test?

Gonorrhea Arthritis

Gonorrhea NAAT
HIV
Chlamydia

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Constipation in children

Treatment? 4

Fiber
Water
Laxatives
Suppository / Enema

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Syphilis @ pregnancy

Maternal effects? 2
Fetal effects? 6

IUFD
Preterm

Hepatomegaly / Jaundice
Hemolytic Anemia
Thrombocytopenia
Long bone
FTT

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Necrosis @ palate / orbit / brain

Diagnosis?
Risk? 3
Diagnostic? 3
Treatment? 2

MucorMycosis

DM / DKA / Transplant

Sinus endoscopy + biopsy + culture

Debridement
Amphotericin B lipid

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Toxic Shock syndrome

Common microbe?
Mechanism?
Treatment?

S. Aureus + foreign object

ExoToxin –> T-cell activation –> Cytokine ↑

IVF + Oxacillin / Nafcillin / Vancomycin

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Latent TB (treatment)

Typical?
If requries supvervision?
If resistant?
If non indication of infiltration?

Isoniazid: 6-9m

Isoniazid + Rifampin: 3m supervised

If resistant –> Rifampin 4-6m

No Infiltration –> No work restriction

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Chagas disease

Cardiac problems? 4
GI problems?

R > L HF
Cardiomegaly
Ventricular apical aneurysm
Conduction anomaly

Dilation @ esophagus / colon

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Decaying plant/soil / Gardner / Landscaper
Papule
Ulceration
drain (nonpurulent / odorless)
Proximal lymphatic

Diagnosis?
Diagnostic?
Treatment?

SporoTrichosis
Dimorphic fungus

Fluid aspiration / Skin biopsy & culture

Itraconazole PO 3-6m

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Pneumonia (differential)

Verucus + Heaped up border
Abscess
Nodular / Papular / Plaque
Fever / Fatigue / Weight ↓

BlastoMycosis

CoccidoMycosis

Histoplasmosis

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Jaw
Non-Tender mass
Abscess / Fistula
Discharge (yellow / serous / granule)

Diagnosis?

ActinoMycosis

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Fever by duration

< 10d? 5
1-3w? 5
> 3w? 3

Typhoid
Dengue
Chikugunya
Influenza
Legionella

Typhoid
Malaria
LeptoSpirosis
SchistoSomiasis
Rickettsia

TB
LeishManiasis
Enteric parasite

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Thin
White
Fish odor

Diagnosis?
Vaginal inflammation?
labs?
Treatment?

Vaginosis

Clue Cells
Whiff KOH

Metronidazole (chlamydia co infection)

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Yellow Gray
Frothy
Malodorous

Diagnosis?
Vaginal inflammation?
labs?
Treatment?

Trichomoniasis

Yes

Motile
Flagellated

Metronidazole + Treat Partner

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Thick
White
Cheesy

Diagnosis?
Vaginal inflammation?
labs?
Treatment?

Candidiasis

Yes

PseudoHyphae

Fluconazole

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Necrotizing Fasciitis

Common microbes? 3
Medications? 3

StreptoPyogenes
S. Aureus
C. Perferingens

1) Zosyn / Imipenem / Meropenem
2) Vancomycin
3) Clindamycin

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Neisseria Meningitis (exposure) Treatment indication? 4 Medication? 3

Household Daycare Resp / Oral Exposure Exposure > 8h 1) Rifampin PO 2) Ciprofloxacin IM 3) Ceftriaxone

C-diff diarrhea | Recurrent prevention

Vancomycin | Monoclonal Ab

Human Bite Microbe? Treatment?

Eikenella Corrodens Augmentin (Amoxicillin+Clabulanate)

RMSF Labs? 4 Treatment?

Plt ↓ Na ↓ AST ↑ / ALT ↑ Doxycycline

Urethritis Watery / Scant Common microbe/cause? 4 Treatment?

Chlamydia Ureplasma Myoplasma Trichomonas Azithromycin

Urethritis Purulent Common microbe/cause? Treatment?

