Infectious Disease

  1. Septic arthritis
    Bacteremia of one joint
  2. S/s septic arthritis
    • Swelling, loss of ROM, joint warmth, tenderness
    • Fever
  3. Dx septic arthritis
    Sample synovial fluid
  4. To septic arthritis
    Treat with abx IV 2 weeks, then oral
  5. Osteomyelitis
    • Infection in the bone
    • WBC may be elevated
  6. Most common cause of osteomyelitis
    Usually staph aureus (MSSA or MRSA)
  7. Dx septic arthritis
    U/S or MRI, bone biopsy
  8. S/s Acute osteomyelitis
    pain, loss of ROM, soft tissue swelling. Weeks of abx
  9. S/s Chronic osteomyelitis
    malaise, night sweats, anorexia, fever, bone necrosis and instability. Months of abx
  10. Trichomoniasis infects
    Vaginal / lower urinary tract infection in females, GU tract in males
  11. S/s trichomoniasis
    • Malodorous frothy yellow or green discharge,
    • vaginal erythema, red macular lesions on cervix
  12. Dx trichomoniasis
    wet mount
  13. Treat trichomoniasis
    One dose of metronidazole
  14. HPV
    • 77 types, there?s a vaccine for most common ones
    • Causes warts: palmar, plantar, genital
    • Histology & DNA
  15. Herpes simplex
    Lesions on mouth (type 1) or genitals (type 2)
  16. HSV Can reactivate when
    • Stress
    • UV exposure
    • Menses
    • Fever
  17. S/s HSV
    Fever, anorexia, gingivitis
  18. Dx HSV
    culture vesicular fluid
  19. Chlamydia
    Intracellular parasite
  20. Chlamydia Causes
    • Women: PID, cervical inflammation, infertility
    • In men, urethritis, proctatitis, rectal stricture.
  21. s/s chlamydia
    Evanescent genital lesion, lymph node enlargement
  22. Dx chlamydia
    Negative gram stain, confirmed by DNA amplification
  23. To chlamydia
    • Azithromycin
    • Erythromycin
    • DCN
  24. Syphilis
    • Spirochete
    • Sexually transmitted or via placenta
  25. s/s syphilis
    • Painless ulcers
    • Can have secondary lesions in kidneys, liver, eyes, bone
    • Late stage: CNS
  26. Dx syphilis
    Immunofluorescence, serology
  27. Tx syphilis
    Benzathine PCN one IM dose
  28. Gonorrhea
    15-29 year olds primarily
  29. s/s gonorrhea
    • Men: burning on urination, milky/creamy/bloody discharge
    • Women: if symptomatic, disurea w/urinary urgency, urethral discharge, vaginitis
  30. Dx gonorrhea
    Negative gram stain, Need to get cultures
  31. Tx gonorrhea
    DCN or azithromycin, oral cefixime or IM ceftriaxone
  32. Influenza
    • 3 strains, can be epidemic or pandemic
    • Droplet nuclei, worst Dec-Mar
  33. Influenza incubation
    8-72 hr, usually two days
  34. Influenza Contagious
    from day before until 5 days after symptoms resolve
  35. s/s influenza
    Fever, chills, myalgia, malaise, Cough, wheezing in bronchi, substernal chest pain
  36. Dx influenza
    Viral cultures, rapid antigen test, CXR
  37. Tx influenza
    neuraminidase inhibitors, symptomatic relief
  38. Histoplasmosis
    Soil fungus, bat/bird droppings
  39. Inhalation transmission
  40. Histoplasmosis s/s
    • Mild: fever, cough, dyspnea, weight loss
    • Possible ulcers in mouth, pharynx, liver, spleen
  41. Lab results histoplasmosis
    Blood work could show pancytopenia, anemia, ^LDH, ^ferritin
  42. Tx histoplasmosis
    Itraconazole or amphotericin B
  43. Rhinovirus
    • Common cold, 4-9 days
    • myalgia, sneezing, congestion, sore throat
    • No testing needed
    • Symptomatic relief
    • Can exacerbate COPD, asthma
    • Can develop sinusitis, otitis medi
  44. Tuberculosis
    • Aerosolized transmission
    • Common in large confined populations
  45. Progression of TB
    Dry cough, progresses to productive, progresses to hemoptysis
  46. TB s/s
    Pleuritic chest pain, tachycardia, weight loss, night sweats
  47. Dx TB
    PPD, CXR
  48. Treat TB
    /RIPE, isolation
  49. Haemophilus influenzae
    Causes secondary bacterial PNA
  50. s/s h. Influenzae
    Fever/chills, SOB, typically with OM, sinusitis, epiglottitis
  51. Dx h. Influenzae
    CXR
  52. Tx h. Influenzae
    amoxicillin
  53. Coccidioidomycosis
    Valley fever, southwestern states and Mexico, soil dwelling fungus
  54. High risk coccidioidomycosis
    HIV pt, Filipinos, blacks
  55. s/s coccidioidomycosis
    Fever/chills, cough, night sweats, fatigue
  56. Blood work coccidioidomycosis
    leukocytosis, eosinophilia
  57. Dx coccidioidomycosis
    • CXR: mediastinal lymph node enlargement, patchy nodular upper lobe infiltrates
    • Tx coccidioidomycosis
    • Fluconazole, Amphotricin
  58. What is used to treat syphilis?
    • Benzathine penicillin, one IM dose
    • Three weekly injections for latent or tertiary
  59. Jarisch - Herxheimer
    • Reaction to treatment of spirochetal infections
    • Fever, headache, myalgia
    • Give antipyretic and caution pt
  60. How to test for syphilis?
    • Doesn?t grow on culture
    • Nontreptonemal antigen test,
    • Possible False positives tested with treptonemal antibody test
  61. How to know when syphilis is cured
    Four-fold decline in non-treptonemal test
  62. Causes of false positive on syphilis nontreptonemal test
    • Lyme dz
    • Autoimmune disorder/Lupus
    • Pregnancy
    • Viral infection
    • Malaria
    • Leprosy
  63. Chancre
    • Painless ulcer
    • Rolled edges
    • Ulcerated
    • Punched out
  64. Rash suggestive of syphilis
    • Macular, copper-colored
    • Followed by red papular rash on palms and soles
  65. Argyll Robertson pupil
    • Accommodate to near
    • Non-reactive to bright light
  66. Ocular indications of syphilis
    • Argyll Robertson pupil
    • Uveitis
    • Neuroretinitis
    • Interstitial keratitis
    • CSF normal ~ 50%
  67. When to screen pregnant women for syphilis
    • 1st visit
    • 28-32 weeks
    • @delivery
  68. Chlamydia symptoms women
    • Often asymptomatic
    • Transient vesicular lesion
    • Cervicitis, abnormal bleeding
    • Change in vaginal discharge
    • PID
    • Cervical motion tenderness
    • Tenderness on abdominal palpation
  69. Complications of chlamydia
    • Risk of future ectopic pregnancy
    • Can cause infertility
  70. Chlamydia s/s men
    • Watery penile discharge
    • Transient vesicular lesion
  71. Fitzhugh-Curtis Syndrome
    • Inflammation of liver capsule
    • RUQ or pleuritic pain
    • Liver function tests usually normal
  72. How to diagnose chlamydia
    • Clinically
    • DNA amplification if confirmation needed
  73. Treatment for chlamydia
    • Erythromycin - esp for pregnant women
    • DCN
    • Azithromycin
  74. Complications of chlamydia in men
    • Epididymitis
    • Prostatitis
    • Dysuria, painful ejaculation, pelvic pain
    • Rectal pain, discharge, pressure
    • Conjunctivitis
    • Reactive arthritis
  75. Reiter syndrome
    • ?Can?t pee, can?t see, can?t climb a tree?
    • Arthritis
    • Uveitis
    • Urethritis
  76. Trichomonas infects
    • Females: Skene gland, vagina, lower urinary tract
    • Males: genitourinary tract
  77. Symptoms of trichomonas in women
    Malodorous frothy green/yellow vaginal discharge
  78. How to diagnose trichomonas
    Wet mount - motile flagellates
  79. Treatment for trichomonas
    Metronidazole
  80. Lymphogranuloma venereum
    • Vesicular or ulcerative lesion
    • Spreads to lymph nodes
    • Inguinal buboes
    • Breakdown of buboes cause draining sinuses and scarring
  81. Anorectal disease from lymphogranuloma venereum causes
    fistula, discharge and tenesmus
  82. Diagnosis of lymphogranuloma venereum
    nucleic acid amplification test
  83. How to treat lymphogranuloma venereum
    • One gram azithromycin
    • Or DCN bid x 7 days
  84. Gonorrhea incubation period
    2-8 days
  85. Complications of gonorrhea in women
    • Urethritis
    • Cervicitis
    • Chronic pelvic pain
    • PID
    • Infertility
    • Ectopic pregnancy
  86. Symptoms of gonorrhea in men
    • Urethral pain
    • Milky/bloody penile discharge
    • Can spread to prostate and epididymis, causing urethral strictures and prostatitis
  87. Symptoms of gonorrhea in women
    • Usually asymptomatic
    • Purulent urethral discharge
    • Dysuria, urinary frequency/urgency
  88. Best way to diagnose gonorrhea
    Nucleic acid amplification test
  89. How to treat gonorrhea
    • Multi drug resistant
    • One dose of IM ceftriaxone 250 mg
    • Treat for chlamydia as well
  90. Image Upload 1
    Erythema marginosum: rheumatic fever, carditis, polyarthritis
  91. Image Upload 2
    Erythema migrans: Lyme disease
  92. Exam signs of trichomonas
    Diffuse erythema on vagina and red macular lesion on cervix
  93. Endocarditis signs/symptoms
    • Febrile
    • Pallor
    • Regurgitation murmur, stable
    • Osler nodes
    • Roth spots
    • Janeway lesions
    • Petechiae: palate, conjunctiva, subungual
    • Splinter hemorrhage
    • Splenomegaly
    • Symptoms can be nonspecific
  94. Tests for endocarditis
    • echocardiography
    • 3 sets of blood work, 1 hr between each, before abx
    • CXR might show diffuse infiltrates
  95. Osler nodes
    Painful papular Purple polka dots on the phalanges
  96. Janeway lesions
    Painless red lesions on the palms and soles
  97. Roth spots
    Exudative retinal lesions
  98. Transmission risks for endocarditis
    • ?Teeth and tubes?
