K Infectious Disease Part 3 And Immunology

Front 1

Vector of Lyme Disease

Back 1

Ixodes scapularis tick

Front 2

Epidemology of Lyme Disease

Back 2

Northeast typically.

Front 3

Presentation of Lyme Disease

Back 3

Rash (Erythema migrans). Joint (most common knee, but can be olgioarthritis). Neurological (bells balsy, encephalitis, meningitis). Cardiac (most common transient heart block)

Front 4

Intitiation of Treatment of Lyme

Back 4

Begin if rash is present and symptoms of lyme are present. If neurlogical, cardiac, and joint present serological testing should be done first.

Front 5

Treatment of Lyme

Back 5

For rash or Joint or seventh cranial nerve palsy treat with doxycycline or amoxicillin. If Cardiac or other neurological treat with IV ceftriaxone.

Front 6

Prophylaxis for Lyme

Back 6

When Ixodes is identified. Tick was on for longer than 24 to 48 hours. Tick is in the engorged nymph state. In endemic area.

Front 7

Transmission of HIV

Back 7

IVDU. Needle Stick. Perinatal. Blood Transfusion. Sex (particularly anal).

Front 8

Chances of Transmission of HIV

Back 8

1:10000 penatrative sex. 1:1000 receptive. 1:100 anal sex. 25% to 30% mother to child with out treatment.

Front 9

Pneumocystis Pneumonia and CD4 Count

Back 9

<200

Front 10

Infections at Greater Rate above >200 in AIDS Patient

Back 10

Varicella. HSV. TB. Oral and vaginal candidiasis. Bacterial pneumonia.

Front 11

Best Initial Test for HIV

Back 11

ELISA. Confirmed with Western Blot

Front 12

Role of Viral Load

Back 12

Used to assess affectivness of treatment. If an HIV+ persons viral load is undetectable and CD4 rises life expectancy is equal to HIV negative person.

Front 13

Viral Resistance Testing

Back 13

Done before a person begins treatment or there is a treatment failure, first signified by viral load increase.

Front 14

Initiation of HIV Treatment

Back 14

CD4 count below 500. Viral load above 10,000. Opurtunistic infection occurs.

Front 15

Best Initial HIV Treatment of HIV

Back 15

Enfirenz (NNRTI). Tenofovir (NRTI). Emtricitabine (NRTI).

If resistance occurs than three drugs from at least 2 different classes: NRTI, NNRTI, Protease Inhibitors.

Front 16

Second Line Classes for HIV

Back 16

Entry Inhibitors. Integrase Inhibitor.

Front 17

Entry Inhibitors

Back 17

Enfuvirtide. Maraviroc.

Front 18

Integrase Inhibitors

Back 18

Raltegravir.

Front 19

Postexposure Prophylaxis for HIV

Back 19

Needlestick and Bite.

Not needed if stool or urine. If unknown not routinely needed.

Front 20

Zidovudine ADE

Back 20

is NRTI can cause Anemia

Front 21

DIdanosine ADE

Back 21

Is and NRTI that may cause peripheral neuropathy or pancreatitis.

Front 22

Abacavir ADE

Back 22

Is an NRTI that can cause steven johnson.

Front 23

Protease Inhibitors ADE

Back 23

Hyperlipidemia. Hyperglycemia.

Front 24

Indinavir ADE

Back 24

Protease inhibitor that can cause nephrolithatiasis

Front 25

Tenofovir

Back 25

Is an NRTI that may cause renal insufficiency.

Front 26

Prevention of Perinatal Transmission

Back 26

Continue antiretrovirals if on. Change Efavirenz to protease inhibitor due to teratogenicity risk. If not on and not indicated, than give antiretrovirals for second and third trimesters. Zidovudine given for the first 6 weeks of life.

Front 27

Cessarian Section and HIV

Back 27

Indicated if viral load is above 1000 or CD4 is below 350.

Front 28

Anaphylaxis

Back 28

Is defined by the severity of an IgE mediated mast cell release that causes release of histamine, leukotrienes, and prostaglandins. This causes bronchoconstriction, vomiting, rash, and vasodilation.

Front 29

Anaphylactoid

Back 29

Is an anaphylatic reaction that is not mediated by IgE binding.

Front 30

Major Cause of Anaphylaxis

Back 30

Food. Insect Bite. Medication (Penicillin, Lamogtrigine, rifampin, sulfa, phenytoin, quinidine).

Front 31

Treatment of Anaphylaxis

Back 31

Epinephrine. Antihistamines. Gluccocorticoids. Intubation.

Front 32

Angiodema

Back 32

Is the swelling of the lips, eyes, tounge, or airway. Can be due to C1 esterase inhibitor deficiency. Most have unknown cause. Look for ACE start.

Front 33

Clinical Presentation and Treatment of Herditary Angioedema

Back 33

Causes swelling of the face and stridor with no utricaria or stridor. Unresponsive to coriticosteroids.
Treat with fresh frozen plasma and androgens danazol and stanzol.

Front 34

Urticaria

Back 34

Is sudden swelling of the superfiical layers of the skin. Caused by insect bites and medications. Also caused by pressure, cold, virabration

Front 35

Treatment of Urticaria

Back 35

Antihistamines: hydroxyzine, diphenhydramine, fexofenadine. Monteleukast or zarfirlukast.

Front 36

Allergic Rhinitis

Back 36

Is an IgE mediated inflammation of the nasal passage ways. Associated with nasal polyps, watery eyes, and itchy nose. Diagnostically skin tests to find etiology. Treated with antihistamines, corticosteroids inhaled, anticholinergic, and removal or desnsitization of allergen.

Front 37

Common Variable Immunodeficiency

Back 37

Is a normal number B cells but decreased output of all sets of Ig. Presents with frequent sinus infections, increased autoimmune, sprue, and giardias. B cell count and Ig count. Treat with chronic maintenance with Ig's

Front 38

X-Linked Agammaglobunemia

Back 38

Results in low IgG with diminshed B cells and adenoid tissue. No tonsils and adenoids, and decrease in spleen. Treat with gammaglobulin replacement.

Front 39

SCID

Back 39

Severe Commined Immunodeficiency results in the death of B and T cells. B cell loss results in sinopulomonary infection and T cell loss results in fungal infections. Bone marrow transplant.

Front 40

IgA Deficiency

Back 40

Is low IgA that results in Autoimmune, Atopic diseases, and anaphylaxis to blood transfusions. Treat infections as they arise.

Front 41

Hyper IgE Syndrome

Back 41

Causes coarse Facies, Abcess staph. Teeth retained. Hyper IgE. Derm eczema.

Front 42

Wiskott-Aldrich Syndrome

Back 42

Wiskott-Aldrich Syndrome results in thrombocytopenia, eczema, and decreased t cells. Bone marrow Transplant.

Front 43

Chronic Granulomatous Disease

Back 43

Is a decrease of NADPH Oxidase detected by nitroblue tetrazolium test. With out this enzyme no respiratory burst so lymph nodes fill with purulent tissue. Aphthous ulcers and inflammation of nares common.

Front 44

Infections and Chronic Granulomatous Disease

Back 44

Staph. Burkholderia. Nocarida. Aspergillus. in combination.