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72 Cards in this Set
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- Back
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infants and young children. usually severe if <1. small fastidiious gram neg coccobacillus. transmitted by droplets. 7-10 day incubation. can survive on dry inanimate surfaces for 3-5 days.
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bordetella pertussia
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highly contagious. adheres to ciliated epithelium, then releases toxins that paralyze cilia.
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bordetella pertussia
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Clinical presentation: cough illness lasting >2 weeks, any of paroxysms of coughing, inspiratory whoop, or posttussive vomiting w/o apparent cause
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bordetella pertussia
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what are the 3 stages of bordetella pertussia
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catarrhal: rhinorrhea, occasional cough 1-2 weeks
paroxysmal: on/off forceful continued cough convalescent: gradual resolution, weeks to months |
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Physical findings: inspiratory "whoop", pt turns blue and takes a big gulp at end of fit
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bordetella pertussia
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lab tests for bordetella pertussia
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PCR, culture.
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Cases to report, regardless of test results
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bordetella pertussia
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tx for bordetella pertussia
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azithromycin (zithromax) - only one recommended for infants
clarithromycin (biaxin) erythromycin alternative: tmp-smx |
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prevention of bordetella pertussia
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DTaP vaccine
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gram (+) bacillus, progressive deterioration of myelin sheaths in CNS and PNS
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diptheria
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type of diptheria. caused by toxin-producing strains. incubation of 2-5 days after infection
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respiratory diptheria
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type of diphtheria. caused by toxigenic or nontoxigenic strains. causes chronic nonhealing sores or shallow ulcers with dirty gray membranes. less severe.
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cutaneous diptheria.
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nasal discharge, sore throat, low grade fever, adherent gray membrane on tonsils and pharynx or nose, neck swelling if severe ("bull neck")
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diphtheria
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what confirms dx of diphtheria?
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culture
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tx for diphtheria
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erythromycin, antitoxin for severe cases
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prevention diphtheria
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DTaP vaccine
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how many doses for DTaP? what ages?
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5 doses at 2,4,6,and 5-18 months, 4-6 yo
adult booster shot every 10 years |
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how is diphtheria transmitted?
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direct person-to-person physical and respiratory contact
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gram (-) bacteria, transmitted via respiratory droplets, MC presents as meningitis
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Hib
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clinical presentations prevaccination era of hib
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meningitis (50%), epiglottis (17%), pneumonia (15%), arthritis (8%), cellulitis (6%), bacteremia (2%), osteomyelitis (2%)
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tx for hib
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cefotaxime, ceftriaxone, ampicillin with chloramphenicol, rifampin
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viral infection; leading cause of vaccine-preventable mortality
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measles
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caused by paramyxovirus. rapidly inactivated by heat and light.
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measles
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how is measles transmitted?
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via respiratory droplets
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when is measles contagious?
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4 days before to 4 days after rash onset
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with is the incubation period of measles?
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10-12 days
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risk factors of measles
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lack or or limited vaccination
time of year (feb - April) overcrowding low level of herd immunity |
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clinical presentation, prodrome: increasing fever, cough, coryza, conjunctivitis, Koplick spots on buccal mucosa (grains of salt on a wet background)
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measles
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clinical presentation, rash: developed 2-4 days after prodrome, maculopapular, erythmatous, starts on scalp line and descends, lesion may become confluent, persists 5-6 days
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measles
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complications of measles
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pneumonia, otitis media, diarrhea, subacute sclerosing pan-encephalitis
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Tx for measles
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mainly supportive, Vit A for hospitalized children, prophylactic drugs
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Prevention for measles? How long does it last?
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MMR vaccine. life-long immunity.
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caused by paramyxovirus. incubation pd of 14-24 days. Effects the parotid gland.
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mumps
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how is mumps transmitted?
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respiratory droplets
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when is mumps contagious?
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1-7 days before onset of parotid swelling to 9 days after
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clinical presentation: fever, HA, fatigue, inflammation of salivary glands, parotid swelling. prodrome of fever, malaise, anorexia and increased parotid pain with citrus juice
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mumps
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Lab for mumps
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IgM aby within 5 days of onset - if negative, 2nd specimen 2-3 weeks after onset.
swab from parotid or other affected salivary gland. **Negative tests should not be used to rule out mumps! |
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complications of mumps
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meningitis, orchitis, spontaneous abortion, deafness
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Tx for mumps
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symptomatic.
