Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MTB > Infectious Disease p23-34 > Flashcards

Infectious Disease p23-34 Flashcards

1
Q

Which gives urethral discharge? Urethritis or Cystitis ?

A

Urethritis - Dysuria with urinary frequency and burning + urethral discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Best initial test for urethritis ?

A

Urethral swab for gram stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most accurate test for urethritis ? Best screening test ?

A

Urethral culture, DNA probe, NAAT for N gonorrhea and chlamydia. Best screening test is NAAT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What organisms cause Urethritis?

A

N Gonorrhea, C Trachomatis, Mycoplasma genitalium, Ureaplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tx for Urethritis ?

A

Cephalosporin (Gonorrhea) and Azithromycin or Doxycycline (Chlamydia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Patient presents to clinic with cervical discharge. Upon examination, there is an inflamed strawberry cervix. How do you diagnose? What is your dx and tx?

A

Diagnose with self administered swab for NAA. this is CERVICITIS. Tx - Ceftriaxone + Azithromycin as a single dose. Doxycycline = efficacy to azithromycin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patient presents with fever, lower abdominal tenderness and pain. Blood labs show high neutrophil count. Cervical motion tenderness upon pelvic exam. Dx?
How to diagnose? Management ?

A

PID. Exclude pregnancy. Diagnostic test: Cervical swab for culture, DNA probe, NAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most accurate test for PID is ?

A

Laparoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment of PID ? Inpatient? Outpatient?

A

Inpatient: Cefoxitin or Cefotetan with Doxycycline
Outpatient: Ceftriaxone and doxycycline (possibly with metronidazole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Painless Ulcer

A

Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Painful ulcer

A

Chancroid (Hemophilis Ducreyi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lymph nodes tender and suppurating

A

Lymphogranuloma venereum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vesicles prior to ulcer and painful

A

Herpes simplex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What tests to diagnose Syphilis ? Treatment?

A

Dark-field microscopy. VDRL or RPR (75% syphilis). FTA or MHA - TP (confirmatory)

Treatment - Single dose of IM benzathine penicillin, doxycycline if allergic to penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What tests to diagnose chancroid? Treatment?

A

Stain and culture on specialized media (chocolate agar)

Treatment- Azithromycin (single dose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What tests to diagnose Lymphangogranuloma Venereum? Treatment?

A

Complement fixation titers in blood. Nucleic acid amplification testing on swab.

Treatment - Doxycycline

17
Q

What tests to diagnose Herpes Simplex? Treatment?

A

Initial test: Tzanck prep
Accurate test: Viral culture

Treatment - Acyclovir, valacylcovir, famciclovir, foscarnet for acyclovir resistant herpes.

18
Q

Most sensitive test of CSF for neurosyphilis?

A

FTA is nearly 100% sensitive in CSF. VDRL/RPR is only positive in 50% of patients

19
Q

What is the treatment for primary and secondary syphilis?

A

Single IM injection of penicillin. Oral doxycycline if allergic to penicillin

20
Q

What is the treatment for tertiary syphilis ?

A

IV penicillin, desensitize to penicillin if penicillin allergic

21
Q

A 45-year-old man with no significant past medical history was recently diagnosed with condylomata lata at a nearby clinic. He was given a single intramuscular injection of benzanthine penicillin 2.4 million units. One hour after the injection, the patient began to feel ill while in the waiting room. He tells the doctor that he has a headache and feels flushed. He has no allergies. He feels cold and is short of breath. His blood pressure is 90/60 mm Hg, with a heart rate of 120/min, a
respiratory rate of 26/min, and a temperature of 102.6 F. He has a flushed appearance. His RPR was positive at 1:128. What is the best management for this patient?

