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ID Flashcards

1
Q

What hematologic laboratory abnormality may be found in patients with infection by the organism Rickettsia ricketsii ?

A

This infection causes Rocky Mountain spotted fever, a disease which affects the vascular endothelium. Thrombocytopenia is a common lab abnormality found in these patient

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2
Q

what bug causes vomiting and diarrhea within hours of ingestion?

A

S. aureus can cause severe diarrhea and vomiting within hours of ingestion due to the toxin produced in the body as a consequence of ingesting this food.

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3
Q

what sexually transmitted dz would Intracytoplasmic inclusions be seen on dx testing?

A

found during diagnostic testing, would confirm the diagnosis of Chlamydia

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4
Q

Fungemia

A

yeast in the blood

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5
Q

tx of fungemia?

A

Amphotericin B, Flucytosine or Fluconazole

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6
Q

Cryptococcus Neoformans is found

A

soil from pigeon poop, pulmonary and CNS/visual symptoms, think immunocompromised

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7
Q

Cryptococcus Neoformans Dx

A

Crypotcoccal antigen in CSF or serum. India ink stain

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8
Q

Cryptococcus Neoformans tx

A

Amphotericin B or Fluconazole for 10 weeks

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9
Q

Histoplasmosis

A

Dimorphic fungus found in soil/bird poop/bat poop in mississippi and ohio

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10
Q

Histoplasmosis symptoms

A

Fever, cough, mouth ulcers, wt loss, retinal deposits

● Chronic progressive pulmonary and Calcified nodules

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11
Q

Histoplasmosis tx

A

Tx: Long term itraconazole, Amphotericin B

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12
Q

chest x ray for histoplasmosis will show?

A

CXR will show miliary infiltrates

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13
Q

Pneumocystis Jiroveci (PCP/PJP) x rays finding

A

diffuse interstitial infiltrates, “Bat wing pattern

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14
Q

Pneumocystis Jiroveci (PCP/PJP) dx

A

BAL or induced sputum

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15
Q

tx of Pneumocystis Jiroveci (PCP/PJP

A

TMP/SMX, steroids if PO2

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16
Q

Pneumocystis Jiroveci (PCP/PJP most common opportunistic infection of ______patients

A

HIV

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17
Q

Tx for Botulism

A

Botulinum antitoxin from CDC

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18
Q

rheumatic fever is caused by

A

Group A Streptococcus (S. pyogenes)

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19
Q

how long after strep hemolytic infection does rheumatic fever show up

A

2-3week

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20
Q

botulism symtoms Ds

A

double vision, droopy head, difficulty speaking, dilated pupils and dry mouth

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21
Q

Major Criteria Jones criteria

A

Polyarthritis, Carditis, Nodules, Chorea, Erythema

Marginatum

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22
Q

Minor Criteria:

A

Arthralgias, Fever, Leukocytosis, Elevated CRP/ESR,

prolonged PR interval

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23
Q 
Risus sardonicus (spasm of the facial muscles causing a
“joker smile”) and Opisthotonus (spasm causing body to go into extreme hyperextension)
A

tentanus

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24
Q

hypersecretion of water & chloride → massive diarrhea →

hypovolemia and metabolic abnormalities

A

Vibrio cholerae

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25
Q

tx cholerae

A

Oral rehydration, antibiotics shorten course (Tetracycline, Ampicillin, TMP/SMX, Quinolones)

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26
Q

Corynebacterium diptheriae

A

Transmitted by respiratory secretions (trachea)

Deadly for infants

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27
Q

complications of Corynebacterium diptheriae

A

Exotoxin causes myocarditis/neuropathy

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28
Q

Enteric fever (typhoid fever) is caused by

A

salmonella (pea like diarrhea and will have fever)

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29
Q

systemic symptoms of enteric fever?

A

splenomegaly, abdominal distension/tenderness, paradoxical bradycardia (low HR even with fever), rash in week 2 (faint pink papular rash on trunk that fades with pressure)

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30
Q

tx of Enteric fever (typhoid fever)

A

Ceftriaxone or Quinolones for 2 wks

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31
Q

Salmonella Bacteremia differs b/c of prolonged fever and what else

A

osteomyelitis

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32
Q

Shigella dysenteriae

A

Sudden onset diarrhea, abdominal cramps, tenesmus (feeling as if you constantly need to evacuate bowels), fever, malaise, headache, loose stools with
blood and mucous

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33
Q

tx Shigella dysenteriae

A

TMP/SMX (Bactrim)

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34
Q

tx of Diphtheria

A

Horse serum antitoxin from CDC,Antibiotics: Penicillin or Erythromycin/Azithromycin and vaccine

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35
Q

pseudomembrane or corn flake membrane

A

Diphtheria

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36
Q

pertussis is caused by

A

Bordetella pertussis

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37
Q

what stage is the Catarrhal

A

the first stage: hacking

cough (mostly at night) most infectious stage

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38
Q

Paroxysmal is what stage of pertussis

A

2nd stage: coughing spasms followed by high-pitched inspirations (whoops, gasping for air)

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39
Q

final third stage of pertussis

A

Convalescent: happens about 4 wks after the onset of cough; paroxysms improves; lasts another 2-3 wks

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40
Q

jones ( must have two major criteria) use JONES for rheumatic fever what are they?

