ID USMLE2
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| TB treatment | RIPE-rifampin, INH, pyrazinamide, ethambutol + B6 w INH to prevent peripheral neuritis
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| cut-offs for PPD + | 5mm if HIV, close TB contacts, CXR evidence of TB; 10 indigent/homeless, IV drug, chronic illness, health care workers, inmates, residents of developing nations; 15 everyone else
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| complications assoc w TB meds | rifampin=body fluids orange; ethambutol=optic neuritis, red-green color blind; INH=peripheral neuritis and hepatitis
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| how active TB diagnosed | sputum acid fast stain (take 3 a.m. samples)
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| what is prophylactic TB therapy | INHx9mo (for PPD conversion w/o active symptoms, CXR suggests old TB)
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| what vaccine makes PPD+ | BCG vaccine
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| standard treatment for malaria | oral chloroquine--but increasing resistance, so now also add primaquine
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| how difft Strep and Staph | Strep catalase - chains, Staph catalase + clusters
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| how difft subtypes of Staph | all catalase +, coag +, b hemo = S Aureus; coag - novobiocin sensitive= S epidermis; coag - novobiocin resistant= S sapro
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| how difft subtypes of Strep | all catalase -, then subdivide by hemolysis: alpha=pneu, viridian; beta=GrpA (pyo), GrpB (aglact); gamma=Enterococc
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| what do alpha, beta, gamma hemolysis for strep mean in culture? | alpha=green partial hemolysis; beta=clear, complete hemo; gamma=no hemo
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| + Quellung test indicates what | S pneu (its capsule)
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| name some gram + rods | Clostridium (anaerobe, spore), Listeria (milk, meningitis in baby), bacillus (aerobe, spore)
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| beta hemo, Grp A Strep is which organism | S Pyo
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| how difft alpha hemo Streps? | optochin sensitive, bile soluble=S Pneu; optochin resistant, bile insoluble=viridians (no capsule)
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| name some gram - cocci/coccoid rdos | cocci=Neisseria, coccoid=H flu, Pasteurella, Brucella, Bordetella
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| gram - non cocci/non rods | spirochetes=H pylori, borrelia; comma=vibrio, Camp Jej; safety pin=yersinia; branch=Nocardia
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| gram - rods aerobic | Pseudo, Legionella, Bordetella, Brucella
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| gram - rods facult anaerobic | Enterobac, Pasteurella, H Flu, Vibrio
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| subdivide gram neg rods based on lactose ferment | lactose ferment [LEEK]=Klebsiella, E coli, Enterobac; non fermenter [SSPP]= Shigella, Salmonella, Proteus (oxidase -); Pseudo (oxidase +)
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| subdivide gram neg rod non lactose ferment | Shigella, Salmonella, Proteus (oxidase -); Pseudo (oxidase +)
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| obligate anaerobe bac | Clostridium, Actinomyces, Bacteroides
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| clinical presentation PCP | severe hypoxia with normal CXR or diffuse, bilateral interstitial infiltrates and dry cough **esp suspect in HIV w PNA
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| classic triad of Strep pharyngitis? Centor criteria (4)? | fever, exudative pharyngitis, cervical lymphadenopathy (w/o cough)--the Centor criteria includes 4: errhythematous and exudative pharyngitis, cervical lymphadenopathy, w/o cough
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| characteristics of rheum F | No rheum for SPECC: subQ nodules, polyarthritis, eythema marginatum, chorea, carditis
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| Strep B causes | PNA, meningitis, sepsis mainly in babies
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| lab test indicates recent Strep pyo infx | ASO titer
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| symptoms not indicating Strep pyo pharyngitis | cough, hoarseness, GI, conjunctivitis
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| characteristics of scarlet F | sandpaper-like rash on trunk, strawberry tongue; rash desquamates after few days
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| difft bw Janeway lesions and Osler nodes | Osler's painful and raised on finger pads, Janeway errhyth and on palm or sole--both endocarditis
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| adenovirus causes | pharyngitis, PNA, pink eye
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| besides adenovirus, what other organisms cause pharyngitis-like illnesses | Hflu=epiglottitis, parainflu=croup, C Diphth=pseudo mem pharyngitis, Strep pyo=pharyngitis and rheum F
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| parvo causes | slapped cheek (erythema infectosium), hydrops fetalis, plastic crisis in sickle cell
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| papilloma causes | HPV warts CIN, cervical cancer
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| poxvirus causes | small pox, molluscum (think HIV)
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| list various Herpes virus | HSV1,2, varicella, EBV, CMV, HHV6,8
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| HSV1,2 cause | HSV1-oral, HSV2 genital
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| varicella causes | chicken pox, zoster, shingles
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| EBV causes | mono, Burkitt lymph
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| CMV causes | various dz in immunosuppresses
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| congenital CMV causes | petechial rash, periventricular Ca++, (MC congenital infxn)
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| HHV6 causes | roseola-very hi fever, stops and then rash
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| HHV8 causes | Kaposi's sarcoma in HIV
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| Tzanck smear is used to ID | HSV and VZV
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| tx CMV | ganciclovir
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| tx HSV | acyclovir (also for EBV tx)
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| name DNA viruses | adeno, parvo, papillo, pox, various Herpes