(A) Aspirin
(B) Steroids
(C) Diphenhydramine, steroids, and oxygen
(D) Intensive care unit monitoring for 24 hours
(E) Switch the penicillin to doxycycline

A

The Jarisch-Herxheimer reaction is a systemic reaction that occurs within
24 hours after the initial treatment of syphilis with effective antibiotics,
especially penicillin. It consists of the abrupt onset of fever, chills,
myalgias, headache, tachycardia, hyperventilation, vasodilation with
flushing, and mild hypotension. It is common in syphilis after treatment has
been started and may occur in as many as 90% of patients. It can last from
12 to 24 hours and has been correlated to the release of a heat-stable
pyrogen from the spirochetes. The reaction is self-limited and can be
treated with aspirin.

22
Q

A 43-year-old man presents to his primary care physician in a panic stating that his wife is going to kill him! The doctor calms him down and learns that during a recent trip to Las Vegas he had sexual relations with a prostitute. He know has raised groupings of lesions that resemble a cauliflower on the shaft of his penis. He asks if there is anything you can do. What is this? How will you treat it?

A

Condyloma Acuminata (genital warts)

Tx: Remove via physical means - Cryotherapy with liquid nitrogen, surgery for larger ones, laser or melting them away with (TCA or podophyllin). Imiquimod can be applied locally (actinic keratosis and basal cell cancer).

23
Q

Tx for Pediculosis (crabs) ?

A

Permethrin. Lindane is equally effective but more toxic

24
Q

A 23-year-old college student comes to see you with complaints of itching all over her body for the past 10 days. She hardly gets to sleep at night, because of it. On further questioning, she agrees that her roommate is also suffering from similar complaints. On examination, you notice vesicles and pustules in short, gray wavy channels on the finger webs, heels of palms and in wrist creases. Papules are also seen over nipples and areola of breasts. Her vitals are stable and she is afebrile. What is your diagnosis?

A. Insect bites
B. Urticaria
C. Scabies
D. Body lice
E. Bed bugs
A

C. Scabies – Tx is Permethrin

Scabies - found in web spaces between fingers and toes or at elbows or genitalia. Found around the nipples or near the genitals. BURROWS visible. Scrape and magnify.

25
Q

How will a UTI present?

A

Dysuria (freq, urgency, burning) and fever. Urinalysis - increased WBC

26
Q

Most common organism for UTI

A

Ecoli

27
Q

30 y.o female presents with increased frequency, urgency and burning upon urination. She has suprapubic pain with no fever. Urinalysis shows 50 WBC. Dx? Tx?

A

Cystitis.

Tx: Nitrofurantoin ( 3 days for uncomplicated cystitis, 7 days for anatomic abnormality) or fosfomycin, TMP SMX, Ciprofloxacin (reserved from routine use to avoid resistance), Cefixime

28
Q

30 y.o female presents with increased frequency, urgency and burning upon urination. She has a fever 102 F. CVA tenderness is elicited. Urinalysis shows increased WBC. Dx? Tx?

A

Pyelonephritis

Tx: Ceftriaxone or ertapenem, Ampicillin and gentamicin until culture results are known, Ciprofloxacin (oral for outpatient)

29
Q

A 46-year-old white male presents to your office with fever and chills, for the past 2 days. His fever was gradual in onset and is associated with back pain, which is worse towards the sacral area. He is also having repeated urges to urinate, along with pain on micturition. His rectal examination reveals a boggy exquisitely tender prostate.

Labs
Hb 13, Hct 50, WBC 12000, Plt 329000

Dipstick urinalysis
Esterase +++, pH 5.9, Nitrite +++, Ascorbic acid -. Protein +, Blood ++

What is most appropriate next step in management?

A. Send culture of post-prostatic massage sample
B. Send culture of mid stream urine sample
C. Administer alpha blocking agents
D. Start empirical treatment on an outpatient basis
E. Urethal catheterization

A

B. Acute bacterial prostatitis. Tx : same as for Pyelonephritis. Chronic prostatitis Tx - Ciprofloxacin or TMP-SMX for 6-8 weeks

30
Q

A patient was treated for pyelonephritis with ceftriaxone. Despite therapy for 1 week, his fever continues to persist. What do you do?

A

Perinephric abscess. Imaging study (sonogram or CT scan), Drainage of the fluid collection. Culture of fluid.

MTB (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions