Infectious disease 2
Terms
undefined, object
copy deck
- incubation of varicella.
- 14-16 days. 28 days who receive VZIG
- treatment for entamoeba histolytica
- metronidazole
- flucytosine
- adjunct for cryptococcus and candida severe infections. Like rifampin has lots of resistance, must be used with ampho
- Rx for invasive pulm aspergillosis
- ampho.
- Rx for gc/chlamyd
- azithromycin, ceftriaxone.
- complications of measles
- pneumonia. most deaths from measles are from pneumonia. encphalitis is less common but is more common in older kids. Few die from enceph but many have perm damage.
- skinned rabbit, think and treat
- Yersinia. from flea bites. lymphadenitis regional (near bites), fever. Streptomycin
- community acquired celluluits from varicella. treat
- nafcillin/oxcillin
- highest risk factor for transmitting Hep B
- e antigen positive.
- complications of mumps
- meningeal signs, arthritis, thyroiditis, orchitis, hearing problems. test for mumps in parotitis
- most common org in peritonitis from chronic dialysis
- Staph epi and Staph aureus.
- early signs of Lyme
- erythema migrans. 90% of patients ahve rash. 1-2 weeks after tick bite. lasts for 1-2 weeks.
- seventh nerve palsy think
- early Lyme
- timing of arthritis in Lyme
- late. wks to months after infection. knees.
- giardia Rx
- metro
- ALL patient with high fever, herpetic lesions, deep seated and umbilicated, palms and soles
- varicella. HSV is grouped not generalized.
- risk from MMR vax in 1st trimester
- risk is congenital rubella syndrome. no cases reported from MMR. theoretical risk 1%. pregnant after 3 months from vax is completely safe.
- pertussis duration and complications
- 6-10wks, sz, pneumonia, encephalopathy, death
- treatment of household with pertussis
- erythromycin for all household contacts, irrespective of age or vaccination status.
- cipro modifies which drugs
- theophylline
- How many months do you have to wait for HIV Ab to revert to neg in a baby that has HIV+ mom but has no HIV infection
- 18 months.
- Rx for varicella exposed immunocomprimised patient
- VZIG withing 96hrs.
- chemoprophylaxis for malaria
- 1 week before travel. chloroquine. Mefloquine if going to sub-saharan africa (chloroquine resistant)
- meningococcal vax covers which goups
- A, C, Y, W. none for B
- at risk groups who need meningococcal vax
- >2yrs. asplenia, copmlement def.
- Hep A IG can prevent hep A if given within 2 wks of exposure. who gets it?
- only direct contacts. If in child care with diapers, give to all kids and all employees.
- who gets invasive aspergillus
- immunocompromised pt. bone marrow is most likely. allergic bronchopulmonary aspergillosis is noninvasive.
- Don't treat salmonella enteritis in
- chronic carriers. usually self-limited illness. most cases are <1yr old. Give Abx if <3mo, bacteremia, invasive disease, hemoglobinopathyies.
- lab detection of arboviruses
- serology. acute and convalescent titers of IgG
- ulcerated tick bite, fever, chills, regional adenopathy
- tularemia
- Tularemia labs
- serology for Francisela tularensis.
- ticks or rabbit exposure, flu
- tularemia
- patients who get worse EBV infections
- cell-mediated immune system disorders. T-cell disorders
- SE of chronic fluconazle
- GIsx.. LFTs elevated
- penicillin mech of action
- disrupts cell wall synthesis. no cross linking of peptidoglycans
- how to manage Hep B exposure in a fully immunized pt
- check anti-HBs. If positive, do nothing, if neg give another hep B vax
- animals in whom to suspect rabies
- unknown cat, bats, raccoons, skunk, fox, coyote
- management of rabies suspected bite
- wash well. HRIG injected around wound within 7 days. vaccine 4 times within first 4 weeks
- when to give TD
- every 10 yrs. give if wound is complex and no vax within 5. TIG is only for bad wound and incomplete primary series of IZ
- 2 week old diffuse vesicobullous lesions
- congenital syphilis
- HS megaly, mildly preterm infant, IUGR, lymphadenopathy, chorioretinitis. intracranial Ca, hydrocephalus
- Toxo
- TORCH with cataracts
- rubella > toxo
- TORCH with heart defect
- Rubella
- TORCH with hydrocephalus
- toxo
- TORCH with microcephaly and anemia
- CMV
- TORCH with intracranial Ca
- toxi, CMV
- TORCh with thrombocytopenia
- CMV
- 7yr old, fever, headache, edema, palpable purpura, early Spring
- Rocky Mountain spotted fever
- recent transplant, pneumonia
- CMV from the transplant
- 3 yr old fever, abdom pain, wheeze, urticaria, HSmeg, lymphadenopathy, eosinophilia
- toxocariasis. round worm from dog or cat.