A

JONES (major criteria): Joints (polyarthritis), O (imagine “O” is heart shaped for Carditis), Nodules (subcutaneous nodules on extensor surfaces), Erythema
Marginatum, Sydenham chorea (choreiform movements)

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41
Q

minor criteria for jones criteria (PEACE) or you can have one major and two minor to make dx

A

PEACE: PR, ESR, Arthralgias, CRP, Elevated temperature

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42
Q

LGV (lymphgranuloma venereum)

○ vesicular lesions or ulcers spreading to lymph nodes (inguinal buboes) and anorectal involvement possible

A

Chlamydia

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43
Q

dx Chlamydia

A

ELISA/DNA test to confirm (cervical or urethral swab, or urine sample)

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44
Q

tx for Chlamydia

A

Azithromycin (1gram PO x 1) or Doxycycline course

○ Erythromycin in pregnancy

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45
Q

more painful than Chlamydia
○ milky discharge and dysuria initially then days later have worsening
symptoms with profuse, yellow discharge

A

Gonorrhea

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46
Q

Conjunctivitis via direct inoculation

○ copious purulent discharge (pus pouring out of eye)

A

Gonorrhea

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47
Q

Bacteremia

○ skin lesions (small pustules, gun metal gray, hemorrhagic component and septic arthritis

A

Gonorrhea

48
Q

dx of gonorrhea

A

Culture from infected area

● Infant gonococcus: gram stain of discharge (will see gram negative intracellular diplococci)

49
Q

Name the other Mycobacterium that is not TB?

A 
Mycobacterium avium intracellulare (MAC)
● Affects AIDS patients and immunosuppressed
● Causes lung disease and bone marrow suppression
Mycobacterium marinum
● Affects fish handlers
● Causes skin infections
Mycobacterium kansii
● lung disease
Mycobacterium ulcerans
50
Q

inhaled droplet to get TB everyone gets primary, how many will become latent?

A

95%

51
Q

most common symptoms of TB

A

cough

52
Q

Toxoplasmosis in the brain

A

brain lesions in patients with AIDS (ring enhancing

lesions on CT)

53
Q

Toxoplasmosis tx

A

Pyrimethamine

54
Q

Rickettsia Rickettsii

A

rocky mountain spotted fever

55
Q

Borrelia Burgdorferi

A

lymes

56
Q

Transmission by the Ixodes Tick

A

lyme dz

57
Q

lyme dx

A

Dx by antibodies (ELISA – 50% are false negative so mostly a clinical diagnosis

58
Q

lyme tx

A

Tx: Doxycylcine

59
Q

Erythema Migrans

A

first stage of lyme (target lesion)

60
Q

what MS, CNS and Cardiac complications does lyme dz have?

A

Musculoskeletal (arthralgias), CNS (bells palsy – can be bilateral), Cardiac (heart
block)

61
Q

Transmitted by Wood Tick

A

rocky mountain spotted fever

62
Q

Rash to wrists and ankles which
spreads to the trunk, hepatosplenomegally, ARDS, increased WBC’s,
thrombocytompenia, hyponatremia, hematuria

A

rocky mountain spotted fever

63
Q

tx for rocky mountain fever

A

Treatment: Doxycycline

64
Q

Treponema Pallidum

A

Syphilis

65
Q

Syphilis test dx

A

RPR/VDRL confirm with FTA –ABS

66
Q

Chancre – ulcer to inoculated site with raised edges, round, smooth base, painless, and lymphadenopathy

A

Syphilis

67
Q

Gummatous lesions: skin/bones/viscera/cardiovascular/ aorta

A

syphillis

68
Q

Neruosyphilis

A

Tabes Dorsalis - demyelination of dorsal columns→ impaired

proprioception/ loss of vibratory sense

69
Q

Argyll Robertson Pupil (like prostitutes)

A

accommodation but don’t react (constrict with accommodation but not light)

70
Q

tx syphilis

A

Tx: Benzathine Penicillin G 2.4million units in a single dose – if diagnosed late
give 3 doses 1 week apart

71
Q

name 3 spirochetes

A

lyme, rocky mountain and syphillis

72
Q

worse type of malaria

A

Falciparum is the worst

73
Q

Anopheles mosquito

A

transmits malaria

74
Q

dx malaria

A

Dx. by blood smear stains (not easy)

