1 Flashcards
A pt presented with a slow growing, non tender jaw mass after a dental procedure. There is a purulent fluid with yellowish granules draining from the mass
Dx?
Rx?
Actinomyces (sulfur granules…)
Penicillin is the preferred therapy
Splenectomy
Vaccinations against encapsulated organisms is given; when is that?
14 days before or 14days after splenectomy
Because the functional activity of the antibodies is lower within 14 days…
Asymptomatic bacteriuria definition
1st line abx (3)
> =100,000 CFU/ml of a single bacterial type from a clean catch urine in the absence of UTI
Cephalexine, amoxicillin-clavulinate, nitrofurantoin
A pt went on a trip to north eastern US and developed fever chills, rigor after getting back. Lab results show anemia with signs of intravascular hemolysis and thrombocytopenia
The most likely dx?
It’s transmitted by?
Dx is made by?
Babesiosis( tick born protozoan illness)
Ixodes scapularis ( dame tick transmitting borrelia)
Dx is made by identifying the organisms on peripheral blood smear (Maltese cross)
The most common cause of community acquired bacterial meningitis is? ( overall)
Streptococcus pneumonia’s
The most common cause of bacterial meningitis in children and young adults is?
Meningococcus
The 2 most common causes of bacterial meningitis in children above the age of 1month?
Abx of choice?
Role of dexamethasone?
Pneumococcus n meningococcus
Ceftriaxone/cefotaxime + vanco
Dexa can reduce the risk of sensory neural hearing loss especially if Hib is the causative agent
A man developed AFI with confusion, mental status changes, clonus after a trip to Arkansas. He has leukopenia n thrombocytopenia n elevated AST ALT LDH. What should b the next step in the mx of this pt?
Definitive dx is made by?
Doxycycline! Since dx can b made clinically., epidemiology- southeastern n south central US
Definitive dx- visualization of intracytoplasmic morulae in WBCs or thru PCR
Bright red, firm, friable, exophytic nodules in an HIV infected pt r most likely?
The cause is?
Abx of choice(2)
Bacillary angiomatosis
Bartonella, gram negative bacillus
Erythromycin or doxycycline
A patient presented with fever chills, anterior cervical lap, a warm, tender, erythematous rash with sharply demarcated borders on her face involving the external ear
Dx? Most common cause?
Difference from the ddx on top
Erysipelas
Group A strept
Involves upper dermis n superficial lymphatic system(external ear involvement is particularly suggestive since external ear lacks lower dermis level), sharp borders.
Cellulitis is a deeper infection, no sharp demarcation
Chikungunia fever clinical features, lab
Epidemiology
Transmission
Fever, malaise, LAP, polyarthralgia(almost always present), rash; lymphopenia, thrombocytopenia Ades mosquitoes ( like dengue fever) Endemic in west Africa; recent outbreaks in America n Caribbean islands
3 common causes of neonatal conjunctivitis
Which one is the most destructive one if left untreated? Age of onset for each?
Rx for each?
Prevention?
Chemical; <24hr; eye lubricant
Gonococcal; 2-5days, iv/Im ceftriaxone or cefotaxime
Chlamidial; 5-14; oral erythromycin
Gonococcal is the worst n can lead to permanent blindness.
Erythromycin ointment at birth can prevent gonococcal but not chlamydial conj.
Universal maternal prenatal testing n Rx for chlamydia
Neonatal Chlamydial conjunctivitis very characteristic finding is
Blood stained eye discharge
Mycoplasma pneumoniae
CXR typically reveals?
Interstitial infiltrates; serous pleural effusion may b present in ~25% of pts
The most common complication of influenza is secondary bacterial infection especially in >65yr (organisms being strept pneumo n staph aureus )
- Rare in those <65 but an exception occurs with ———, an organism that preferentially attacks young ppl with influenza.
- manifestations include?
- empiric therapy
Community associated methicillin resistant staph aureus CA-MRSA
C/f- rapidly progressive, high fever, productive cough with hemoptysis, leukopenia, multilobar cavitary infiltrate.
Vancomycin or linezolid
