Infections and infectious diseases, should expect 10 questions on the final

Question 1

Erythematous, maculopapular rash begins on the face and spreads to body and may end in desquamation

A. Rubeola
B. Fifth’s Disease
C. Scarlet fever

Answer 1

Rubeola or measles

Question 2

Rash that is maculopapular and appears after fever and fades in 24 hours

Answer 2

Roseola

Dont forget to ask if if had recent travelling? when taking history
in roseola you dealing with someone with 6-12 montns up to 4 years but 90% before 2

Question 3

A child is brought up to your clinic with symptoms of high fever of 106 lasting 3-5 days, lethargic, irritable
What is your diagnosis and treatment plan?

Answer 3

Roseola
Supportive care and observe for febrile seizures

Question 4

pastia’s lines (petechiae) in neck, axillary folds and groin
strawberry tongue following strep infection
sandpapery rash that blanches on pressure

Answer 4

Scarlet fever

Question 5

Which infectious disease in infants cause high fevers and can result in febrile seizures?

Answer 5

Roseola—- is viral illness caused by human herpes viride virus (HHV)-6

Question 6

Complications from measles(rubeola) are

Answer 6

diarrhea
otitis media
most severe- pneumonia and death

Question 7

Kopliks spots are associate with…..

Answer 7

Measles(rubeola)

Question 8

Rash that starts on the face and moves down….

Answer 8

Measles(rubeola)

Question 9

Maculopapular rash that starts on trunk then moves to face, upper arms and fades within days hint: ( this rash appears after fever )

Answer 9

Roseola

Question 10

Management of the measles(rubeola)

Answer 10

immunize
report fever over 103F/39.4 C
acetaminophen for fever/ discomfort
No aspirin
encourage clear fluid intake
cool mist vaporizer for cough
rest until feeling better

Question 11

What infection causes puffy cheeks and tender swollen jaw? Swelling of salivary glands (Stensen’s duct)

Answer 11

Mumps

Question 12

What are the symptoms that patients with mumps will present?

Answer 12

Signs of aseptic meningitis such as fever, stiff neck, HA

Question 13

How mumps spread?

Answer 13

Direct contact and respiratory route

Question 14

What are serious complications of mumps in adults?

Answer 14

Orchitis and Epididymitis

Question 15

What are the CDC recommendations for MMR vaccine ?

Answer 15

CDC recommends all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Question 16

Which infectious disease is mainly in infants and children and has honey-colored crusts from pustules that rupture?

Answer 16

Impetigo caused by S. aureus (gram positive) and Strep. pyogenes.

Question 17

What is one topical tx for impetigo?

Answer 17

Mupirocin ointment tid x 10 days and to nares for 10-14 days

Question 18

What abx would be your option for impetigo?

Answer 18

Cephalexin (Keflix) 250-500 g qid x 10 days for adults
children 40-50 mg/kg/day x 10 days

Augmentin 20 mg/kg tid x 10 days

Emycin 1-2 gm/day qid x 10 days for pcn allergic pt
40 mg/kg/day qid—–kids

Question 19

Painful mouth ulcers followed by painful white vesicles with surrounding erythema on fingers, palms, toes, soles……..

Answer 19

hand-foot-and- mouth. disease

Question 20

What other conditions would you consider if you see pt with rash on palms and soles

Answer 20

syphilis
meningococcemia
RMSF-rocky mountain spotted fever

Question 21

What other symptoms will you see in hand-foot-and-mouth disease?

Answer 21

low grade fever
sore throat
malaise
submental and cervical lymphadenopathy

Question 22

Herald patch papulo-squamous eruption that is rapidly evolving and viral cause
The patch is faintly reddened patches on trunk and upper extremities
looks like “T-shirt and shorts” presentation
What condition is described above?

Answer 22

Pityriasis rosea——- adolescents most common
——mild to severe pruritis

Question 23

Unilateral rash that is painful and may be preceded by severely painful area with tingling
contagious by direct contact and to a degree by air
What condition described above?

Answer 23

Herpes Zoster (shingles)

Question 24

Treatment options for herpes zoster(shingles)

Answer 24

acyclovir, famcyclovir, valcyclovir
po steroids over 3 weeks
analgesics
topical zovirax cream
domeboro soaks
narcotics

Question 25

What would be given for pts with tinea capitis?

Answer 25

Griseofulvin for 2-4 months, teach pt to take this me with high fat to help the absorption

Question 26

What is most common causative agent of Lyme disease

Answer 26

Borrelia burgdorferi

Question 27

What other symptoms except classic bull's eye rash will you note in patients infected with Lyme disease?

Answer 27

Malaise fatigue HA fever chills stiff neck myalgia and arthralgia lymphadenopathy n, v, abd pain Neuro exam is vital

Question 28

What is the treatment for Lyme disease?

Answer 28

doxycycline/tetracycline 100 mg bid x 14-21 days or emycin or amoxicillin if allergic

Question 29

What is your diagnosis for pt that presenting with retro-orbital pain, severe joint and muscle pain, abd and back pain Saddleback fever lowers on day 3 then rises again 4-5 th day

Answer 29

Dengue fever --------no ASA and NSAIDs ONLY supportive treatment

Question 30

The disease that is similar to dengue fever but in this disease NSAIDs are helpful for arthralgias

Answer 30

CHIKV

Question 31

What is the most common organism responsible for diarrhea in6-24 months old and usually seen in winter?

Answer 31

Rotavirus

Question 32

What medication can cause prolonged QT in persons on SSRIs as well as Achilles tendon rupture?