    • Dental surgery
    • Invasive procedure of
    • upper respiratory
    • GI
    • Urologic
  99. Minor signs of endocarditis
    • Immunologic response
    • Vascular issue
  100. Causes of endocarditis
    • Staph aureus - IVDU, prosthetic heart valve
    • Strep viridans
    • Enterocci
  101. Image Upload 3
    Chancre: syphilis
  102. Image Upload 4
    Herpes zoster
  103. Image Upload 5
    Chlamydia
  104. Image Upload 6
    Herpes Simplex
  105. Image Upload 7
    Janeway lesions: endocarditis
  106. Image Upload 8
    Osler’s nodes: endocarditis
  107. Complications of measles
    • Encephalitis
    • pneumonia
    • death
  108. s/s of measles
    • Fever, dry cough,
    • spreading rash,
    • runny nose, conjunctivitis
  109. Image Upload 9
    Measles
  110. s/s of mumps
    • Fever, fatigue
    • headache, myalgias
    • swollen salivary glands
  111. S/s of pertussis
    • Runny nose
    • severe cough
    • apnea
  112. complications of pertussis
    PNA, death
  113. s/s rotavirus
    • Fever
    • diarrhea, vomiting
  114. S/s tetanus
    • Fever
    • muscle spasms
    • difficulty swallowing
    • neck and abdominal muscles
  115. s/s rubella
    • fever
    • rash
    • lymphadenopathy
  116. Ddx EBV vs CMV
    • EBV:
    • longer fever, exudative pharyngitis, heterophile +
    • CMV: profound fatigue, rash, night sweats
  117. mumps w/o parotitis
    dx w/buccal swab and blood specimen
  118. three C's of measles
    • Cough
    • Coryza
    • Conjunctivitis
  119. Ddx night sweats
    • TB
    • endocarditis
    • EBV
  120. Epstein-Barre Triad
    • lymphadenopathy
    • fever
    • pharyngitis w/ exudate
  121. risk factor for measles
    Vitamin A deficiency
  122. CMV rash vs measles
    • measles: rash followed by very high fever
    • CMV: fever throughout
  123. Rubella lymphadenopathy vs CMV
    • rubella: occipital
    • CMV: cervical
  124. roseola fever vs measles fever
    • roseola: fever is before rash,
    • measles: rash is before fever
  125. lymphoma sign
    fixed, nontender lymph nodes
  126. Epstein-Barre fever
    • low-grade
    • 2-4 weeks
  127. CMV s/s
    • Profound fatigue
    • nonspecific rash
    • cervical lymphadenopathy
    • night sweats
  128. rubella s/s
    • occipital lymphadenopathy
    • arthralgia
    • eye pain on movement
    • petichial lesions on uvula
  129. Fordyce spots
    peticheal lesions on uvula
  130. aftercare for EBV
    avoid contact sports for 6-8 weeks
  131. EBV management
    • self-limited
    • give supportive care/antipyretic
  132. which rashes are pruritic?
    varicella, measles, roseola, fifth
  133. which heart valve is most often affected by rheumatic heart disease
    mitral valve
  134. purulent vs pruritic
    • purulent: pus
    • pruritis: itching
  135. risk factor for rubella
    foreign born
  136. contagion period of measles
    5 days before rash -> 4 days after
  137. name of the measles virus
    morabilli virus
  138. Koplik's spots
    • 48 hours prior to rash
    • white lesions clustered opposite the molars
  139. measles rash and fever
    very high fever, then 2-4 days later rash
  140. measles rash begins on the
    face and spreads to the trunk and extremities
  141. measles rash and cough
    cough lasts 1-2 weeks after measles
  142. Rubella communicable
    one week before and one week after rash onset
  143. rubella lymphadenopathy
    occipital
  144. measles rash vs rubella rash
    • measles: coalesces
    • Rubella: remains distinct
  145. rubella is caused by what
    virus B19
  146. third vs fifth disease
    • Third: Rubella, German measles
    • Fifth: slapped cheek
  147. roseola rash vs rubella rash
    roseola: nonpruritic, high fever, coalesces

    patchy itchy
Author
ketch22
ID
337571
Card Set
Infectious Disease
Description
infectious disease
Updated