Infectious Disease

Question 1

4 s/sxs of streptococcal pharyngitis

Answer 1

Fever, pharyngeal erythema, tonsillar exudate, lack of cough

Question 2

Non-suppurative complication of streptococcal infxn that is not altered by tx of 1˚ infxn

Answer 2

Postinfectious glomerulonephritis

Question 3

Asplenic pts are particularly susceptible to these organisms

Answer 3

Encapsulated organisms: pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella

Question 4

of bacteria on a clean-catch specimen to dx a UTI

Answer 4

10^5 bacteria/mL

Question 5

Which healthy population is susceptible to UTIs?

Answer 5

Pregnant F. Tx this group aggressively bc of potential complications.

Question 6

Pt rom California or Arizona presents with fever, malaise, cough, and night sweats. Dx? Tx?

Answer 6

• Dx: coccidiomycosis

- Tx: amphotericin B

Question 7

Nonpainful chancre

Answer 7

1˚ syphilis

Question 8

“Blueberry muffin” rash is characteristic of what congenital infxn?

Answer 8

Rubella

Question 9

Meningitis in neonates: Causes? Tx?

Answer 9

• Causes: GBS, E. coli, Listeria

- Tx: gent and amp

Question 10

Meningitis in infants: Causes? Tx?

Answer 10

• Causes: Pneumococcus, meningococcus, H. flu

- Tx: cefotaxime and vanco

Question 11

What should always be done prior to LP?

Answer 11

Check for increased ICP; look for papilledema

Question 12

CSF findings: (L) glucose, PMN predominance

Answer 12

Bacterial meningitis

Question 13

CSF findings: nl glucose, lymphocytic predominance

Answer 13

Aseptic (viral) meningitis

Question 14

CSF findings: numerous RBCs in serial CSF samples

Answer 14

Subarachnoid hemorrhage (SAH)

Question 15

CSF finding: increased gamma globulins

Answer 15

MS

Question 16

Initially presents with a pruritic papule with regional LAD; evolves into a black eschar after 7-10 days. Tx?

Answer 16

Cutaneous anthrax. Tx with pen G or cipro.

Question 17

Findings in 3˚ syphilis

Answer 17

Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, ao root aneurysm

Question 18

Characteristics of 2˚ Lyme dz

Answer 18

Arthralgias, migratory polyarthropathies, Bell’s palsy, myocarditis

Question 19

Cold agglutinins

Answer 19

Mycoplasma

Question 20

24 yo M presents with soft white plaques on his tongue and back of his throat. Dx? W/u? Tx?

Answer 20

• Dx: candidal thrush
• W/u: include HIV test
• Tx: nystatin oral suspension

Question 21

Begin PJP prophy in HIV+ pt at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophy?

Answer 21

• PJP: ≤200 (with TMP-SMX)

- MAI: ≤50-100 (with clarithromycin/azithromycin)

Question 22

RFs for pyelonephritis

Answer 22

Pregnancy, vesicoureteral reflux (VUR), anatomic anomalies, indwelling catheters, kidney stones

Question 23

Neutropenic nadir post chemo

Answer 23

7-10 days

Question 24

Erythema migrans

Answer 24

Lesion of 1˚ Lyme dz

Question 25

Classic physical findings for endocarditis

Answer 25

Fever, heart murmur, Osler's nodes, splinter hemorrhages, Janeway lesions, Roth's spots

Question 26

Aplastic crisis in sickle cell dz

Answer 26

Parvovirus B19

Question 27

Ring-enhancing brain lesion on CT with szs

Answer 27

Taenia solium (cysticercosis)

Question 28

Organism: branching rods in oral infxn

Answer 28

Actinomyces israelii

Question 29

Organism: painful chancroid

Answer 29

Haemophilus ducreyi

Question 30

Organism: dog or cat bite

Answer 30

Pateurella multocida

Question 31

Organism: gardener

Answer 31

Sporothrix schenckii

Question 32

Organism: pregnant F with pets

Answer 32

Toxoplasma gondii

Question 33

Organism: meningitis in adults

Answer 33

Neisseria meningitidis

Question 34

Organism: meningitis in elderly

Answer 34

Strep pneumo

Question 35

Organism: alcoholic with PNA

Answer 35

Klebsiella

Question 36

Organism: "currant jelly" sputum

Answer 36

Klebsiella

Question 37

Organism: infxn in burn victims

Answer 37

Pseudomonas

Question 38

Organism: osteomyelitis from foot wound puncture

Answer 38

Pseudomonas

Question 39

Organism: osteomyelitis in a sickle cell pt

Answer 39

Salmonella

Question 40

55 yo M who is a smoker and heavy drinker presents with a new cough and flu-like sxs. Gram stain: no organisms. Silver stain of sputum: GNRs. Dx?

Answer 40

Legionella PNA

Question 41

Middle-aged M presents with acute-onset monoarticular jt pain and b/l Bell's palsy. Likely dx? How did he get it? Tx?

Answer 41

- Dx: Lyme dz - Ixodes tick - Tx: doxycycline

Question 42

Pt develops endocarditis 3 weeks after receiving a prosthetic heart valve. What organism is suspected?

Answer 42

S. aureus or S. epidermidis

Question 43

3 MCC of fever of unknown origin (FUO)

Answer 43

Infxn, CA, autoI dz