Gonorrhea Ceftriaxone + Azithromycin

Oral Lesion (differential) Anterior No systemic Vesicular / Ulcer Posterior Fever Vesicular / Ulcer Anterior / Mouth Fever Tonsillar exudate Fever Ant Cerv Lymph Tonsillar exudate Fever Post Cerv Lymph HepatoSplenomegaly

Apthous HerpAngina Herpes GingivoStomatitis GAS / Strep Inf Mono

Breast mass Fluctuating & tender Diagnosis? Diagnostic?

Breast abscess US --> FNA

``` Rash Posterior OP Painful Vesicle Summer Age 3-10 ``` Diagnosis? Microbe?

HerpAngina Coxsackie A

HookWorm Lab? Treatment?

Hb ↓ Eosinophilia Albendazole Nitrazoxanide

Acute OM Treatment?

Amoxicillin Augmentin Azithromycin Clindamycin

C-diff diarrhea (treatment) Initial? Recurrence? Multiple recurrence? 2 Fulminant (shock / ileus)? 3

Vancomycin / Fidaxomicin Repeat treatment Vancomycin + Rifaximin Fecal transplant Metronidazole IV Vancomycin PO Surgery

Congenital infection Hearing loss Cataract PDA Purple non-blaching nodule Hydrops / IUFD Vesicles Meningitis Hepatomegaly Jaundice Rhinitis MaculoPapular rash Hepatosplenomegaly Hearing loss Purpura PeriVentricular calcification Hepatosplenomegaly Hearing loss Purpura IntraCerebral calcification

Rubella HSV Syphilis CMV Toxo

HIV screening Age group? Tests?

Age 15-36 | P24 antigen + HIV Ab

Cystitis treatment @ pregnancy? 4 | Medications to avoid? 2

Nitrofurantoin Cephalexin Fosfomycin Augmentin Floroquinolone Bactrim @ T1

Pyelonephritis @ pregnancy Common microbe? 2 Fetal complications? 3 Management?

E. coli Klebsiella reterm SGA ARDS Admit IVF Ceftriaxone/Cefepime

Hepatitis B Typical course? Admission criteria? 4

Clear within 6m OP FU monitor Age > 50 Poor Po intake Unstable / Ill Coag ↓

Congenital Toxoplamosis Important findings? 3 Other findings? Treatment?

ChorioRetinitis Diffuse IC calcification Hydrocephalus ``` Microcephaly Macrocephaly Seizure Jaundice Hepato/Spleo-megaly Rash IUGR ``` Pyrimethamine (deplete FA) + Sulfadiazine + Folinic acid

Bacterial Sinusitis (medication) Treatment? 3 Avoid? 4

1) Augmentin 2) Doxycycline 3) Fluoroquinolone Amoxicillin Macrolides Bactrim Cephalosporin 2/3

Hep B High risk = need vaccine? 8

``` Multiple sexual partner History of STD Homosexual IVDU CKD Hep C HIV Hep B contact ```

Lactational mastitis (treatment) MSSA? 4 MRSA? 3

1) Dicloxacillin 2) Cephalexin 3) Erythromycin 4) Clindamycin 1) Bactrim 2) Clindamycin 3) Vancomycin

NeoNatal Sepsis 2 Common microbe? 2 treatment? Age < 28d Age > 28d

E. Coli GBS Ampicillin + Gentamicin Cefotaxime S. Pneumoniae N. Meningitidis Ceftriaxone Cefotoxime + Vancomycin

Infectious Mono | Steroid indication? 4

Airway obstruction Overwhelming infection Aplastic anemia Plt ↓

HIV @ pregnancy Lab checks? 2 Start what medication? Avoid what procedures? 3 Delivery?

RNA q2-4w CD4 q4-6m Start: HAART Avoid amniocentesis / AROM / FSE Typical: Vaginal delivery CS if Viral load > 1k

Syphilis treatment Primary / Secondary / Latent < 12m ? Latent > 12m / Gumma / CV? Neuro? Congenital?

Penicillin G IM x1 Penicillin G IM q1w x3 Penicillin G IV q4h x14d Penicillin G IV q6-8h x10d

Fever Systemic illness Rash Progression 1) Painless / Red macule 2) Pustule / Bullae 3) Gangrene ulcer Diagnosis? Risk factors? Common microbe? Treatment?