- when to give VZIG
- within 72hrs of exposure to immunocprimised. If receiving monthly IVIG, no need.
- risk factor for hepC
- transfusions, IV drug, hemodialysis. perinatal transmission is low.
- late onset GBS sites
- meningitis.
- conjunctivitis, cervical adenopathy lasting weeks
- Bartonella henselae
- bad complication of VZ in immunocomprimised
- pneumonia
- most common complication of mumps in young child
- meningitis. orchitis is common only after puberty.
- PPD + sib of INH resistant TB, Prophylaxis
- Rifampin alone
- etiology of atypical pneumonia in teen
- Mycoplasma. viral and bacterial causes less likely.
- Abx causing fever, morbilliform rash, neutropenia
- bactrim
- drugs that suppress bone marrow
- chloramphenicol, sulfonamides, anticonvulsants.
- Initial therapy for fever, neutropenia
- gram+ and Gram -. with pseudomonas covered. aminoglycoside + anti-pseudo abx, meropenum
- IVIG SE
- fever, chills, headaches. rarely hypotension, shock.
- reasons to not give further doses of DTaP
- anapylactic reaction. encephalopathy within 7 days,
- PPD neg with known TB
- severe disseminated TB has sufficiently immunesuppressed the response.
- 6yr old, tick bite, HA, photophobia, myalgia, HSmeg, pancytopenia
- ehrilichiosis. A ricketsial infection similar to RMSF but with more leukopenia and pancytopenia. Rash is not as common.
- Malaria like illness, anorexia, high fevers, chills, myalgia, arthralgia.
- Babesiosis (parasite)
- ketoconazole common SE
- nausea.. can also increase LFTs
- CMV retinitis Rx
- gancyclovir, if recurs foscarnet
- immunocomprimised. pneumonitis and retinitis
- CMV
- VZ maternal infection 1st tri, sx
- 2% risk of congeintal VZ. limp hypoplasia, eye, brain abnormal, skin lesions.cataracts, chorioretinitis
- Viruses which can be cultured
- CMV, HSV, enterovirses, respiratory viruses
- mono rash from Abx, which Abx
- ampicillin, less so amox, less augmentin
- organism in nephrotic S peritonitis
- Strep pneumo
- fever, tachycardia, low BP
- myocardial vs pericardial disease. pulsus paradoxus favors pericardial.
- treatment of RMSF or Ehrlichiosis
- Tetracycline for any rickettsiae.
- <4yrs old exposed to active TB
- PPD, CXR. INH if ppd (-), retest in 12 weeks. INH for at least 9 months
- SCC pneumococcus prevention
- oral penicillin prior to age 4mo.. Prevnar and later pneumococcal im
- when does C3 return to normal after post strep gmn
- 6-8weeks. if still low at 10weeks work up for something else.
- MMR not to be given to
- pregnant women. Or planning to be in 4 months. immunocomprimised, not including healthy HIV. OK for breastfeeders. OK for egg allergic.
- signs of anaphylaxis in IVIG
- IgA deficiency. most common immunodef. often unknown. Presence of IgA provokes anaphylaxis. IVIG has a small amount of IgA. Same problem to blood products.
- timeline for maternal varicella
-
<20wk gestation 2% risk for congenital VZ
>20wk sensitized without problem up to:
5 days prior to delivery to 2 days after (in mother) infant at risk for primary VZ - who gets VZIG
-
exposure of suseptible household contact or playmates
mother has onset 5 days prior to 2 days after delivery, then give to baby. - potential complication of EES therapy in <6wk old
- hypertrophic pyloric stenosis.
- who gets pertussis prophylaxis
- household and close contacts of known patient
- Pertussis prophylaxis in classmates
- no Abx, give IZ if not up to date.