Acetaminophen or ibuprofen for pain. cold or hot compresses avoid fruit juice and acid foods usually resolves within 1 week |
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another name for "3 day measles" or "german measles"
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rubella
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togavirus, RNA virus. rapidly inactivated by chemical agents, UV light, low pH and heat. incubation pd of 14-17 days.
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rubella
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clinical presentation: low grade fever, lymphadenopathy in 2nd week, maculopapular rash 14-17 days after exposure for 3 days
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rubella
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Lab/diagnostic findings of rubella
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leucopenia early followed by increased plasma cells.
elevated IgM aby and 4fold inc in IgG aby tiers |
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complications of congenital rubella syndrome
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deafness, cataracts, heart defects, microcephaly, mental retardation
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common complications of acquired rubella
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arthralgia (up to 70% of adults)
miscarriage |
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who especially should be vaccinated for rubella?
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all unvaccinated women of childbearing years
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minor sxs - flu like. eruption of clusters of red macules on trunk and face. rapidly develop into tiny vesicles on erythematous base. vesicles become pustular, pruritic, then encrust and scab.
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varicella (chickenpox)
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pain or pruritis occur prior to rash. rash presents as eruption of clusters on erythematous base found unilaterally along a single dermatome (often on the trunk or face)
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herpes zoster
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this causes serious corneal damage and visual impairment and is associated with a rash found following a dermatome
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ophthalmic zoster
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what lab test would you do for varicella and what are you looking for?
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Tzanck test - multinucleated giant cells with inclusions
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Tx for varicella
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acyclovir and supportive tx for pain/pruitis
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caused by an anaerobic, spore forming gram (+) bacti
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tetanus
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pathophys for tetanus
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enters body --> toxin produced (tetanospasmin) and binds in CNS --> interferes with NT release to block inhibitor impulses --> unopposed m contraction and spasm
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risk factors for tetanus
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2 or more predisposing conditions: penetrating injury, devitalized tissue, foreign body, localized ischemia
being unvaccinated |
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clinical presentation: trismus (lock jaw), difficulty swallowing, m rigidity, spasms 3-4 weeks, incubation pd of 8 days
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tetanus
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complications of tetanus
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airway obstruction, urinary retention and constipation, cardiac failure and resp. arrest
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Tx for tetanus
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Tetanus immunoglobulin IV or IM
metronidazole diaxepam penicillin |
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which form of taenia solium involves eggs that hatch and larvae released into the stomach where they become worms
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taeniasis
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which form of taenia solum involves larvae that penetrate and encyst in various tissues
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cysticerosis
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which parasite are you in danger of getting if you eat uncooked pork?
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taenia solium
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what is the most common cause of seizures worldwide?
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taenia solium
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clinical presentation: seizures, chronic HA, hydrocephalus and meningitis
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cysticercosis
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what tests would you do to dx cysticerosis?
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CT head or MRI brain
CSF - lymphocytes, eosinophils, low glucose and high protein ELISA - aby against taenia |
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Tx of cysticercosis
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dilantin (phenytoin) to control seizures
prednisone - but with caution bc it may exacerbate larvae albendazole - controversial bc it can make seizures worse |
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what is the most common worm infection in the US
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enterobius vermicularis (pinworms)
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what is the source of pinworms?
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contaminated bedding, towels, clothes, etc
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how do pinworms invade the body?
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hatch in sm intestine and mature in colon
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how long are pinworm eggs infective?
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up to 2 weeks
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what is the lab test for pinworms?
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scotch tape test.
3 tries over 3 consecutive nights = successful. |
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clinical manifestation: nocturnal perianal pruitis - "itchy buns". insomnia, weight loss, bed wetting, irritability
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pinworms
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tx for pinworms
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mebendazole
albendazole or pyrantel |
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migration of pinworms can cause...?
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vulvovaginitis
diverticulitis appendicitis cystitis granulomatous reactions |
