Infectious Disease

Question 1

Management for Necrotizing fasciitis?

Answer 1

Immediate surgical consultation

Question 2

CDC recommendation on positive H1N1 in long term care facility

Answer 2

If two or more are positive: considered as Outbreak!!!

Do Chemoprophylaxis on all residents!

Question 3

Diabetic foot ulcers.

Cover for what and what initial meds to start

Answer 3

Cover for Pseudomonas and MRSA!

Give Zosyn and Vancomycin!

Question 4

Patient with aspleenia?

Answer 4

Give antibiotics for any episode of fever!

Question 5

Wrestler, acutely ill, with Cellulitis, admitted in the hospital
Initial med and why?

Answer 5

Give Vanco for MRSA

Question 6

Acute Pyelonephritis
Meds?
Bacteria?

Answer 6

Ciprofloxacin
E. Coli

Bactrim and Nitrofurontoin are NOT effective for Pyelo

Question 7

Miliary pattern of BB size calcification

DX?

Answer 7

Histoplasmosis

No treatment

Question 8

Pertussis

TX?

Answer 8

Azithromycin - tx and prophylaxis
In order to prevent transmission:
Tx should be within 6 wks of onset of cough for <12 months
Tx should be within 3 wks for everone else

Question 9

Day care worker with diarrhea

Cause?

Answer 9

Giargia: TX with Metro!

Question 10

Patient with fever and Muffling of the voice and tonsil are swelling?
DX?
MGT?

Answer 10

Peritonsillar abscess
Do Needle drainage
If not, do tonsillectomy

Question 11

26 y/o Male in a MONOGAMOUS sexual relationship with another male
What to do in the visit?

Answer 11

1. Hepatitis Surface AG testing

* PreP HIV prophylaxis not needed if monogamous

Question 12

27 y/o Male with 1wk fatigue, dyspnea, chest pain and fever.
(+) Meth user
(+) systolic murmur on PE
CXR: multiple Emboli

DX?
What Medication?

Answer 12

1. Infectious Endocarditis
2. Give Vanco to cover Gram positive cocci!
3. If with prosthetic valves, give Vanco + Rifampin

Question 13

50 y/o with 4 day rash on lower trunk to extremities. Has bilateral testicular swelling as well.

DX?

Answer 13

1. Henoch-Schonlein purpura – 35% associated with orchitis!

Question 14

27 y/o male with elevated temp.
Hx of splenectomy
Recommendations?

Answer 14

Give IV antibiotics to prevent sepsis!
IV or IM ceftriaxone preferred
If 2 hrs away from hospital, give oral

Question 15

55 y/o female coughing until emesis
Work in day care
DX?
Test

Answer 15

Pertussis!
Tx: Azithro or Clarithro
PCR

Question 16

30 y/o with abscess
No erythema 
No fever
I&D done
Antibiotics?
If with non purulent then cellulitis? Tx 
If purulent? Tx

Answer 16

No, observe only. No cellulitis
Cephalexin or Augmentin if non purulent
Bactrim or Clindamycin to cover MRSA

Question 17

Coalescing macules in the inguinal fold
Wood lamp reveals reddish fluorescence
DX?
TX?

Answer 17

Erythrasma - intertriginous rash
Cause by Corynebacterium
Tx: oral Erythromycin