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Med Bct
Test 2
| Question | Answer |
|---|---|
| Rhinovirus | Picornaviridae family(hep a, polio); Icosahedral, + ssRNA; no capsule; Transmit: aerosol; prevelent: winter spring; Incu: 8-10hrs; Peak: 1-3 days; disease: nasopharyngitis, otitis media; Extreme: bronchitis |
| Coronavirus | Coronavirdae family; Helical, enveloped, + ssRNA; Transmit: aerosol + fomites(can infect animals); Incu: 2-5 days; Syptoms: 1 wk; Nasopharyngitis, otitis nedia |
| Pharyngitis | Most are viral: Corona, Rhino, adeno, CMV, flu, EBV, HSV, Coxsackie A; Bacterial caused: S. Pyogenes(most common), N. Gonno, C. diptheriae,; Presents: strawberry throat, erythema. |
| S. Pyogenes - General(Stain, shape, respiration, etc.) | G+, diplococci, Faculatative;Group A(lansfield); Beta Hemolytic; |
| S. Pyogenes - Virulence Factors | Streptolysin O(titer, lyses plts+wbc anerobically), S(lyses RBC aerobic), Streptokinase(thrombolytic), Hyaluronidase(chondrolytic), erythrogenic toxin(causes scarlet fever), M protein(resists phagocytosis, helps adhesion) |
| S. Pyogenes - Pharyngitis | Affects: 1-15yo; Presents: erythema, pustules, petechiae(palate), cervical lyphadenopathy; Transmits: close contact, droplets; Incu: 1-4 days; Dx: SS, Rapid strept test(80%), Culture; Tx: 1st line: Pcn(amoxi+Clauv), 1,2gen ceph(ceclor); allegy:Macrolide |
| S. Pyogenes - Acute glomerulonephritis | Non-Suppurative comp; 10 days after infection(resolved or not); 0-28%prevalance(children); men>females; 95% completely resolve(nephrotic syndrome), 1% permanant; Presents: azotemia(^BUN), HTN, olgria; |
| S. Pyogenes - Rheumatic Fever | Non-Suppurative comp; Don't finish Ab; 2-4wks after infection; 4-9yo; females>males; 3% of Strept infections; Presents: carditis, arhtritis, erythema marginatum, Stenotic and insufficient mitral valve; Tx: High dose pen; secondary: ab up to life |
| S. Pyogenes - clinical manifestations(supporative) | Scarlet fever - erythrogenic toxin causes rash(no palmar, plantar; 2-10yo; by day 2 rash; day 6 improve + peel; Pyodermal infections, Toxic Shock syndrome |
| Pyodermal Infections | Staph or strept infection; crusty lesions; cellulitis(infect of subq, noninfectious); Impetigo(infectious); Tx: cephalexin, 2nd gen pen (dicloxacilin); allergy: clinda |
| Acute otitis Media | Earache; children(2/3 by age 3); 40% viral(RSV+FLU); resp infection 4-7 days prior; causes: bct colony(S. pneumo, H. flu, M cat.); smoke, breast-rfeeding, tube dysf(x)'; pacifier, host immune defenses, genetics, cleft palate |
| S. Pneumoniae - General(Stain, shape, respiration, etc.) | G+, diplococci, fac,; Causes: AOM(50% of bct caused), pneumonia, bct meningitis, sinusitis, bacteremia; Vaccine: ployvalent pneumoccocal vac.(65+ yo, splenectomy(sickle cell), immuno suppressed every 5 years. |
| Acute Otitis Media - Treatment | Observe under 6 months, 6-2 years treat if ear pain+fever(uncertain); Amoxicillin, Bactrum, Azythomycin, Cefdinir(3rd) or cefuroxime(2nd) for 10 days |
| S. Pneumonia - virulence factors | benign: hemolysin, protease, neuraminidase, hyaluronidase; Polysaccharide capsule(very virulent) |
| Acute Epiglottitis - General(Signs&symptoms, prevelence, causes) | SS: fever, dysphagia, drooling, stridor; prevel: men, children, AA; Causes: H. flu B, S. pneumo, S. aureus, (strept group A,B,C&F) |
| Acute Epiglottitis - treatment | 1. Visualize stricture(x-ray, scope); 2. broad Ab:cefazoin(1st gen) or ampicilin and clavulanic acid 3. culture; 4: specific AB |
| Acute Bronchitis - General(Signs&symptoms, prevalence, causes) | SS: fever, malaise, chest pain, no effusion(r/o pneumonia; prevel: winter months; Causes: mostly viral:corona, rhino, influ; Bct very rare: M. Pneumo(5%), C. Pneumo(5%), S. peneumo, H. flu(superimposed) |
| Bronchiolitis - (Signs&symptoms, prevelence, causes) | SS: wheezing, nasal flaring, accessory muscles; Prevel: newborns and infants; Causes: mostly viral: RSV, Influ, parainflu, adeno; Bct: Atyp: myco, urea, chlamydia, special: pneumocystis |
| RSV Bronchiolitis - General(virus shape, envelope, virulents, Diagnose, prevelence) | Helical, enveloped, -ssRNA; 75% causative of Bronciolitis; G, F protein: attachment; incu: 5 days; ELISA diagnosed; Prevel:winter, kids and immunocomp |
| RSV Bronchiolitis - Treatment and prevention | respiratory support; fluid resucitation; bronchodilators; use to use ridivrin(stops RNA polymeerase); Ig for F protien(not standard); avoid crowded spaces, wash hands, no smoke |
| Ambulatory Community Acquired Pneumonia - (Signs&symptoms, prevalence, causes) | SS:Dry cough, headache, malaise, dec. appetite, low fever; Prevel: prisons, college, military, not the old or young; Causes: M. pneumo(1), C. pneumo, Legionella, S. pneumo(3), viral(2). |
