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Infectious 2

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mikenakhla's version from 2016-05-19 21:47

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Question Answer
2 causes of pneumonia in Cystic fibrosis patientspseudomonas and staph aureus
• Klebsiella pneumonia in who?homeless or alcoholics - currant jelly sputum
• How do you empirically treat for gram negative pneumonias?antipseudomonal penicillin with beta latamase inhibitor (ticarcillin or piperaillin with clavulanate or tazobactam). Alternative is ciprofloxacin or ceftazidime
• Long prodromal pneumonia, gradual worsening of malaise, headache, nonprodutive cough, sore throat, low grade fever. Positive cold agglutinin antibody titers may cause hemolysis or anemia. What is this and how do you treat?this is mycoplasma pneumonia, an atypical pneumonia. Treat with azithromycin doxy, or broad spectrum fluoroquinolone (levofloxacin or moxifloxacin)
• Most common atypical pneumonia causes in adolescens and young adults?mycoplasma and chlamydophila species
• Difference between mycoplasma and chlamydophila atypical pneumonia?mycoplasma has positive cold agglutinin antibody titers and the other is negative
• Treatment for chlamydophila pneumonia?erithromycin if younger than 8 and doxy or azithro older than 8
• Pneumonia in HIV characterized by intracellular inclusion bodies? How do you treat?this is CMV, treat wth valganciclovir
• Treatment for sporothrix schenckii? Thorn gardening thingitraconazole
• Encapsulated bacteria causing sepsis post splenectomystrep pneumoni, H flu, neisseria meningitis (SHiN)
• Pneumonia in california/arizona. How do you treat?coccidiodes immitis, treat with itraconazole or fluconazole but amphotericin B if really severe
• Cave exploring or bird droppingshistoplasma capsulatam
• Pneumonia after exposure to an exotic birdchlamydophila psittaci
• Treatment for aspergillus?voriconazole
• Pneumonia in patient with silicosis:TB
• Treat pregnant woman with toxo withspiramycin
• B12 deficiency and abdominal symptoms, what is this?intestinal tapeworm (diphyllobothrium latum)
• Seizures with ring enhancing brain lesions. What is this and how do you treat it?taenia solium (neuroscystercosis). Treat with albendazole or praziquantel and steroids
• But itching in a kidenterobius. Treat with metro or albendazole
• Eating raw meet, then fever, muscle pain, periorbital edema and eosinophiliatrihinella (trichinosis)
• Gastroenteritis in young childrenrotavirus or norwalk virus
• Treatment for e coli diarrhea?cipro
• How does clostridium botulinum work?blocks acetylcholine release
• Genital lesions in kids w/o sexual abuse or activitymolluscum contagiosum
• Treat animal wounds withamoxicillin-clavulanate (augmentin). Pasturella is the bug
• Pneumonia after being in hotel near air conditioner or water tower. How do you treat?legionella, treat with azithromyin or levofloxacin
• Burn wound infection. Two organisms, one is blue/green in colorpseuomonas (color) and Staph aureus
• False positives on RPR and VDRL?think lupus
• Which syphillis tests stay positive for life?FTA-ABS and MHA-TP
• Syphillis treatment if allergic to penicillin?doxy
• Secondary stage of syphilis symptoms?condyloma lata, rash on palms and soles and lymphadenopathy
• Gummasgranulomas in many organs, tertiary syphilis
• This cardiac risk is associated with tertiary syphilisthoracic aortic aneurysms
• Koplik spots?white spots on mouth or tongue seen three days after high fever, cough, runny nose, conjunctivitis win measles (rubeola) in a child. Rash then begins on head and spreads downward.
• Late encephalitis following measles infection?subacute sclerosing panencephalitis happens years later.
• Rubella vaccine during pregnancy ?no, contraindicated
• HHSV6roseola infantum. High fever with no apparent cause that resolves as a rash appears on chest and abdomen. Uncommon in children older than 3
• Definitive diagnosis of chickenpox?Tzank smear with multinucleated giant cells.
• Major complication of chickenpox?infection of lesions with strep or staph causing erysipelas, cellulitis, or sepsis.
