clin med ID major presentations

Cat Scratch disease

-cutaneous manifestations(vascular-> erythematous->papular)

-tender regional lymphadenopathy

Botulism

-FLACCID paralysis

-b/l CN deficits with symmetric descending weakness

-patients are A&O

tetanus

-SPASTIC paralysis (opisthotonos, risus sardonicus)

-autonomic overactivity

-patients are A&O

Respiratory Diptheria

-thick leather membrane from pharynx to trachea

-bull neck

cutaneous diptheria

chronic, nonhealing ulcer with dirty gray membrane

Chancroid

-PAINFUL genital ulcers

-inguinal lymphadenopathy-> buboes

Chlamydia in females

-UTI symptoms

-PID

Chlamydia in males

-WATERY discharge

-UTI symptoms

chlamydia outside of gu

rectum, eye, throat

untreated chlamydia complications

reactive arthritis triad- arthritis, conjunctivitis, urethritis

Gonorrhea in females

-PID

-UTI symptoms

-bartholinitis

Gonorrhea in males

-MUCOPURULENT discharge

-UTI symptoms

Gonorrhea outside of gu

rectum, throat, eye

untreated gonorrhea complications

-bacteremia!!

-tenosynovitis, arthritis

Rocky mountain spotted fever(RMSF)

-macular/petechial rash on PALMS AND SOLES

MRSA direct tissue invasion

-skin + soft tissue infx !!!

-pnemonia, endocarditis, osteomyelitis, septic arthritis

MRSA exotoxin-mediated

-bacteremia!!!!

-necrotizing skin, scaled skin, TSS

Rheumatic fever

5 major-> arthritis, carditis, CNS(chorea), subQ nodules, erythemia marginatum

4 minor-> arthralgia, fever, elevated ESR/CRP, prolonged PR

Scarlet fever

strawberry tongue, bright red rash, pharyngitis

cambylobacter

-pseudo-appendicitis (RLQ pain)

->10 episodes of bloody diarrhea/day

influenza

-abrupt fever, nonproductive cough, myalgias

-weird CNS atypical symptoms in older adults

EBV mono

-tonsillar enlargement

-splenomegaly

-cervical lymphadenopathy

EBV mono complications

lymphoma, GBS

CMV mono

-milder symptoms than EBV mono.

-no splenomegaly, less lymphadenopathy/throat involvement

Herpes simplex

-painful, vesicular, erythematous sores that can be reactivated.

ocular-> dendritic lesions (bad)

herpatic whitlow-> finger

gladiatorum-> wrestlers

neonatal herpes simplex

-skin, eye, mouth

-CNS disease

-disseminated disease(sepsis-like)

varicella

"dew drop on rose petal"

super itchy + contagious

shingles (VZV)

prodromal pain

dermatonal vesicular rash

congenital varicella

-cicatrical skin lesions

-ocular defects

-CNS involvement/neuro abnormalities

HPV

warts (verrucae)

genital warts (condyloma acuminatum)

Stage 1 HIV

flu-like sx

lymphadenopathy

stage 2 HIV

mainly asymptomatic

maybe thrush, herpes, other infx

stage 3 HIV

-"wasting"

-opportunistic infx

poliomyelitis

Mild-> nonspecific symptoms resolve quickly

Severe nonparalytic-> fever, vomiting, meningismus, may progress to

Severe paralytic polio-> flaccid + asymmetric weakness. Can lead to respiratory failure and quadriplegia

Rabies

-at first flu like symptoms

-then neurologic hyperactivity, salivation, agitation

-hydrophobia

thrush

cottony feeling in mouth

white plaques that bleed when scraped

esophagitis candidiasis

painful swallowing+speaking

yeast infx

itchy + cottage cheese discharge

balanitis candidiasis

pain, itchy, white curd exudates

mammary candidiasis

deep sharp painful breasts with unremarkable PE (maybe shiny or flaky nipple)

intertriginous dermatitis candidiasis

moist itchy rash in skin folds

onychomycosis candidiasis

painful nasty disfigured nails

otomycosis candidiasis

thick creamy white discharge from ears

hearing loss/pain

peritonitis candidiasis

surgical abdomen (stiff + painful)

cryptococcus

looks like meningitis but worse

-plumn features

-neuro features (CN defects, papilledema, much more)

atypical mycobacterial disease

pnemonia symptoms

lymphadenopathy, hepatosplenomegaly

TB

->2-3 weeks cough

-fevers, night sweats, weight loss

-recently traveled to endemic region

Blastomycosis

looks like chronic pnemonia

extrapulmonary blastomycosis

-verrucous skin lesions

-bone + joint infx

-male gu infx

Coccidioidomycosis

-looks like pnemonia

-rash(erythema nodosum)

-can manifest as skin or bone/vertebrae infx

coccidiodomycosis complication

coccidioidal meningitis. insidious onset with just bad headache

histoplasmosis

looks like pneumonia

pneumocystis (PCP)

looks like pneumonia. WL/night sweats

amebiasis

acute-> bloody/mucus diarrhea

chronic-> mimics colon cancer/IBD

Helminth

constitutional symptoms, GI symptoms, + symptoms relating to where the parasite is in the body

Pinworms

-itchy anus at night

giardiasis

acute-> diarrhea with foul smelling oily stool

chronic-> WL, stunted growth, lactose intolerance, malabsorption

Malaria

initial-> flu like

later-> petechiae, CNS abnormalities, jaundice

toxoplasmosis

flu-like, lymphadenopathy, hepatosplenomegaly, rash

trichomoniasis

UTI sx, punctate hemmorhages on cervix, green-yellow frothy discharge

early syphilis

painless chancre, regional lymphadenopathy

secondary syphilis

-rash on PALMS AND SOLES

-epitrochlear lymphadenopathy

-alopecia

tertiary syphilis

-tabes dorsalis

-argyll-roberson pupils

-gummas

-can present as meningitis

lyme disease early

-flu-like sx

-erythema migrans

-CN nerve palsies, meningitis

lyme disease late

arthritis, polyneuropathy, encephalopathy

prion disease

neurodegenerative

UMN lesion sx

congenital toxoplasmosis

microcephaly, vision loss, CNS involvement

congenital syphillis

rash + rhinitis(sniffles)

CNS involvement

congenital zika

-microcephaly

-craniofacial dysmorphisms

-neuromotor abnormalities

congenital rubella

-blueberry muffin rash

-sensorineural hearing loss

-PDA

congenital CMV

-sensorineural hearing loss

-CNS involvement

GBS

-generalized sepsis (bacteremia)

-meningitis, pnemonia