| Ambulatory Community Acquired Pneumonia - Treatment | no comorbids: Azithro, clarithro, doxycycline,(anything broad enough to cover atypicals and strept). Comorbids: Levoquin, Arithro+Amoxicilin. (more strept coverage cause of increase likelyhood with comorbids.) |
| Hospitolized Community Acquired Pneumonia - (Signs&symptoms, prevalence, causes) | SS: productive cough, yellow sputum, hemoptysis, respiratory difficulty; Prevel: young and old(immunocomprimised); Causes: S. pneumo, H. flu, Viral, S. aureus, M. Cat |
| Hospitolized Community Acquired Pneumonia - Treatment | no comorbid: Rosephten(3rd)+Azithro; comorbid: levoquin; pneumovax: vac. against strept the most common cause of CAP; indicated for immunocomp., spleenectomy, |
| Community Acquired Pneumonia(aspiration) - (Signs&symptoms, prevalence, causes) | SS: insidious, fever, cough, dragon breath, empyema(pus effusion); Prevel: decreased conciousness(druggies, drunks, strokes, seizures, peridontal disease); Causes: S. Pneumo, K. pneumo, peptostrept, bacteroides fragilis, fusobacterium nucleatum |
| Community Acquired Pneumonia(aspiration) - Treatment | O2, pain meds, ^ CBC(left shift), BAL(culture); Drain empyema(culture), Clinda, PCN+ metronidazole(peptostrept), Unasyn(IV)/Augmentin(oral) |
| Pneumonia-Nosocomial - General(Risk factors, Causes, Diagnosis) | RF: Exogenous(no hand washing), Patient(malnourished, immunocomp); Causes: Psedomonas, S. aureus(MS+MRSA), K. pneumo, E. Coli, Serratia marcrscens, H. Flu; Dx: blood cultures, o2 assess, BAL, PBS |
| Pneumonia-Nosocomial - Treatment | NO MDR: ceftriaxone, Pipercillin/tazobactam, Levofloxacin; MDR: A(ceftazidime, cefepime, Pipercillin/tazobactam)+B(Levofloxacin, gentimicin, vacnomyocin) |
| Risk factors for MDR | AB w/in last 90 days, Hospitolized > or = 5 days, from other health facility, high resistnace in community, immunosuppressed |
| Salmonella | G- bacillus; bacteremia, Inflamed rrhea high ID; inc. risk: antacids; raw under cooked food, Summer months, pets & reptiles, contaminated H20; . |
| Shigella | G- bacillus; inflamed rhea, shiga toxin; low ID, person to person, water and food borne; Flies, common in developing country |
| Campylobacteria | G- rod, seagull shaped, inflamed rhea(intracellular); poultry contamination(livestock + pets); inc. in summer months(can live in wood) |
| E. Coli | G - rod; 0157:H7 inflamed rhea; HUS; cholera like enterotoxin, children, shiga like toxin, travelers diarrhea(non inflamed |
| Yersinia Enterocolitis | G - Bacillus; high ID; R sided abd pain; rare in us; children |
| V. Cholerae | food and waterborne, cholera toxin, survive in ocean estuaries; seafood and shellfish; epidemics in India and Bangledesh; also seen in US |
| Enteric Fever | S. Typhi and S. para typhi; typhoud fever; very ill: fevers chills, cough, lethargy, bloody rhea, abd distention, splenomegaly. rash on abd, positive blood cultures, leukocytosis; |
| Antibiotic Associated Diarrhea | C. Diff G= sporeformer anerobic bacillus; toxin A enterotoxin(inflamed epithelium); Deadly(pseudomembranous colitis); vanco or metronidazole |
| Norovirus | food and water borne; swimming pools and lakes; seafood; infected handlers; epidemic; mild, no Tx |
| Rotovirus | Wheel like; 3-15 months; vommiting first then watery diarrhea; dehydration; resistant to hand-washing and many disinfectants; chlorine dactivates; problem: daycare |
| Cytomegalovirus | HIV-Aids; 25% of diarrhea in HIV; abd pain, wgt loss, fever, watery diarrhea(inflamed); biopsy to confirm |
| Amebiasis | giardia; gradual onset; cramps, pain, foul smell, fat in pp, RUQ pain; hepatomegaly; water contamination: west of mississippi(GR too) |
| UTI - host contributing factors | vesiculoretero reflux; uncircumcised; neurological(caths); renal caliculi; tumors; preggers(hydronephrous; FB; infection at another site; |
| UTI - bacterial factors | fimbrie, capsule, hemolysin, urease(stone) |
| UTI - uncomplicated | not associated with any anatomic or structural deformity |
| UTI - complicated | associated with anatomic or structural deformity |
| UTI - community acquire | E. coli(80%); Staph sapro(10-15% women under 40yo); Proteus mirablilis |
| Uncomplicated cystitis - treatment | Bactrum; Nitrofurantoin; Ciprofloxacin |
| Pyelonephritis - treatment | ceftriaxone(best); levofloxacin(concentrates in kidneys and prostate); bactrum; siproflocacin |
| Pyridium | symptomatic relief of pain, burning, urgency, frequency; analgeisa; contraindicated in renal insufficiency |
| Peylonephritis in Preggers | Treat in hospitol; spontaneous respiratory distress; ancef then add gentimycin if needed; nitrofurantoin(macrobid); Amoxicillin |
| Pernephric abcess | Rare; S. arueus, enterobacteriaceae); comes in with pyelo, abs don't help; CT or ultra; incise and drain |
Created by:
bmg4