Infectious Disease

Question 1

What are the three most common causes of fever of unknown origin (FUO)?

Answer 1

Infection, cancer, and autoimmune disease.

Question 2

What are four signs and symptoms of streptococcal pharyngitis?

Answer 2

Fever, tender anterior cervical lymphadenopathy, tonsillar exudate, lack of cough.

Question 3

What is a nonsuppurative predisposing factor for acute sinusitis?

Answer 3

Post infectious glomerulonephritis.

Question 4

What is the most common predisposing factor for acute sinusitis?

Answer 4

Viral UTI.

Question 5

Asplenic patients are particularly susceptible to these organisms.

Answer 5

Encapsulated organisms - pneumococcus, mengingococccus, haemophilius influenzae, Klebsiella.

Question 6

The number of bacteria needed on a clean-catch specimen to diagnose a UTI.

Answer 6

10^5 bacterial/mL.

Question 7

Which healthy population is susceptible to UTIs?

Answer 7

Pregnant women. Treat this group aggressively because of high risk of complications.

Question 8

A patient from California or Arizona presents with fever, malaise, cough, and night sweats. What is the diagnosis?

Answer 8

Coccidioidomycosis

Question 9

What is the treatment for coccidioidomycosis?

Answer 9

Amphotericin B

Question 10

What causes a non painful chancre?

Answer 10

Primary syphilis.

Question 11

A “blueberry muffin” rash is a characteristic of what congenital infection?

Answer 11

Rubella.

Question 12

What are the causes of meningitis in neonates?

Answer 12

Group B strep (GBS), E coli, Listeria.

Question 13

What is the treatment of meningitis in neonates?

Answer 13

Gentamicin and ampicillin.

Question 14

What are the causes of meningitis in infants?

Answer 14

Pneumococcus, meningococcus, H influenzae.

Question 15

What is the treatment of meningitis in infants?

Answer 15

Cefotaxime and vancomycin.

Question 16

What should always be done prior to LP?

Answer 16

Check for increased ICP; look for pailledema?

Question 17

CSF findings: low glucose, PMN predominance

Answer 17

Bacterial meningitis

Question 18

CSF findings: normal glucose, lymphocytic predominance

Answer 18

Aseptic (viral) meningitis

Question 19

CSF findings: numerous RBCs in serial CSF samples

Answer 19

Subarachnoid hemorrhage (SAH)

Question 20

CSF findings: increased gamma globulins

Answer 20

MS

Question 21

What initially presents with a pruritic papule with regional lymphadenopathy; evolves into a black eschar after 7-10 days.

Answer 21

Cutaneous anthrax

Question 22

What is the treatment for cutaneous anthrax?

Answer 22

Penicillin G or ciprofloxacin

Question 23

What are the findings in primary syphilis?

Answer 23

Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms.

Question 24

What are the characteristics of secondary Lyme disease?

Answer 24

Arthralgias, migratory polyarthropathies, Bell palsy, myocarditis.

Question 25

Cold agglutinins

Answer 25

Mycoplasma

Question 26

A 24-year-old man presents with soft white plaques on his tongue and the back of his throat.

Answer 26

Candidal thrush

Question 27

What is the workup and treatment for candidate thrush?

Answer 27

HIV test; Treat with nystatin oral suspension

Question 28

At what CD4 count should Pneumocystis jiroveci pneumonia prophylaxis be initiated in an HIV+ patient?

Answer 28

<200 (txt with TMP-SMX)

Question 29

At what CD4 count should mycobacterium avium-complex (MAC) prophylaxis be initiated in an HIV+ patient

Answer 29

< 50-100 (with clarithromycin/ azithromycin)

Question 30

What are the risk factors for pyelonephritis?

Answer 30

Pregnancy, vesicoureteral reflex, anatomic anomalies, indwelling catheters, kidney stones

Question 31

How long is the neutropenic nadir post chemotherapy?

Answer 31

7-10 days

Question 32

What is erythema migrans?

Answer 32

Lesion of primary Lyme disease.

Question 33

What are the classical findings for endocarditis?

Answer 33

Fever, heart murmur, Osler nodes, splinter hemorrahes, Laneway lesions, Roth spots.

Question 34

What causes aplastic crisis in sickle cell disease?

Answer 34

Parvovirus B19.

Question 35

What organism causes branching rods in oral infection?

Answer 35

Actinomyces israelii

Question 36

What organism causes weakly gram +, partially acid-fast in lung infection?

Answer 36

Nocardia asteroids

Question 37

What organism causes painful chancroid?

Answer 37

Haemophilus ducreyi

Question 38

What organisms cause infection in dog or cat bites?

Answer 38

Pasteurella multocida

Question 39

What organism causes infection in gardeners?

Answer 39

Sporothrix schenckii

Question 40

What organisms are associated with raw pork and skeletal muscle cysts?

Answer 40

Trichinella spiralis

Question 41

What organisms are associated with sheepherders with liver cysts?

Answer 41

Echinococcus granulosus

Question 42

What organism causes perianal itching?

Answer 42

Enterobius vermicularis

Question 43

What organism is associated with pregnant women with pets?

Answer 43

Toxoplasma gondii

Question 44

What organism causes meningitis in adults?

Answer 44

Neisseria meningitidis

Question 45

What organism causes meningitis in elderly?

Answer 45

Streptococcus pneumoniae

Question 46

What organism causes meningoencephalitis in AIDS patients?

Answer 46

Cryptococcus neoformans

Question 47

What organism is associated with alcoholics with pneumonia?

Answer 47

Klebsiella

Question 48

What organism is associated with "current jelly" sputum?

Answer 48

Klebsiella

Question 49

What organism causes malignant otitis externa?

Answer 49

Pseudomonas

Question 50

What organism causes infection in burn victims?

Answer 50

Pseudomonas

Question 51

What organism is associated with osteomyelitis from a foot wound puncture?

Answer 51

Pseudomonas

Question 52

What organism is associated with osteomyelitis in a sickle cell patient?

Answer 52

Salmonella

Question 53

A 55 year old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain shows gram neg- rods. What is the diagnosis?

Answer 53

Legionella pneumonia

Question 54

A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell palsy. What is the likely diagnosis, and how did he get it?

Answer 54

Lyme disease, Ixodes tick

Question 55

What is the treatment for Lyme disease?

Answer 55

Doxycycline

Question 56

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

Answer 56

S aureus or Staphlococcus epidermidis

Question 57

What organism is associated with a patient who develops endocarditis in a native valve after having a dental cleaning.

Answer 57

Streptococcus viridians