MDT Infectious Disease 15.12 Test 2
Terms
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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