K Infectious Disease Part 2

Front 1

Blood and WBCs In Stool Pathogen Causes

Back 1

Salmonella. Campylobacter(most common). EHEC. Vibrio. Yersina. C. diff.

Front 2

Best Initial Test for Diarrhea

Back 2

Blood or fecal leukocytes. If Stool lactoferrin present better choice.

Front 3

Most Accurate test for Diarrhea

Back 3

Stool Culture

Front 4

Scombroid

Back 4

Is due to a histadine in the fish that breaks down into histamine. causes rapid onset wheezing, flushing, and rash. Treat with antihistamines.

Front 5

Definition of Severe Diarrhea Disease

Back 5

Tachycardia. Fever. Hypotension. Abdominal pain. Bloody Diarrhea. Metabollic acidosis.

Front 6

Treatment of Severe Diarrhea

Back 6

Supportive and oral antibiotic.

Front 7

Giardia Treatment

Back 7

Metronidazole. Tinidazole.

Front 8

Cryptosporidosis Diarrhea Treatment

Back 8

Nitazoxanide. Treat underlying AIDS.

Front 9

Viral and Food Poisoning Treatment

Back 9

Supportive fluid replacement.

Front 10

Acute Infection and Viral Hepitis

Back 10

Hep A and B present as acute infection. Hep C rarely has acute infection may first present as cirrhosis. Hep D is only present with Hep B.

Front 11

Routes of Transmission of Viral Hepatitis

Back 11

A and E through fecal oral route.
B, C, and D through blood, sex, and perinatal.

Front 12

Clinical Presenation of Viral Hepatitis

Back 12

All forms of hepatitis present the same with jaundice, fever, weight loss, fatigue. Dark urine. Nausea vomiting, and abdominal pain. Hepatosplenomegaly.

Front 13

Lab Tests and Hepatitis

Back 13

Elevated direct billirubin. Increase ALT over AST. Increased ALP.

Front 14

Increased Lab Value and increased Mortality from Viral Hepatitis

Back 14

Elevated PT.

Front 15

Best Initial Test for Viral Hepatitis

Back 15

IgM for all virsuses. IgG to test for the resolution.

Front 16

Best Measure of Hep C Treatment Evaluation

Back 16

Hep C PCR.

Front 17

Antibody for the Vaccinated for Hep B

Back 17

IgG Surface. Core antibody is only seen those with previous infection.

Front 18

Hep B Indication of Functional Virus

Back 18

e-antigen (equivalent to DNA polymerase). This person most likely to recieve antiviral medicaiton in chronic infection.

Front 19

Treatment of Viral Hepatitis

Back 19

A and E remit on their own. Hep B only becomes chronic 10% of the time. Hep C that is detected should be treated with ribavarin and interferon alpha.

Front 20

Best First Choice of Chronic Hep B Infection

Back 20

First choices include entecavir, adefovir, lamivudine, tenofovir.

Front 21

ADE of Interferon Alpha

Back 21

ADE make interferon alpha not a first choice. Include depression, flu like symptoms, leukopenia, thrombocytopenia.

Front 22

Goat of Chronic Hep Infections

Back 22

Reduce DNA polymerase to nothing. Convert to IgG anti e-antigen.

Front 23

Liver Biopsy and Hep B

Back 23

In chronic hep b or C hepatitis, a liver biopsy that shows fibrosis and patien has DNA polymerase antivirals should be started immediately.

Front 24

Goal of Thearpy for Hep C Infection

Back 24

Undetactable Hep C viral load.

Front 25

ADE of Ribavarin

Back 25

Anemia

Front 26

Most Likely Diagnosis: Urethritis vs. Cystitis

Back 26

Urethritis is the only one that give urethral discharge, cystitis does not. Both cause dysuria with frequency and burning.

Front 27

Most Accurate Test for Urethritis

Back 27

Urethral culture. DNA Probe. Nucleic Acid Amplication.

Front 28

Best Initial Test for Urethritis

Back 28

Swab for Gram Stain.

Front 29

Treatment for Urethritis

Back 29

Must treat for Gonnorrhea and Chlamydia. Give ceftriaxone and doxycycline, or cefixime and azithromycin.

Front 30

Clinical Presenation and Work Up for Cervicitis

Back 30

Cervical discharge and strawberry cervix. Work up includes gram stain swab, culture, DNA probe, or PCR.

Front 31

Clinical Presenation of PID

Back 31

Lower abdominal pain. Fever. Cervical motion Tenderness. Leukocytosis.

Front 32

Best First Step in Managment of PID

Back 32

Rule out pregnancy in lower abdominal pain.

Front 33

Most Accurate Test for PID

Back 33

Laparoscopy. Never really done.

Front 34

Treatment of PID

Back 34

Inpatient Cefoxitin with doxycycline. Oupatient cefriaxone and doxycycline.

Front 35

Painless Gential Ulcer Most LIkely

Back 35

Syphillis

Front 36

Painful Ulcer

Back 36

Chancroid

Front 37

Lymph Node Tender Most LIkely STD

Back 37

Lymphogranuloma venerum.

Front 38

Vesicles prior to Painful Ulcers

Back 38

HSV

Front 39

Diagnostic Tests and Treatment for Syphillis

Back 39

Dark field microscopy (spirochete positive than stop). RPR and VDRL. FTA or MHATP confirmatory. Penicillin, doxycycline if allergic.

