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107 Cards in this Set

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What is a parasitic intestinal and/or biliary tract infection?
Giardiasis
This parasite infection occurs world wide, it is the number one intestinal protozoal pathogen in the U.S. and Europe?
Giardiasis
In Giardiasis what is the predominant age of humans affected?
children and 20-40 year olds
Frequent diarrhea, becomes watery, copious frothy, malodorous and greasy is a physical finding in what parasitic infection?
Giardiasis
What is the Rx for Giardiasis?
Metronidazole 250mg PO TID for seven days.
This is a protozal parasistic infection of the colon?
Amebiasis
What are the modes of transmission for Amebiasis?
Infected food and water
oral fecal route
What is the incubation period for Amebiasis?
2-4 weeks, severe case appear in 8 days
In a pt. with Amebiasis and mild or moderate colitis will present with what physical findings.
Fatigue, hyperactive bowels, and remission periods with constipation.
A patient with Amebiasis and severe dysentery has what physical findings?
Frequent bowel movements 10-20 QD. Stools are semiformed with little fecal matter.
What happens as the severity of Amebiasis increases?
Temperature rises to 105
What is a febrile, flulike illness, caused by the genus plasmodium?
Malaria
What are the four types of Malaria?
P. Falciparum
P. Vivax
P. Malaria
P. Ovale
What is the mode of transmission for Malaria?
Female Anopheles mosquito
What are the general findings of Malaria?
fever
rigors
diaphoriasis
fatigue and malaise
nausea and vomitting
mild jauandice
mild hepatomegaly with tenderness
splenomegaly
What physical findings are specific to P. Falciprarum?
Bloody diarrhea
Headache
Seizures
How often do you repeat a malarial smear?
Every 6 hours
What is the drug of choice in the operational treatment of malaria?
Mefloquine 750mg
Primaquine 26.3mg
What are complications of Malaria?
Cerebral malaria
Hemolytic anemia
Noncardiogenic pulmonary edema
Cerebral malaria presents as what physical findings?
H/A
Retinal hemorrhages
Convulsions
Delerium
Coma
What is the most serious form of Malaria that causes a serious infection, with a higher fatality rate?
P. Falciparum
What is a blood fluke infection with adult and female worms living within mesenteric or venules of veins of the host
Schistosomiasis (Snail Fever)
Humans are the main reservoir for which species of blood fluke?
S. Mansoni

Haematobium
What is described as localized itchy erythematous or petechial rash that progresses to macules, and papules lasting up to 5 days
Cercarial dermatitis
Acute schistomiasis has an incubation period of how long? It is also seen in who?
And what is a significant manifestation?
2-7 weeks

Travelers

Diarrhea (it may be bloody)
What are the physical findings of chronic schistomiasis in S. Mansoni and Japonicum?
Irregular bowel movements, and anorexia with weight loss over 5-15 years.
S. Haematobium usually only presents chronically with what?
Early SX of UTI, frequency, dysuria.
What can be found in the UA of a pt. with Snail fever?
Hematuria and proteinuria
What is a complication of S. Haematobium?
Strictures or distortion of ureteral orfices such as, Urolithaisis, and renal failure.
What is a polymorphic protozoan disease of the skin and mucous membranes?
Leishmaniasis
A parasitic infection caused by a nematode (round worm) is defined as?
Ascariasis
Ascariasis affects what amount of people world wide?
1 billion people
High prevalence where there is low hygiene and sanitation standards, and in moist tropical countries (Thailand) is a demographic of what infection?
Ascariasis
Where night soil is utilized as a fertilizer is a demographic of what infection?
Ascariasis
What is the most common intestinal helminthes?
Ascarias lumbricoides
What parasitic infection is not transmitted by person to person contact, or from fresh feces?
Ascarias
What are physical findings of Ascarias?
Sx's occur from larva migration to lungs
Non-productive cough
Blood tinged sputum
Wheezing and localized rales
Dyspnea
Substernal px
Sx's occuring from larva migration to the lungs is a physical finding of what infection?
Ascarias
Eosinophils may reach 30 to 50%, and remain high for 1 month in which phase of the CBC of a pt w/ Ascarias?
Pulmonary phase
Normal eosinophils will be seen in which phase of the CBC of a pt w/ Ascarias?
Intestinal phase
What is the tx for Ascarias?
Mebendazole (vermox)
500 mg PO single dose, or 100 mg PO BID x 3 days.
Repeat tx in 2 wks
A intestinal round worm disease, whose larvae migrate and become encapsulated in the muscle is defined as?
Trichinosis
What are the 3 stages of Trichinosis?
Intestinal stage
Muscle invasion stage
Convalescent stage
In what stage of Trichinosis will permanent muscle atrophy occur?
Convalescent stage
Parasitized muscle showing intense inflammatory reaction can be seen in which stage of Trichinosis?
Muscle Invasion stage
Visceral Leishmaniasis is also known as?
Kala Azar
Visceral Leishmaniasis is caused by what?
L. Donovani
L. Infantun
L. Chagasi
What is the incubation period for Visceral Leishmaniasis?
10 days thru 24 months usually 4-6 months.
What are physical findings of Visceral Leishmaniasis?
Chills
Weight loss
Hepatosplenomegaly
Jaundice
Ascites
In what protozoan disease do lesions vary from single to multiple on exposed skin, have a phased progression from papule to nodule becoming either ulcerated or wart like?
Mucocutaneous Leishmaniasis
In which protozoan disease are nonulcerating lesions, resembling lepromatous, and leprosy over entire body presents it self?
Diffuse Cutaneous Leishmaniasis
What is the incubation period for P. Falciparum?
9-14 days mean is 12
What is the incubation period for P. Vivax?
12-17 days mean is 13