- At what age do you discontinue pen prophylaxis for sickle cell
- 5yrs
- fever, sweats, weakness, lymphadenopathy, (flu-like) unpasteurized milk
- brucellosis. doxycycline
- flu-like illness, conjunctivitis, no pus, can have jaundice, rash. Myalgias of calf and back.
- Leptospirosis
- Treatment of Lepto, complications
- Penicillin. jaundice, renal failure, hemorrhagic pneumonitis
- Lepto, where do you get it?
- animal urine, mucosa or abraded skin, wacontminated water, veterinarians, famers, sewer workers
- flu-like illness, painful maculopapular lesion with regional lymph adenitis
- Tularemia
- tularemia Rx and epi
- Streptomycin, rabbits, domestic animlas, tick and mosquito bites from these animals.
- fever, leuikocytosis, eosinophilia, hepatomegaly
- toxocariasis. roundwroms of dog and cat. get from eating contaminated soil. mebendazole
- seizures, pork
- cysticcercosis, taeniasis. forms cysts anywehere. . one adult worm in intesine, larbae cause the illness. months to years between ingestion and sx.
- school exposure to VZ
- if not immunized do so within 72 hrs
- meningococcus prophylaxis
- household contacts, childcare congacts, including 7 days prior to onset. Rif for kids, cipro for adults
- Salmonella return to school crit
- 24hrs no diarrhea if >5yrs. 3 neg stool cx if <5yrs test all in school
- TB in healthcare worker
-
PPD+, CXR neg, INH alone
PPD+, CXR+, therapy, no work until cough gone and sputum neg x 3 - best test for HSV encephalitis
- PCR of CSF
- best time to measure Gent Peak
- 1hr after infusion
- tests for congenital rubella
- IgM or IgG over time
- TORCH with calcifications on head CT
-
diffuse = toxo
periventricular = CMV - PPD>15mm withhx of BCG
- + PPD, if CXR - treat with INH
- who is PPD + at 5mm
- close contact has active TB, clincal signs of TB, CXR shows signs of TB
- PPD + at 10mm
- <4yrs, immunocopm, increased exposure to TB
- intial treatment of dental abscess
- pen VK oral
- gentamycin peak and trough
- peak 5-12, trough 0.5-1
- chloramphenicol SE
- rare dose independent aplastic anemia. dose dependent bone marrow suppression. check CBC twice weekly
- rifampin drug interactions
-
OCPs don;t work as well
warfarin, digoxinm, chloramphenicol all affected - meorpenem use and SE
- resistant enterobacter. Long time in PICU, suddenly worsened. increased risk of seizures
- amantadine, rimantadine, oseltamivir
-
oseltamivir keds to 1yr flu A or B
Rimantadine amantadine: flu A - ganciclovir SE
- anti-CMV for immunocomprimised or congenital. bone marrow suppression is most common.
- foscarnet use and SE
- acyclovir resistant herpes viruses, nephrotoxic
- ampho Se
- low K, nephrotoxicity, rigors
- ketoconazole, use and SE
- GI SE, most dangerous is hepatic failure.
- EBV labs
-
primary infection goes to B cells, lifelong latent infection established.
EBV capsid Ag. IgG rises quickly, IgM + in acute
EBV nuclear Ag takes weeks to months to see. - contagious period for VZ
- 1-2 days before rash until lesions crusted
- measles contagious period
- 4 days on either side of rash.
- incubation for measles
- 8-12days
- neonate, septic, rash: 1-2mm light papules
- Listeria
- Staph aureus is different than other staph in what way
- coagulase +
- animal bite bacteria
- Pasteurella, penicillin
- human bite bacteria
- eikenella
- treatment of primary Lyme
- doxcycline. amoxicillin for kids younger than 8.
- Camping trip Colorado, fever, painful unilateral lymphadenitis
- Yersinia pestis, bubonic plague
- bacterial diarrhea associated with animal contact or uncooked meat
- Yersinia. self limited in most
- H. pylori Rx
- only treat in patients with EGD proven ulcers. amox, metro, bismuth
- HUS signs
- pallor, oliguria, hematuria
- types of acid fast stain
- Kinyoun and Ziehl-Neelson
- treatment for amebiasis
- iodoquinol
- treatment for ascaris
- vague GI sx, chronic low level infectino. mebendazole
- treatment for schistosomiasis
- praziquantel