Erythema Gangrenosum Immunocompromised Central venous cathether Pseudomonas infection Zosyn + Gentamicin

Pharyngitis: Gray & Pseudomembrane Cervical Lymph Diagnosis? Complication? 3 Tests? 2 Treatment? 3

Diphtheria MyoCarditis Neuritis Kidney disease Resp Culture Toxin Assay 1) Erythromycin 2) Penicillin 3) Anti-Toxin

Hep B (PEP) Vaccinated? No vaccine + source has Hep B? No vaccine + source has no hep B?

Nothing Vaccine + IVIG Vaccine

Dengue Symptoms? 4 Hemorrhagic indication? 4

Flulike Myalgia Joint pain Retro-Orbital pain Plt ↓ Spontaneous bleed Shock Petechia @ BP cuff

Strep Throat Treatment? 3 Compmlications? 4

1) Penicillin / Amoxicillin 2) Cephalexin / Cefadroxil 3) Azithromycin / Clindamycin Peri-Tonsillar abscess Cerv Lymph Adenitis Glomerulo Nephritis Rheumatic Fever

HIV infection Skeletal like appearance Abdominal fat Diagnosis? Risk/cause? Complication? Treatment?

HIV LipoDystrophy NRTI Stavudine Zidovudine Insulin resistance Dyslipidemia CV disease Statin

High infection risk wound? 5

``` Crush Hand / Feet Cat bite Human bite ImmunoCompromised ```

Cutaneous Cryptococcus Skin manifest? Diagnostic?

Mollescum like Papule Central umblication Central hemorrhage / necrosis Biopsy Granuloma Encapsulated yeast

Chlamydia | Treatment? 4

Azithromycin Doxycycline Ceftriaxone Gentamicin

Pneumonia Microbe & Treatment? Preschool? Older?

S. pneumoniae Amoxicillin Mycoplasma Azithromycin

Salmonella Enteritis (treatment) Age < 12m? 4 Adults? 5

Ciprofloxacin Bactrim Azithromycin Ceftriaxone Levofloxacin Bactrim Azithromycin Ceftriaxone

TB Initial tests? 2 Latency indication? Treatment? Active indication? Treatment?

PPD / Ig ⊕ CXR CXR ⊕ Symptoms ⊝ Isoniazid 9m Rifampin 4m ``` CXR ⊕ Symptoms ⊕ Sputum ⊕ Rifampin Isoniazid Pyridimine Ethambutol ```

Symptom > 3m Recurrent UTI Pain @ penis / groin Diagnosis? Treatment?

Prostatitis FQ Bactrim

SchistoSomiasis Labs & Tests? 2 Treatment?

Eosinophil ↑ Urine: Sediment & Eggs Praziquantel

CAP (empiric treatment) OP? 3 IP? 2 ICU? 2

Macrolide / Doxycyline FQ Ceftriaxone + Azithromycin FQ Ceftriaxone + Azithromycin Ceftriaxone + Azithromycin Ceftriaxone + FQ

PCP @ HIV Steroid use indication? 2 BAL indication? 2

A-a > 35 PaO2 < 70 Worsening symptom Confirm PCP

Serous OM Treatment?

After AOM, Persist > 3m Observation

Diarrhea (differential / microbee?) Short duration < 2w - Short / Vomit? (2) - Contamination? - Bloody / Pseudo-Appenditis - Fever - Fever / Bloody Long duration > 2w - Chronic / Immune ↓ (3) - Prolong / Relapse - Wild / Rural

Short duration < 2w - Rota / Noro - E. coli - CampyloBacter - Salmonella - Shigella Long duration > 2w - CryptoSporidia / ystoSporidia / MicroSporidia - CycloSpora - Giardia

Anti-Retroviral treatment @ HIV Initial improvement Subsequent (weeks) paradoxical worsening Diagnosis? Management?

Immune Reconstitution Inflammatory Syndrome Continue medical treatment

Aspergillosis 3 common symptoms? CT chest findings? 3 2 Additional testing? Treatment?

Cough Pleurisy Hemoptysis CT chest Ground glass opacitiy / Halo Cavitations Pulmonary nodules Serum: GalactoMannan / Beta-D-Glucan Sputum: Fungal stain & culture Treatment = VoriConazole

Cat scratch | Treatment?

Azithromycin