Infectious Disease

Question 1

What pathogen commonly causes infective endocarditis in IV drug users?

Answer 1

Staph. Aureus

Question 2

What pathogen commonly causes infective endocarditis on native valves following dental procedures?

Answer 2

Viridans Streptococci

Question 3

What pathogen commonly causes infective endocarditis on prosthetic valves?

Answer 3

Staph. Epidermidis

Question 4

What pathogen commonly causes infective endocarditis and is associated with colon cancer?

Answer 4

Strep. Bovis/Gallolyticus

Question 5

What pathogens commonly cause infective endocarditis following UTIs?

Answer 5

Enterococci

Question 6

If right sided endocarditis is suspected, what may be found?

Answer 6

Septic emboli in the lungs

Question 7

List some findings of infective endocarditis?

Answer 7

• New murmur
• Janeway lesions
• Osler nodes (painful)
• Roth spots (eye hemorrhage)
• Nail splinter hemorrhages

Question 8

Treatment for Infective Endocarditis?

Answer 8

Vancomycin + Gentamicin

Question 9

With infectious mononucleosis, pharyngitis is common. Where is a common LAD spot?

Answer 9

Posterior cervical

Question 10

With infectious mononucleosis, what findings are common in the mouth? (3)

Answer 10

Tonsillar enlargement/exudates
Pharyngitis
Palatal petechiae

Question 11

Why should those with infectious mononucleosis avoid contact sports?

Answer 11

Splenomegaly –> RUPTURE

Question 12

4 lab number findings with infectious mononucleosis?

Answer 12

• Thrombocytopenia
• Atypical lymphocytosis
• Elevated LFTs
• Elevated Alk Phos

Question 13

4 lab number findings with infectious mononucleosis?

Answer 13

• Thrombocytopenia
• Atypical lymphocytosis
• Elevated LFTs
• Elevated Alk Phos

Question 14

If you see someone with pneumonia and diarrhea, what should be high on your differential?

Answer 14

Legionella

Question 15

What are the symptoms of Legionella?

Answer 15

Pneumonia
GI - diarrhea/vomiting
AMS

Question 16

What lab finding is seen with Legionella?

Answer 16

LOW sodium

Question 17

Treatment for Legionella?

Answer 17

Fluoroquinolone

Question 18

If a neutropenic fever occurs, what antibiotics should be chosen empirically?

Answer 18

Cefepime OR
Piperacillin-Tazobactam
==> Pseudomonas coverage

Question 19

If a neutropenic fever persists despite adequate antibiotic treatment, after 72 hours add ____

Answer 19

Antifungal coverage

Question 20

If you suspect a tick-borne illness and it has associated anemia with jaundice, what is the likely cause?

Answer 20

Babesiosis

Question 21

If Babesiosis is suspected, what is the diagnostic and what will be seen?

Answer 21

Blood smear = Maltese crosses

Question 22

Treatment for Babesiosis?

Answer 22

Azithromycin and Atovaquone
= Flu-like + anemia/jaundice

Question 23

What rash is seen with primary lyme disease?

Answer 23

Erythema Migrans (bull’s eye)

Question 24

Fever, myalgias, arthralgias and a targetoid rash is likely?

Answer 24

Lyme disease

Question 25

What can be seen with Secondary Lyme Disease (3)?

Answer 25

- Heart block - Facial nerve palsies - Migratory polyarthropathies

Question 26

What can be seen with Tertiary Lyme Disease (2)?

Answer 26

- Arthritis - Encephalitis

Question 27

Treatment for Lyme disease? CNS involvement? Children under 8?

Answer 27

Doxycycline CNS = Ceftriaxone Kids = Amoxicillin

Question 28

How will Rocky Mountain Spotted fever present?

Answer 28

Rash that begins at the wrists and ankles and spreads centrally

Question 29

Treatment for Rocky Mountain Spotted fever?

Answer 29

Doxycycline for ALL

Question 30

Primary syphilis

Answer 30

PainLESS Chancre (genital ulcer)

Question 31

Secondary Syphilis has many possible symptoms. List 4 unique ones.

Answer 31

- Maculopapular rash involving palms/soles - Epitrochlear LAD - GRAY oral lesions - GRAY genital papules = condyloma lata

Question 32

Secondary Syphilis has many possible symptoms. List 4 unique ones.

Answer 32

- Maculopapular rash involving palms/soles - Epitrochlear LAD - GRAY oral lesions - GRAY genital papules = condyloma lata

Question 33

3 things that can be seen with Tertiary Syphilis?

Answer 33

- Tabes Dorsalis - Gummatous lesions - Aortic aneurysms

Question 34

3 things that can be seen with Tertiary Syphilis?

Answer 34

- Tabes Dorsalis - Gummatous lesions - Aortic aneurysms

Question 35

What is the treatment for Syphilis?

Answer 35

IM Penicillin G Benzathine

Question 36

If your patient with Syphilis has a penicillin allergy, what should be given?

Answer 36

Doxycycline

Question 37

What is the pneumonic to assess if it is safe to perform an LP?

Answer 37

FAILS

Question 38

FAILS

Answer 38

Focal neurologic deficit AMS Immunosuppressed Lesion on skin Seizures

Question 39

If any of FAILS is (+), do NOT?

Answer 39

NO LP - Focal neurologic deficit - AMS - Immunosuppressed - Lesion over skin - Seizures

Question 40

If it is unsafe to do a LP, do what?

Answer 40

CT scan with antibiotics