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EM Licensing Exam > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What is a centripetal rash and in what condition is it seen?

A
  • From ankles/wrists to trunk

- Rocky Mountain Spotted Fever

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2
Q

Toxic shock syndrome treatment

A

Clindamycin (treats causative organism AND decreases synthesis of exotoxin)

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3
Q

Erythema infectiosum cause & presentation

A

(Fifth disease)

Human parvovirus B19

Prodrome of low-grade fever, malaise & HA followed by slapped cheek rash that later spreads to extremities & trunk (lacy appearance)

Can precipitate aplastic anemia in sickle cell disease

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4
Q

Roseola infantum cause & presentation

A

Most commonly caused by herpesvirus 6

High fever that resolves and is followed by blanching maculopapular rash on trunk/neck —> extremities

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5
Q

Scarlet fever cause & presentation

A

Strep pyogenes (GAS) exotoxin

Sandpaper rash, circumoral pallor, strawberry tongue & Pastia’s lines (axilla)

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6
Q

Tularemia cause, presentation & treatment

A
  • Francisella tularensis (pleomorphic gram-negative coccobacillus); vector-borne (ticks & flies)
  • Flu-like symptoms; ulceroglandular (papule at inoculation site that then ulcerates); if aerosolized, may affect eyes, oropharynx and lungs
  • Streptomycin or gentamicin
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7
Q

Neisseria meningitidis prophylaxis

A

Rifampin

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8
Q

Jones Criteria for Rheumatic Fever

A

Evidence of strep infection + (2 major OR 1 major + 2 minor OR 3 minor)

Major: arthritis, carditis, subQ nodules, erythema marginarum & Sydenham chorea

Minor: fever, arthralgia, elevated ESR/CRP & prolonged PR interval on EKG

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9
Q

CD4 count for PCP

A

< 200

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10
Q

Disseminated gonococcal infection presentation

A
  • Fever/chills
  • Rash
  • Painless pustules (necrotic or purulent center with erythematous base)
  • Tenosynovitis
  • Septic arthritis
  • Polyarthralgias
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11
Q

CSF study for cryptococcal meningitis?

A

India ink stain

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12
Q

Rocky Mountain Spotted Fever organism?

A

Rickettsia rickettsii (gram-negative obligate intracellular bacterium)

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13
Q

Rocky Mountain Spotted Fever epidemiology?

A

Children ages 5-9; most common in Carolinas, Oklahoma & Virginia

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14
Q

Rocky mountain spotted fever presentation

A

5-7 days after tick bite, develop fever, HA (severe), photophobia, myalgias, nausea & maculopapular rash (starts on wrists, palms, soles & ankles before spreading centripetally to upper extremities & trunk; face spared)

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15
Q

Babesiosis

A

Malaria-like illness transmitted by Ixodes tick characterized by spiking fevers, HA & anorexia (NO rash)

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16
Q

CMV retinitis CD4 count

A

<50

17
Q

Measles (rubeola) presentation, management & complications

A
  • pres: high fever, 3 C’s (cough, coryza & conjunctivitis), Koplik spots (red spots with blue/white center on buccal mucosa), discrete red maculopapular rash starting on forehead spreading down to trunk
  • mgmt: human immune serum globulin (ISG) if given within 6 days of exposure
  • comp: acute disseminated encephalomyelitis (ADEM), subacute sclerosing panencephalitis (SSPE), PNA (most common cause of death), diarrhea
18
Q

Ehrlichiosis & anaplasmosis epidemiology, pathophysiology, presentation, labs, management & complications

A
  • epi: South Central & South Atlantic US, June-August
  • path: gram-negative, obligate intracellular coccobacilli residing within circulating leukocytes
  • pres: 9 days after tick bite, abrupt onset of fever, HA, myalgias & rigors
  • labs: leukopenia (w/ bands), thrombocytopenia, elevated AST/ALT, LDH & AP
  • mgmt: doxycyline (rifampin if severe tetracycline allergy)
  • comp: optic neuritis, ARDS, meningitis, pericarditis, renal failure & DIC
19
Q

Sporotrichosis etiology, risk factors, presentation & management

A
  • eti: sporothrix schenckii (dimorphic fungus)
  • RF’s: landscaping & gardening
  • pres: suppurative subcutaneous nodules progressing proximally along lymph channels
  • mgmt: itraconazole (AmphB if severe/disseminated)
20
Q

Psittacosis etiology, risk factors, presentation & management

A
  • eti: Chlamydia psittaci (obligate intracellular gram-negative organism)
  • RF’s: bird owners, vets, pet-shop employees
  • pres: high fevers, HA, myalgias, nonproductive cough, hepatosplenomegaly
  • mgmt: doxycycline (erythromycin in children & pregnant women)
21
Q

Malaria fever pattern

A
  • early: paroxysms occurring at irregular intervals each day

- late (s/p rupture of infected RBC’s): vivax, ovale & falciparum every other day; malariae every 3rd day

22
Q

Malaria treatment

A
  • uncomplicated, chloroquine-sensitive areas (Central America & Caribbean): chloroquine/hydroxychloroquine
  • uncomplicated, chloroquine-resistant areas (South America, South Asia & Africa): atovaquone-proguanil
  • complicated: artesunate (IV)

EM Licensing Exam (19 decks)

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