Front 40

Diagnostic Test and Treatment Chancroid

Back 40

Culture and Stain. Azithromycin single dose.

Front 41

Diagnostic and Treatment for Lymphgranuloma venerum

Back 41

Compliment fixation in blood or PCR swab. Doxycycline.

Front 42

Diagnostic Test and Treatment for HSV

Back 42

Best initial Tzanck prep. Viral culture most accurate. Acyclovir and Vancyclovir. Foscarnet if resistant.

Front 43

Clinical Presenation of Neurosyphillis

Back 43

Meningovascular. Tabes dorasalis. General paresis. Argyll Robertson pupil.

Front 44

Causes of False Positive VDRL

Back 44

Infection. Older age. IVDU. AIDS. Malaria. Antiphopholipid syndrome. Endocarditis.

Front 45

Jarisch-Herxheimer Reaction

Back 45

Fever and worse symptoms after tereatment. Treat with aspirin and antipyretics.

Front 46

Desensitization for Penicillin Treatment of Syphillis

Back 46

Tertiary syphillis and Pregnant women with syphillis.

Front 47

Diagnosis and Treatment of Condylomata Acuminata.

Back 47

Is through visual inspection. Give imiquimod or can remove through freezing or surgery.

Front 48

Pediculosis Diagnosis and Treatment

Back 48

Is crabs, can be found on body or pubic hair. Treat with premthrin. Lindane is as efficous, but more toxic.

Front 49

Scabies Diagnosis and Treatment

Back 49

Presents with burrowing track marks. Take out and magnify. Treat with premethrin. Widspread responds with ivermectin.

Front 50

Clinical Presenation of UTI

Back 50

Fever. Dysuria (increased frequency, pain, burning) All will have increased WBC.

Front 51

Most Common Cause of UTI

Back 51

E. coli

Front 52

Risk Factors for UTI

Back 52

Diabetes. Stones. Strictures. Tumor or prostate hypertrophy.

Front 53

Best Intitial Treatment for UTI

Back 53

Fluorquinolones. After can give TMP/SMZ or Cephalexin.

Front 54

Best Initial Test for UTI

Back 54

Urinalysis WBC 10 or more

Front 55

Most Accurate UTI Test

Back 55

Urine Culture

Front 56

UTI Treatment in Pregnant Women

Back 56

Nitrofurantoin

Front 57

Length of UTI Treatment

Back 57

Uncomplicated treat for 3 days. If anatomic anamoly present than for 3 days.

Front 58

Clinical Presentation and Treatment of Pyelonephritis

Back 58

Fever. Dysuria. Flank Pain. WBC in urine.

Treat with ampicillin and gentamicin for empiric. Ciprofloxacin.

Front 59

Clinical Presenation and Treatment of Acute Prostatis

Back 59

Presents with dysuria, perineal pain, and tender prostate on examination.

Treat with ampicllin and gentamicin.

Front 60

Treatment of Chronic Prostitis

Back 60

TMP/SMZ for 6 to 8 weeks.

Front 61

Clinical Presentaiton of Perinephric Abscess

Back 61

When pyelonephritis does not resolve after 5 to 7 days of treatment. Must drain fluid.

Front 62

Diagnosis of Endocarditis

Back 62

Echocardiogram with vegetations on heart valve and positive blood culutres.

Front 63

Dental Surgery and Endocarditis

Back 63

Must have damaged heart valve already to cause seeding on valves.

Front 64

Clinical Presenation of Endocarditis

Back 64

Fever and new onset murmur. Complications include Fever, Roth spots, osler nodes, murmur, Janeway bodies, anemia, nail bed hemorrhages, emboli.

Front 65

Best Initial Test for Endocarditis

Back 65

Blood culture

Front 66

Most Sensitive Test for ENdocarditis

Back 66

TEE or Blood Culture

Front 67

Streptococcus bovis and Endocarditis

Back 67

Means that bacteria seeded from the colon due to cancer polyps. Next best managment step is colonscopy.

Front 68

Diagnosis of Culture Negative Endocarditis

Back 68

Oscilating vegetation on Echo. Three minor critera of fever, IVDU or prosethetic valve, and signs of embolic phenomena.

Front 69

Best Initial Treatment of Endocarditis

Back 69

Vancomycin and gentamycin until pathogen known. Same for Staph epidermidis.

Front 70

Viradins Streptococci Treatment Endocarditis

Back 70

Ceftriaxone 4 weeks.

Front 71

S. auerus Treatment Endocarditis

Back 71

Oxacillin, Naficillin. Cefazolin.

Front 72

Treatment of Resistant ENdocarditis

Back 72

Add aminoglycoside and extend treatment.

Front 73

Surgery and Endocarditis

Back 73

Used in CHF, prostethic valve, fungal, AV block, abscess, and recurrent emboli on antibioitc treatment.

Front 74

HACEK Treatment

Back 74

H. aphorphilus and parinfluenza. Actinobacillus. Cardiobacterium. Eikenella. Kingella. Treat with ceftriaxone.

Front 75

Prophylaxisis for Endocarditis

Back 75

Significant valvular defect (Prosthetic and previous endocard) and risk of bacteremia. Best initial treatment is amoxicillin. Not needed with Mitral valve prolapse, stenosis, reurge, ASD, and HOCM