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| dog/cat bite assoc with infxn? | Pasteurella
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| cat assoc with infxn? | Toxo
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| cat scratch assoc with infxn | bartonella henslea
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| thorn assoc w infxn | sporothrix schenke
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| sheep assoc w infxn | anthrax
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| crypto assoc w environ causes | soil, pigeon droppings
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| Histo assoc w | bird/bat, Missi/Ohio, caves
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| Cocci assoc w | SW US/CA
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| Paracocci assoc w | S America
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| systemic mycoses (4) | Histo, Blasto, Cocci, Paracocci
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| tx for systemic mycoses | local infxn: flucanozole, ketoconazole; systemic: amphotericin B
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| opport infxns | candida, PCP, systemic mycoses, aspergill, crypto
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| describe mycoplasm PNA | walking PNA chest xray looks much worse than pt, incrsd cold agglutin (IgM) **don't give PCN bc no cell wall
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| pericarditis caused by | coxsackie A, B, TB
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| myocarditis caused by | coxsackie B, Lyme, Chagas, SLE
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| subacute endocarditis caused by | strep viridans
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| acute bac endocarditis caused by | Staph aureus
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| findings RMSF | rash starting on palms, decrsd plts, proteinuria, hematuria
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| list Rickettsi type dz | typhus, prowazeki, Ehrlichia, Q fever (Coxiella burnetti)
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| what organism for Q fever | coxielli burnetti
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| why Q fever unique | no rash, no fever, negative Weill Felix, not Rickettsi genus
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| what's Weill Felix rxn | Ab cross reacts with Proteus (which is an UTI bug in hospitals); all the Rickettsia bugs except Q fever are positive for this
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| which Rickettsi is fleas? Lice? | fleas=R typhi (endemic), lice=prowazeki (epidemic)
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| dzs passed by tick | Lyme (Borrelia burgdorfei), Ehrlichia, tularemia, plague (yersinia pestis), epidemic typhus (Ricket. Prowazeki)
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| what organism for Lyme dz | Borrelia burgdorfei
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| describe typhus rash | begins on trunk and spreads out (v RMSF)
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| what's 5th dz? Name, Symptoms and organism | erythema infectiosum (slapped-cheek--starts on cheek and proceeds to trunk and extremities) ((caused by parvovirus B19))
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| scarlet fever | sandpaper-like rash on trunk, strawberry tongue; rash desquamates after few days
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| dzs can cause rash on palms, soles | RMSF, syphillis, coxsackie A (hand, foot, mouth dz), erythema multiforme
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| what are the dermatophytes? | microsporum, trichophyton, epidemiophyton
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| what dzs do dermatophytes cause? | tineas pedis and cruris (athlete's foot and jock's itch), tinea corporis, tinea capitis (ringworm, scalp caling)
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| how identify dermatophytes? | KOH preparation
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| what organism causes tinea versicolor? | pityrosporum orbiculare (yeast)
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| signs/symptoms rubeola | 3c's: cough, coryza, conjunctivitis, Koplik spots, rash head to toe spread
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| what are the paramyxo viruses? | (PRM) parainfluenza, rubeola (measles), RSV
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| what virus family are german measles under? | togavirus
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| signs/symptoms rubella | generally same as rubeola except more mild, also suboccip and postauricul nodes tneder, rash more faint head to toe and encephalitis also a potl complication
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| what are complications of rubeola | encephalitis and giant cell PNA
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| what's the tx for RSV | ribavirin
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| India ink prep on CSF from HIV pt would mean | Crypto
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| what Rx given at what CD4 count for HIV/AIDs | <500: HAART, <200: PCP Rx (bactrim, same Rx as for Toxo which at risk <100), <100: Mycobac (clarithromycin, erythromycin)
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| what Rx for PCP? If allergies? | trimethoprim-sulfamethoxazole (Bactrim); if allergy: dapsone and pentamidine
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| when is a person diagnosed w AIDs | if CD4<200, if opportunistic infxn
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| Ring enhancing cerebral lesions in HIV pt | usu Toxo, or primary brain lymphoma
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| yrly what should HIV pts get? Overall what vaccines? | PPD, Flu vaccine (+ other vaccines Pneu, Hep, inactive polio vaccine, MMR **only live vaccine they should get)
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| HIV pts at risk for what blood cancer | non hodgkins lymphoma
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| pregnant women w HIV | they and their babies should take AZT (zidovudine), mom's can't breast feed, positive HIV test on infant <6mo is unreliable (could be mom's Abs)
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| how detect PCP path | Silver (Wright-Giemsa or Giemsa)
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| retinitis in HIV due to? Treatment? | CMV, treatment ganciclovir/valganciclovir (back up is foscarnet)
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| at what CD4 count is pt at risk for Toxo? Myco? PCP? | Toxo <100, PCP<200, Myco <100
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