• HIV patient, focal neurological signs and multiple non enhancing lesions with no mass effect seen on CTProgressive multifocal leukoencephalopathy (PML, JC virus)
• Dacryocystitislacrimal duct infection usually staph aureus or beta hemolytic strep
• Tetanus diptheria toxoid should be given to who ?severe/dirty wounds and got a booster at least 5 years ago or if they've got a minor wound and got a booster 10 years ago or more. Give tetanus immune globulin in anybody with a severe wound and unclear/incomplete immunization history
• Unvaccinated people against hep B with active hep B infection should getimmunoglobulin and vaccine ASAP
• Treatment for strep pharyngitis? Prevents rheumatic feveroral penicillin V
• How long do you have to have a fever for to diagnose Kawasaki?at least 5 days. Bilateral conjunctival injection, skin findings on extremities, fissuring of oral mucosa or strawberry tongue
• Treatment for kawaski disease?aspirin and IVIG, reduce cardiac lesions
• Rash of rocky mountain spotted fever? Treatment options?starts at palms/wrists and ankles/soles then spreads to trunk and face. Treat with doxy or chloramphenicol. Patients may have DIC, delirium, etc
• Treatment for impetigo?dicloxacillin, cephalexin, or clindamycin to cover both strep and staph. Topical mupirocin is also an option
• Most common neurologic sequela of meningitis?hearing loss. Do a formal hearing evaluation after bought of meningitis.
• Most common viral causes of meningitis in children?mumps and measles in children who aren't immunized. Also herpes encephalitis in neonates if mom has genital herpes at time of delivery
• Which types of bacterial meningitis require abx prophylaxis in contacts?N meningitidis and H flu. Rifampin usually
• Most causes of croup caused by ___. Treatment?parainfluenza virus. Some by the flu. Treat with dexamethasone, racemic epinephrine and oxygen
• Treatment for epiglottitis?DO NOT examine or irritate the child so you don't cause airway obstruction. Treat with oxacillin/cefazolin/clinda/vanco plus cefotaxime or ceftriaxone
• Viral URI then 1-2 days later have rapid breathing, intercostal retractions and expiratory wheezing with diffuse hyperinflation of the lungs in a child, think ____. How do you treat?bronchiolitis caused most commonly by RSV. Treat with oxygen, IV fluids, eg supportive, ribavirin used in patients with very severe symptoms or at high risk
• Most common middle ear stuff with dull tympanic membrane and hearing loss in an HIV patient?think non infectious effusion due to lymphadenopathy
• Post bone marrow transplant then pneumonia and abdominal pain/diarrhea etc, think thisCMV infection
• Side effects associated with trihexphenidyl?anticholinergic, just like benztropine (red as a beet, mad as a hatter, etc). Used to treat parkinson's in young people
• Treatment if GBS is positive in mom?this is strep agalactiae, given IV penicillin or IV ampicillin
• Treatment for child younger than 5 exposed to TB but negative PPD?Isoniazid for 3 months then repeat PPD. If adult, no treatment
• Prophylaxis for PPD conversion (neg to positive), and no active diseaseIsoniazid for 9 months
• Risk of untreated rheumatic heart disease?stenosis then cardiac emboli and stroke
• Watery vs bloody diarrhea in an HIV patient?cryptosporidium or MAC are water, but MAC has high fever and crypto has low. CMV is bloody diarrhea
• Most common predisposing factor for orbital cellulitis?bacterial sinusitis
• Eggshell calicification cysts. What is this and what infection causes it? Host?Hepatid hydatid cyst. echinococcus granulosus infection. Dogs are the host
• IV drug use history then weight loss and depression or dementia?Think HIV or Hep C infection
• Most common causes of viral meningitis?echovirus and coxsackieviruses (part of the non polip enterovirus family)
• Tick bite, northeast US, jaundice, renal issues, hemolysis but no rash?babesiosis. Treat with quinine-clindamycin or atovaquone-azithromycin
• Ehrlichiosis akarocky mountain spotted fever
• Meat processing workers or vet then flu like symptoms, hepatitis, or pneumoniaQ fever, coxiella burnetti
• Common cause of blood tinged sputum. Viral in etiology, patient is usually afebrile and requires just supportive carebronchitis. If patient was febrile think pneumonia of some kind
• Try this in croup before intubating?racemic epinephrine, try this and if it doesn't work then intubate
• Empyemas/exudative effusions have low glucose, why?because high metabolic activity of leukocytes and bacteria in the fluid
• Treatment for mucormycosis?surgical debridement plus IV amphotericin B
• Cause of epididymitis in younger patients? Older?younger is Chlamydia or gonorrhea older is E coli.
