Temperature from which area more accurately reflect core body temperature?
Rectal temperature (0.4 C higher than oral and 0.8 C higher than axillary)
The most common definition of fever uses a core temperature of
38.3 C and above
Palpable lymph nodes in this area are always pathologic
Epitrochlear nodes
Which inflammatory markers can be used as a) direct and b) indirect measures of acute phase response
A) C reactive protein (CRP)
B) Erythrocyte sedimentation rate (ESR)
What are the infectious causes of relative bradycardia?
A: “Some Funny Bugs Can Look Like My Relatives, Carrying Parasites, Viruses.”
• S → Salmonella typhi
• F → Francisella tularensis
• B → Brucella spp.
• C → Coxiella burnetii (Q fever)
• L → Leptospira interrogans
• L → Legionella pneumophila
• M → Mycoplasma pneumoniae
• R → Rickettsia spp.
• C → Corynebacterium diphtheriae
• P → Plasmodium spp. (malaria)
• V → Viruses (Yellow fever, Dengue, hemorrhagic fevers, myocarditis)
What is the normal CSF profile?
WBC <5/µL (mostly lymphocytes)
• Gram stain: Negative
• Glucose: 40–85 mg/dL
• Protein: 15–45 mg/dL
• Opening pressure: 50–180 mmH₂O
CSF profile in bacterial meningitis?
• WBC: >1000/µL
• Cells: ↑ PMNs (≥80%)
• Gram stain: Positive (>60% cases)
• Glucose: <40 mg/dL
• Protein: >100 mg/dL
• Opening pressure: >300 mmH₂O
• Common causes: Streptococcus pneumoniae, Neisseria meningitidis
CSF profile in viral meningitis?
• WBC: 25–500/µL
• Cells: Predominantly lymphocytes
• Gram stain: Negative
• Glucose: Normal
• Protein: 20–80 mg/dL
• Opening pressure: 100–350 mmH₂O
• Common causes: Enteroviruses
CSF profile in fungal meningitis
• WBC: 40–600/µL
• Cells: Lymphocytes or PMNs (depending on organism)
• Gram stain: Rarely positive
• Glucose: ↓ to normal
• Protein: 150–300 mg/dL
• Opening pressure: 160–340 mmH₂O
• Common causes: Candida, Cryptococcus, Aspergillus
CSF profiles summary
• Bacterial = PMNs + ↓ glucose + ↑↑ protein + very high pressure
• Viral = Lymphocytes + normal glucose + mild protein ↑
• Fungal/TB = Lymphocytes + ↓/low glucose + ↑ protein + high pressure
• Parasitic = Eosinophils + normal glucose + ↑ protein + normal pressure
• Encephalitis = Lymphocytes + normal glucose + mild ↑ protein + pressure normal/↑
What is a condition that increases the risk of a serious adverse reaction to vaccination?
Contraindication
What is a condition that may increase the risk of an adverse event or that may compromise the ability of the vaccine to evoke immunity.
Precaution
Which vaccines are contraindicated for patients with severe allergic reaction to Latex?
Td, Tdap, Hepatitis A and B, menB
Which vaccines are contraindicated for patients with severe allergic reaction to yeast?
HPV, Hepatitis B
Which vaccines are contraindicated for patients with severe allergic reaction to gelatin or neomycin?
MMR, Varicella, Zoster
