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50 Cards in this Set
- Front
- Back
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What is the shape of the rabies virus
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Bullet-shaped
Enveloped RNA virus Negative-sense |
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Prognosis of rabies
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Fatal without early and aggressive post-prophylaxis
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Most common vectors of rabies
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Bats, raccoons, skunks, wolves and foxes
Any infected carrier can transmit the rabies virus |
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Signs and symptoms of rabies
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History of bite
Numbness, tingling of the bite area Non-specific system Limb and facial weakness Hydrophobic period Respiratory paralysis (death) |
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Five main stages of rabies
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Incubation period: 10-365 days
Prodrome stage: 2-10 days Acute neuro stage: 2-7 days Coma: 0-14 days Death |
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Diagnosis of rabies
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Clincal DX! Based on patient history
ELISA may show antibodies but its often too late Definitive DX: postmortem Negri Bodies |
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Are there vaccinations available for rabies?
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Yes: pre-exposure prophylaxis for high risk persons
Human diploid vaccine or RabAvert |
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Post-exposure prophylaxis if previously non-immunized for rabies
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Thorough wond cleaning and debridement
Human anti-rabies immunoglobulin (HRIG) Human diploid vaccine or RabAvert **if previously immunized, do NOT give the HRIG** |
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Shape of herpes virus
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Large, envoloped
DNA virus "Fried egg" appearance |
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How does herpes zoster manifest itself
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Reactivation of dormant virus
Virus dormantly reside in sensory ganglia Higher incidence in immunocompromised patients |
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Signs and symptoms of herpes zoster
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Pain and pruritis prior to rash eruption
Rash present as eruption of cluster of vesicles on an erythematous base. Occur unilaterally along a single dermatome |
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What is ophthalmic zoster
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Serious corneal damage and visual impairment occurs as a reactivation of the zoster virus
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Diagnosis or herpes zoster
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Rashes similar to chicken pox but in a dermatomal presentation
Tzanck smear |
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Treatment for Herpes zoster
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Acyclovir
800 mg po 5 times daily x7-10days Supportive treatment for pain, pruritis |
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Etiological agent of mononucleosis
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Epstein-Barr Virus
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Testing of EBV
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Heterophile antibody test (+)
"Monospot test" |
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Transmission of EBV
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Human saliva
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Hallmark of EBV
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Atypical lymphocytes in peripheral blood smear
AKA "Downey cells" |
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Signs and symptoms of EBV
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Prodrome: Malaise, fatigue, persistent HA
Fever, sore throat, tender lymphadenopathy, splenomegaly |
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Diagnosis of EBV
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CBC: leukocytosis with predominantly lymphocytosis and atypical lymphocytes
Positive heterophile antibodies |
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Treatment of EBV
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Self-limiting
Supportive Tx Avoid contact sports and heavy weight lifting |
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Transmission of Cytomegalovirus (CMV)
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Congenitally, perinatally, via sexual transmission
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Pathology of CMV
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Becomes latent after primary infection and may reactivate years later
Asymptomatic in healthy individuals |
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Signs and symptoms of CMV
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Infants: premature, retarded growth, petechiae, jaundice, microencephaly
Immunocompromised: CMV retinitis, pneumonitis, GI issues, meningoencephalitis |
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Diagnosis of CMV
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Serology
Cytohistology: "Owl eye cells" nuclear inclusions |
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Treatment of CMV
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IV Ganciclovir 5mg/kg BID x 2 weeks
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Prevention of CMV
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CMV Immunoglobulin for at risk moms
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Etiological agent of syphilis and shape
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Treponema pallidum
Cork-screw shaped, motile |
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Transmission of syphilis
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Sexual transmission and vertical transmission from mother to baby
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Incubation period of syphilis
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10-90 days
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Stages of syphilis
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PRIMARY: involves skin and mucosal surfaces
SECONDARY: involves skin, mucosa, and systemic LATENT: early and late show NO symptoms TERTIARY: Gummatous lesions, cardiovascular (Neurosyphilis can occur at any age) |
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When is syphilis most transmissible
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When rash is present, there is high transmission
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Hallmark of primary syphilis
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Chancre
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Describe the rash seen in secondary syphilis
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Seen on the palms and soles
Maculo-papular Non-pruriti 75% to 100% of people actually develop rash |
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Describe the s/s in latent syphilis
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No lesions, asymptomatic
Early latent = less than 1 year Late Latent = more than one year |
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Describe s/s of tertiary syphilis
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Worm like gummata
or Ulcerating gummata (see pictures in lecture) |
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Complications of congenital syphilis
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Still birth, deafness, neuro defects, poor development
HALLMARK= Hutchinson's Teeth |
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Diagnosis of syphilis
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History, signs and symptoms
Dark-field microscopy and direct fluorescent antibody testing. Serological testing with non-treponemal and treponemal tests done to confirm dx |
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What other test should be considered when suspected syphilis
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Always test for HIV
May want to test CSF if neurologic or ophthalmic signs are present in the patient |
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Treatment of primary, secondary, latent, and tertiary
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PCN-G injected IM
2.4 mill units x1 injection Doxy if PCN allergic **must always use PCN in pregnant women** |
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Proof of successful treatment for syphilis
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4-fold decrease in titer
Followups should be makde at 6, 12, and 24 months |
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Etiological agent of chlamydia
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Chlamydia trachomatis
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Signs and symptoms of chlamydia in men
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Urethritis and epididymitis (fever and 1 sided scrotal pain)
No discharge seen |
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Signs and symptoms of chlamydia and women
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Often asymptomatic
Reported cervicitis, urethritis, and PID |
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Signs and symptoms of chlamydia in children
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Conjunctivitis (trachoma) and pneumonia
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Most common serious complication of chlamydia
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Peri-hepatitis adhesions
RUQ pain with nausea and vomiting "Fitz-Hugh-Curtis syndrome" |
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Diagnosis of chlamydia
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Culture or
Nucleic Acid Amplification Tests (swabs) |
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Treatment of Uncomplicated Chlamydia (adults)
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Azithromycin - 1g orally, single dose
OR Doxycycline - 100 mg BID x 7 days |
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Treatment of Chlamydia in children
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Erythromycin 50 mg divided into QID x 14 days
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Etiological agent of gonorhea
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Neisseria gonorrhoeae
Gram negative diplococcus |