may go as long as 6-12 months
What is the incubation period for P. Malariae?
18-40 days mean is 28
What is the incubation period for P. Ovale?
16-18 days mean is 17
Eosinophilia and leukocytosis appear in what amount of time in a CBC of a pt w/ Trichinosis?
2 weeks
How long will it take for eosinophilia to reach 90% in the CBC of a pt w/ Trichinosis?
in the 3rd week (slowly declines to normal over next few months)
What is the tx for Trichinosis?
Mebendazole
A noninvasive infestation of the intestinal tract by a helminth is defined as?
Enterobiasis (Pinworm)
Eggs hatching in the stomalch and then migrating to the colon is the etiology of what infection?
Enterobiasis (Pinworm)
After eggs mature in the colon, Gravid female worms will migrate to what area of the body of a pt w/ Pinworm?
Perianal skin (at night)
How does the life cycle continue of a pinworm?
Autoinfection to the mouth by contaminated food, drink, formites, or hands (nails)
Larvae re-enter the anus and into the large intestine
What is the most common complaint of a pt w/ Pinworms?
Perianal itching (at night)
How many Scotch tape test are required to truly r/o possible infestation of Pinworms?
7 tests
What is a rare complication that occurs in females when infected w/ Pinworms?
Vulvovaginitis
Which types of helminthes cause Uncinariasis?
Ancylostoma duidenale
Necator americanus
A pt complaining of dry cough, wheezing, blood-tinged sputum and low-grade fever are physical findings of the pulmonary stage of what infection?
Uncinariasis
What are the physical findings in the heavy infection of a pt infected w/ Uncinariasis?
Anorexia
Diarrhea
Vague abd. px
Ulcer-like epigastric px
Pallor, and deformed nails
What is the operational tx of Uncinariasis?
Mebendazole 100 mg (Repeat in 2 wks)
Multivitamin
High protein diet
A genus of parasitic flatworms belonging to the class cestode, known to cause disease in man is defined as?
Tapeworm
Tania Saginata is also known as what?
Beeftape worm
Taenia Solium is also known as what?
Porktape worm
Diphyllobothrium latum is also known as what?
Fishtape worm
Hymenoplis nana is also known as what?
Dwarf tapeworm
How is Hymenoplis nana (dwarf tapeworm) transmitted?
Direct person to person contact, where sanitation is poor
What physical findings will you see in small worm infection of a pt w/ tapeworms?
Generally asymptomatic
What physical findings will you see in large worm infection of a pt w/ tapeworms?
May also be asymptomatic
Vague GI problems (N/V/Abd px)
Systemic Sx's (Fatigue/Hunger/ Dizziness)
An infectious disease caused by a fungus, typically asymptomatic, but with severe complications and potentially poor prognosis is defined as?
Coccidiomycosis
Fungus being a barrel-shaped hyphae is the etiology of what infection?
Coccidiomycosis
Symptoms of primary infection of a pt w/ Coccidiomycosis include?
Cough
Malaise
Fever, Chills, Night sweats
Anorexia
Weakness
Arthralgias
Scattered rales & areas that are dull to percussion w/ auscultation
What is the tx of Coccidiomycosis?
Fluconizole 200 to 400 mg
Supportive care
What is the causative agent of Histoplasmosis?
Histoplasma capsulatum
A dimorphic fungus that has been isolated from soil contaminated by bird or bat droppings is the etiology of what infectious disease?
Histoplasmosis
What are the physical findings of acute histoplasmosis?
Fever, HA, Malaise, Pleuritic CP, nonproductive cough, and weight loss
What stage of Lyme Disease is characterized by erythema migrans, occuring 1 wk after the tick bite?
Stage 1
What is the definition of a fever of unknown origin?
Abnormal elevation in temp.
When TX a fever of unknown origin the IDC must contact MO when the temparatures meets what guidelines?
Temp. is 100.4 or 102.9f for 48 hours or temp is 103f
In the operational TX of a fever of unknown origin what is done for each of the following causes?

