Clin Med 1 Infectious Disease 4

Infectious Mononucleosis

What is caused by the Epstein-Barr Virus (EBV)?

Sore Throat, Fatigue*, Swollen glands, Myalgias (muscle pain), Fever

Symptoms for Infectious Mononucleosis

Swollen tonsils, Lymphadenopathy (esp. in post. chain), Splenomegaly (inflammation of spleen)

Signs for infectious mononucleosis

Monospot (antibody test) - most common, CBC

Testing for infectious mononucleosis

Rest, Acute symptoms: 5-15 symptoms, Full recovery: 4-6 weeks

Treatments for infectious mononucleosis

2nd and 3rd week

When is a splenic rupture most likely to occur in infectious mononucleosis?

Exam unreliable, Ultrasound

What causes a higher risk in a splenic rupture in infectious mononucleosis?

LUQ (Left upper quadrant) abdominal pain, Kehr's sign - nonmechanical source of pain, Peritoneal sign, Shock

Symptoms and signs of a splenic rupture

Out 21 days minimum, Asymptomatic, Blood tests within normal limit, +/- ultrasound

Return to play guidelines for infectious mononucleosis?

Herpes Zoster/Shingles

Reactivation of the varicella infection

With pain along a dermatome, Can be severe

How does herpes zoster present?

Radiculopathy (radiating nerve pain/chest/rib) and cardiac

What can herpes zoster mimic?

1-2 days later in the same location as the pain

How many days later will the rash appear in what location?

Herpes Zoster

Antivirals in 48 hours

What is the treatment for herpes zoster?

Chronic pain in dermatome

Post-herpetic neuralgia

Capsaicin

Chronic pain meds used for post-herpetic neuralgia

Shingrix vaccine (people who have had chicken pox)

Prevent herpes zoster?

A novel coronavirus, RNA virus

What is COVID-19

Common cold, MERS, SARS

Coronaviruses cause

Respiratory droplets, Cough, sneeze, speech, Travels only 6 feet

Can't linger in air

COVID-19 transmitted

Direct contact or touch infected surface

Transmission of COVID-19 that is less significant

4-5 days, can be as long as 14 days

Incubation period for COVID-19?

Transmitted 2-3 days before symptomatic

Infectivity of COVID-19

Fever most common, Fatigue/myalgia, Dry cough, Smell/taste, Anorexia, Dyspnea, Asymptomatic

What are the COVID-19 symptoms?

Headache, nausea, diarrhea, sore throat, nasal congestion

Other symptoms COVID-19 can cause

No smell/taste

Biggest indicator for COVID-19

Age, CVD, Type 2 Diabetes Mellitus, COPD, Kidney disease, Obesity, Cancer

Risk factors for severe disease of COVID-19?

Pneumonia, Adult Respiratory Distress Syndrome (ARDS), Acute cardiac injury, Thromboembolism, Multi-organ failure

Complications of COVID-19?

RT-PCR for viral RNA

COVD-19 test for sensitivty

Antigen testing

COVID-19 test for specifics

Antibody Serology, takes 10-14 days to become positive

COVID-19 test will reflect immunity status

Follow Isolation protocols

Treatments for COVID-19 in outpatient?

Support

Hydroxychloroquine NOT TO BE USED

Nebulized meds = avoid

PTs recommend prone position for posterior lung oxygen

Treatments for COVID-19 in inpatient?

Contact tracing, Quarantine close contacts

Prevent the spread of COVID-19?

Quarantine for 24 hrs. post-improvement and afebrile (no fever)

What are the current guidelines for COVID-19?

5 days after quarantine, Enhance hygiene

Well-fitted masks

Distance from others

Post-quarantine precautions for COVID-19?

Pfizer, Moderna, Novavax

Vaccines for COVID 19?

Pfizer, Moderna

COVID mRNA vaccines?

Novavax

COIVD spike protein vaccines

15%

Percentage of college athletes are affected by COVID-19 and myocarditis

Myocardial damage, Arrythmias (cardiac arrest)

Pathology of COVID-19 and myocarditis

It can emerge, persist, resolve, remerge over weeks and months

How does long COVID work?

mild to severe

Severity range of long covid?

Women, Hispanic/Latino, Severe COVID-19 illness, Comorbidities

>65 y.o., Unvaccinated

Risk factors for long covid?

Fatigue, fever, worsening of symptoms after physical or mental effort

What are the general signs and symptoms of long covid?

SOB, Cough, Chest pain, Tachycardia and/or palpations

Signs and symptoms of long covid for respiratory

Difficulty thinking/concentrating (brain fog),Headaches, Sleep problems, Dizziness/lightheadedness

Signs and symptoms of long covid for neurological

Diarrhea, Stomach pain, Constipation

Signs and symptoms of long covid for GI

Joint/muscle pain, Rash, Changes in menstrual cycles

Signs and symptoms of long covid for other