75
Q

tx of malaria

A

Tx: chloroquine

76
Q

HS family 1-8

A
  1. herpes 1
  2. herpes 2
  3. chicken poxes
    4 Eb Barr
  4. CMV
    6&7 Roseola
  5. Karposi
77
Q

herpes cause what brain disorder

A

encephalitis

78
Q

Varicella Zoster complications

A

Can involve lungs (PNA or superinfection PNA) or brain (encephalitis)

79
Q

Herpes Ophthalmicus

A

Trigeminal nerve – may see Hutchinson’s sign:

herpetic lesion to tip of nose

80
Q

Post-herpetic neuralgia

A

can’t be dx until months after zoster occurred months before, tx with chronic pain drugs

81
Q

Pharyngitis, Lymphadenopathy, fever

A

Epstein Barr Virus

82
Q

Epstein Barr Virus associated with

A

Burkitt’s lymphoma and nasopharyngeal carcinoma

83
Q

difference between small poxes and chicken poxes

A

small poxes are all the same stage

84
Q

Sudden high fevers then days later rash starts as the child is getting better

A

roseola (spread from truck to head)

85
Q

Rash starts on Face and spreads to trunk and limbs

A

rubella

86
Q

Congenital CMV

A

Primary CMV in pregnancy: 10% of babies will have low birth wt, microcephally, seizures, rash, hepatosplenomegally, jaundice,
pneumonia, retinal damage

87
Q

symptoms of mono

A

Posterior lymphadenopathy, rash

88
Q

what happens if you give amoxicillin and pt has mono

A

macularpapular/petechial rash

89
Q

Dx

A

atypical lymphocytes on smear, hemolytic anemia,

thrombocytopenia, increased LFT’s, false + RPR/VDRL b/c of heterophilic antibodies

90
Q

can you give aspirin for mono?

A

no Reyes symptoms

91
Q

mono dx can give you a false positive for RPR- which is for

A

syphillis

92
Q

CMV in AIDS below 50 CD count

A

Retinitis in AIDS pt’s with CD4

93
Q

tx for CMV

A

Ganciclovir, Foscarnet

94
Q

“Sixth disease” “Exanthem subitum” are other names for

A

roseola

95
Q

why is rubella horrible

A

BAD in Pregnancy! – Congenital Rubella syndrome

a. Microcephaly
b. PDA (patent ductus arteriosum)
c. Cataracts

96
Q

slapped cheeks 5th dz is caused by

A

parvovirus

97
Q

most common flu

A

A

98
Q

bigger mutation is shift or drift

A

shift

99
Q

flu symptoms

A

FEVER, muscle aches, sore throat,

100
Q

What signs or symptoms would you expect to find at the bite site of a patient infected with Rabies?

A

These symptoms have classically been described with a rabies infection and occur at the site of inoculation.

101
Q

Which of the following organisms would appear red or pink upon application of a Gram stain?

A

Neisseria gonorrheae

102
Q

Salmonellosis incubation peroid

A

8-48 hours after eating bad food

103
Q

Which of the following is the most common vaginal infection?

A

BV

104
Q

test for Gon and Chal

A

Nucleic acid amplification

105
Q

pasteurella multocida organism is transfered in

A

dog bites

106
Q

if the CD4 count is below 200 then HIV becomes AIDS or if

A

you have a AID related illness

107
Q

if CD4 count is below 500

A

samonella or cdiff, herpes, zoster, TB

108
Q

if CD4 count is below 200

A

PJP, treat with TMP-SMX

109
Q

if CD4 count is below 100

A

toxo, tx with TMP-SMX and histo, tx with itraconazole

110
Q

if CD4 count is below 50

A

CMV (retinitis =) and MAC (mycobacterium avium complex) tx with azthriomycin

111
Q

A 10-year-old girl is brought to the office by her mother for human papilloma virus vaccination. The mother is concerned about what she reads on the internet linking causation between vaccines and medical conditions. The vaccine that her daughter is to receive contains an adjuvant, and the mother asks you to explain the purpose of this ingredient. Which of the following best describes the mechanism of adjuvant function?

A

It boosts the body’s immune response to a given antigen dose

112
Q

Which of the following is a recommended therapy in the treatment of Hepatitis C?

A

Ribavirin & alpha-interferon

113
Q

patient’s cellulitis and abscess are suspected to be caused by MRSA, which of the following is the best oral antibiotic choice?

A

bactrim

114
Q

This is the chief pathogen of interest in dog bites.

A

Pasteurella multocida

115
Q

Zidovudine is a medicine that treats HIV what are the SE

A

peripheral neuropathy and pancreatitis

116
Q

What is the therapy of choice for a patient diagnosed with Coccidioidomycosis?

A

The first line drug of choice for Valley Fever is fluconazole.

PANCE review (19 decks)

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