• Fever, painful enlargement of testes, and irritative voiding symptoms?epididymitis
• Pneumococcal pneumonia vs PCP in HIV patients, which has pleural effusion? Other is diffuse bilateral infiltrates?Pneumococal is effusions, PCP is the other
• Granulations from ears, diabetes, osteomyelitis and facial nerve damage possiblepseudomonas aeruginosa causing malignant otitis externa in diabetics
• Meningitis in babies, first step?urgent LP then antibiotics, unless hx of hydrocephalus/neurosurgery, head trauma, neurological findings
• Treatment for H flu type B meningitis in a baby?dexamethasone
• This vitamin has shown to reduce morbidity and mortality in patients with measlesvitamin A
• Most common cause of nosocomial bloodstream infections with central lines or other things IVstaph epidermidis (coagulase negative staph)
• Prolonged isoniazid therapy can result in thispellagra, interferes with metabolism of tryptophan. 3 Ds - dermatitis, dementia, diarrhea
• Liver abscess and bleeding? What is this and how do you treat?Entamoeba histolytica. Treat with metronidazole for abscess and something to eradicate intestinal colonization (eg paromycin)
• Most common causes of acute, unilateral lymphadenitis in childrenstaph aureus and strep pyogenes . Submandibular nodes most common, enlarged, erythematous and very tender
• Patients with HIV and CD4 count < 50 should receiveazithromycin prophylaxis against MAC.
• Diarrhea, fever, cough, night sweats weight loss, elevated alk phos and splenomegaly in an HIV patientDisseminated MAC. Treat with clarithromycin or azithromycin. Prophylaxis with azithromycin too
• Tick bite, then fever, altered mental status, fever, NO RASH, and leukopenia/thromocytopenia with elevated liver enzymes and LDH. Basically rocky mountain spotted fever with no rash. What is this and how do you treat it?Ehrlichiosis. Treat with doxy
• Sensorineural deafness, cardiac defects, and cataracts in a baby, think thiscongenital rubella
• Rheumatic fever complication of strep pharyngitis. Symptoms/diagnosis?JONES criteria, Joints, heart, Nodules subcutaneously, Erythema marginatum, and Sydenham chorea
• EBV patients can develop these blood disorders weeks after onset of initial symptomsautoimmune hemolytic anemia and thrombocytopenia
• Do not give these vaccines to egg-allergic patientsMMR and influenza
• Group A strep causes rheumatic fever. What is thisStrep pyogenes
• Wartlike purple lesions with a mild/moderate pneumonia like symptoms and possible lytic bone lesions in Mississippi and ohio river valleys, upper midwest statesblastomycosis
• You should give MMR and varicela zoster to HIV infected people (if they need it) iftheir CD4 count > 200 and don't have a hx of AIDS defining illness (PCP, MAC, etc)
• Red firm nodules on skin in HIV patient, what is this, how do you treat it, and what causes it?bacillary angiomatosis by bartonella, treat with oral erythromycin
• Infection of submandibular and sublingual glands, infection source from tooh. Causes cellulitis of these spaces and patients have dysphagia, odynophagia, drooling. Can asphyxiate if not treated.ludwig angina
• Heterophile antibody testEBV
• Presents like mono but negative heterophile test and has weird lymphocytes on blood smear, no sore throat, no lymphadenopathy usuallyCMV
• Histoplasma diagnosis in immunocompromised patienturine or serum assay antigen test
• Treatment for histoplasmosisitraconazole
• Hypopigmented plaque with lack of sensation and surround muscle atrophy. Acid fast bacilli on skin biopsyleprosy
• Congenital hepatosplenomegaly, skin lesions, rhinorrhea, jaundice, anemiasyphilis
• Most common organisms responsible for epiglottitisH flu and strep pyogenes
• Linear vs cluster esophagitis in HIV patients?linear is cmv, other is herpes
• Treatment for hepatitis B?entecavir and tenofovir
• Meningococcal vaccination should be given when? When should you get a booster?11-12, then booster at 16.
• Avoid live vaccines in people taking TNF blockers. What are they?Polio (oral), MMR, Rotavirus, Influenza (intranasal), yellow fever, Varicelal
• Cruise ship or hotel the bilateral lung infiltrates, confusion, diarrhea. What is this and what electrolyte abnormality is seen with it? How do you treat it?this is legionnaire's disease. Treat with macrolides or fluoroquinolones
• HIV patient CD4 count < 150 in ohio/mississippi river valleys. What do you have to prophylax against? What do you use?Histoplasma, itraconazole
• Diffuse maculopapular rash involving trunk, extremeties AND PALMS AND SOLES with generalized lymphadenopathy and systemic symptomsthink secondary syphilis.
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