Viral
Bacterial
Parasitic
Viral- Supportive care avoid Asprin

Bacterial- antibiotic therapy

Parasitic- Mebendazole and cordinate with higher medical authority.
What will every person suffer from at least once a year, and is the most common medical disorder seen by primary care practitioners?
Acute Diarrhea
What is the goal in the diagnostic approach to treating acute diarrhea?
To determine the cause.
In the operational TX of acute diarrhea what is done for each of the following causes?

Viral
Bacterial
Parasitic
viral- supportive care

bacterial- diet change, and antibiotic therapy

parasitic- Mebendazole and coordinate with higher medical authority
What is the multisystem disorder caused by the transmission of a spirochete from a tick?
Lyme disease
What is the most common vector bourne disease in the U.S.?
Lyme disease
What is the TX of early Lyme disease?
Doxycycline 100mg BID x21days

Alt is

Amoxicillin 500mg QID x21days
What is the TX for disseminated infection of Lyme's disease?
Doxycycline 100mg BID x30days

If neurological involvement TX with parenteral Ceftriaxone 2g QD x21-28days
What is the range of Stage 1 of Lyme's Disease?
3 to 30 days
What are the most common manifestations in Stage 2 of Lyme's Dz?
Skin, CNS, and musculoskeletal system
Cardiac manifestations including myopericarditis, w/ atrial or ventricular arrhythmias and heart block are physical findings of what stage of Lyme's Dz?
Stage 2
Neurologically patients will manifest what sx's in the final stage of Lyme's Dz?
Memory loss
Mood changes
Sleep disturbance
Distal sensory paresthesias or radicular px
In the final stage of Lyme's Dz, 60% of the pt's will develop musculoskeletal complaints, but with variable manifestations to include?
Joint and periarticular px
Large joint frank arthritis
Chronic synovitis
A late persistent infection that occurs months to years after initial infection and again manifests itself as musculoskeletal, neurological, and skin dz is what stage of Lyme's dz?
Third and Final stage
What is the range of Stage 1 of Lyme's Disease?
3 to 30 days
What are the most common manifestations in Stage 2 of Lyme's Dz?
Skin, CNS, and musculoskeletal system
Cardiac manifestations including myopericarditis, w/ atrial or ventricular arrhythmias and heart block are physical findings of what stage of Lyme's Dz?
Stage 2
Neurologically patients will manifest what sx's in the final stage of Lyme's Dz?
Memory loss
Mood changes
Sleep disturbance
Distal sensory paresthesias or radicular px
In the final stage of Lyme's Dz, 60% of the pt's will develop musculoskeletal complaints, but with variable manifestations to include?
Joint and periarticular px
Large joint frank arthritis
Chronic synovitis
A late persistent infection that occurs months to years after initial infection and again manifests itself as musculoskeletal, neurological, and skin dz is what stage of Lyme's dz?
Third and Final stage