Answer 32

Cipro

Question 33

What abx would you rx for pt with food poisoning such as vibrio cholerae and staph or bacillus poisoning

Answer 33

Cipro 500 mg daily or azithromycin 500 mg x 3 days Bactrim can be used as well Be careful with cipro of its side effects and interaction

Question 34

What should you not give to stop diarrhea?

Answer 34

Kaopectate

Question 35

What is a complication of lyme disease and in some cases the first and only sign?

Answer 35

arthritis

Question 36

What is the treatment of lyme disease?

Answer 36

Doxycycline/tetracycline 100 mg bid x 14-21 days or emycin or amoxicillin if allergic

Question 37

What is most lethal and most frequently reported rickettsial illness in the U.S?

Answer 37

RMSF- rocky mountain spotted fever

Question 38

What is the diagnostic tests for Lyme disease( bull's eye rash)

Answer 38

ELISA test followed by Western blot for confirmation and detects IgM and IgG antibodies for B. burgdorferi

Question 39

Which medications you do not want to give in dengue fever?

Answer 39

aspirin and NSAIDS

Question 40

Which type of meningitis is contagious and deadly?

Answer 40

Bacterial meningitis

Question 41

What are the organisms responsible for bacterial meningitis?

Answer 41

Strep Neisseria (Meningitis B) H. flu Listeria

Question 42

Signs and symptoms of meningitis

Answer 42

Severe headache different than normal sensitivity to light lethargy skin rash

Question 43

What are the risk factors of meningitis?

Answer 43

Viral- under age 5 Bacterial- under age 20 Pregnancy Weakened immune system

Question 44

What is the sign of meningitis that when you flex neck leads to flexion of knees?

Answer 44

Brudzinski's signs B---brain flexion B---- leads to to bending of knees Pneumonic's: B.B.B brudzinski sign- brain flexion- bending of knee

Question 45

What is another sign of meningitis when knee extension causes back pain?

Answer 45

KErnig sign K---- knee E---- extension,,,,, knee extentsion causes pain thus kernig sign positive

Question 46

What would be supportive management for viral meningitis?

Answer 46

Antipyretics Fluids Rest

Question 47

What are the difference between bacterial and viral meningitis?

Answer 47

The symptoms of viral and bacterial meningitis can be similar, including headache, fever, stiff neck, nausea, and vomiting. However, bacterial meningitis may be associated with more severe symptoms such as confusion, seizures, and a rash.

Question 48

When will you stat send pt with shingles (herpes zoster virus) to ER>

Answer 48

Medical emergency---- if pt presents with vesicles in the face and eyes----- pt may have stroke

Question 49

Maculopapular rash usually affecting one side of the body or face, pain can last weeks to months after blisters healed..... what condition described here?

Answer 49

Herpes zoster virus(shingles)

Question 50

We know that early treatment imperative ASAP after onset of symptoms-within 72 days for shingles management What antivirals would you rx and what dosages?

Answer 50

Acyclovir. 800 mg po q 4 h (five times daily) for 7-10 days Valcyclovir 1 G po three times per day for 7 days Famcyclovir 500mg PO three times per day for 7 days

Question 51

What would you recommend for shingles pt for home management hint: non-pharmacological?

Answer 51

1. Apply cold compresses to rash 2. Apply calamine lotion on rashes to help dry and reduce itching 3. Rest and try to decrease stress

Question 52

Rubeola (Measles) is characterized by....

Answer 52

fever malaise cough coryza......acute inflammation of nasal passages conjunctivitis

Question 53

What is the most common cause of measles associated death in children Diarrhea Encephalitis Pneumina

Answer 53

Though all these are complications of measles, of course pneumonia is the main cause death,,,, airway comes first

Question 54

Diagnostic tests for measles are

Answer 54

serum measles IgM antibody significant rise in measles IgG antibody between acute and convalescent titers isolation of measles virus culture detection of mealses virus RNA by RT-PCR

Question 55

What are some differential dx for pt coming with pertussis symptoms whooping cough

Answer 55

mycoplasma pneumoniae chlamydia TB Viral pathogens

Question 56

Common causes of cough

Answer 56

Cigarette smoking GERD Asthma Postnasal drip ACE inhibitors most causes of cough self limiting and from viral upper respiratory infection

Question 57

When can children with pertussis infection return to school or day care ?

Answer 57

They can return when they have completed 5 days of effective antimicrobial treatment or if they are not treated 21 days after the onset of symptoms

Question 58

Can adults especially elderly get RSV ( respiratory synctial virus)

Answer 58

Yes, remember that patients over 65 y.o can get RSV.

Question 59

What population is at risk for RSV? Select all that apply A. Older adults patients with chronic pulmonary disease and functional disability B. Residence at altitude > 2500 m C. Institutionalized older adults

Answer 59

All of these are right answers

Question 60

In what infectious disease of skin erythematous maculopapular rash that begins on face and spreads to body and may end in desquamation?

Answer 60

Rubeola-measles

Question 61

What condition describes Koplik spots, highly communicable viral disease, low grade mod fever 104-105, hacking cough, corzya, conjunctivitis

Answer 61

Rubeola-measles

Question 62

This condition follows pharyngitis, strawberry tongue is a classic finding, fine erythematous rash that blanches on pressure, sandpapery better felt than seen

Answer 62

Scarlet fever

Question 63

This condition has sudden abrupt high fever of 106 lasting 3-5 days and rash that is maculopapular appears after fever and fades in 24 h

Answer 63

Roseola