Infectious Disease Flashcards

1
Q

Tx of Syphilis if penicillin allergy

A

Doxycycline

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2
Q

Fever after Tx of early primary syphilis w/ Penicillin G

A

Jarisch-Herxheimer Reaction

(Rapid lysis of spirochetes, causing acute febrile illness 6-48hrs)

  • Self-limited course (48 hours)
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3
Q

Large painful & purulent penile ulcer + Inguinal LAD

A

Haemophilus ducreyi

(chancroid)

  • Sexually transmitted G- rod in developing countries or from commercial sex workers
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4
Q

Most common behavioral risk factor for TB in US

A

Substance abuse

  • Travel
  • Group living
  • Incarceration
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5
Q

Associated with Vitiligo

A

Hashimoto Thyroiditis

(or any autoimmune disease)

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6
Q

Eosinophilia + Periorbital edema + Myositis

A

Trichinellosis

(Parasitic infection from Mexico, China, or Thailand)

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7
Q

PNA w/ multi lobular cavitary infiltrates following influenza illness

A

CA-MRSA (Staph aureus) PNA

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8
Q

Epiglottitis, most common organism

A

H. flu

(if not vaccinated)

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9
Q

Human bite wound Tx

A
  • Surgical debridement
  • Amox-Clav (polymicrobial coverage: G+, G-, anaerobic beta-lactamase-producing
  • Tetanus Vaccination (if not UTD)
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10
Q

Bright red, firm, friable, exophytic round nodules on HIV pt

A

Bacillary angiomatosis

(Bartonella)

  • Erythromycin
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11
Q

PNA Sx + wartlike lesions, violaceous nodules, skin ulcers +/-osteomyelitis

A

Blastomycosis

(Wisconsin)

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12
Q

C. Difficile Colitis Tx

A

MNZ or Vancomycin

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13
Q

BL diffuse interstitial infiltrates in immunocompromised pt

A

Pneumocystis PNA

PCP)

  • Tx: TMP-SMX + Prednisone if decreased O2 levels (<70)
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14
Q

Most common cause of meningitis

A

Strep pneumo

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15
Q

Meningitis + rapid-onset of hypotensive shock & petechial rash

A

Meningococcal Meningitis

(Neisseria meningitidis)

  • CTX + Vancomycin
  • Strep pneumo (most common) does not have shock or skin manifestations
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16
Q

Acute fevers + Chancre + Myocarditis + CNS involvement + Sleepiness + East Africa

A

Trypanosomiasis

(Tsetse flies)

  • “African Sleeping Sickness”
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17
Q

Fever, HA + Myalgias + Retroorbital pain + Leukopenia + travel

A

Dengue Fever

(Mosquito-borne)

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18
Q

Cyclical/undulating fever + anemia + travel

A
  • Malaria (Africa)
  • Babesiosis (NE or Midwest US; Tick-transmitted)
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19
Q

CD4 <50 + bloody diarrhea

A

CMV Colitis

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20
Q

HA, vomiting, BL Papilledema + HIV

A

Cryptococcal meningoencephalitis

(Cryptococcus neoformans)

  • Dx: CSF antigen testing (or: India Ink or Sabouraud)
  • Tx: Amphotericin B w/ flucytosine + Fluconazole maintenance
  • Normal MRI
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21
Q

Encephalitis + Temporal lobe involvement

A

HSV Encephalitis

  • +cognitive/personality ∆s
  • +seizures or neuro deficits
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22
Q

CD4 <50 + elevated alk phos + splenomegaly

A

Mycobacterium avid complex

(MAC)

  • Tx: Macrolides
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23
Q

Travel + hepatomegaly + unvaccinated

A

HAV

(most common)

  • Fecal-oral
  • MSM/Sexual transmission
  • Illicit drug use
  • Travel
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24
Q

Raw oysters or wound contamination in sailing/marine environment + Rapidly progressive bullous or necrotizing lesion/infection

A

Vibrio vulnificus

(increased in liver disease, especially hemochromatosis due to free iron being catalyst)

  • Bullous lesions
  • Necrotizing fasciitis
  • Tx: CTX + Doxycycline
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25
Q

Immunocompromised + BL diffuse interstitial infiltrates

A

Pneumocystis PNA

(PCP)

  • +Elevated LDH
  • Dx: Bronchoalveolar lavage (cannot be cultured)
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26
Q

Hyponatremia + diarrhea + PNA Sx + confusion/ataxia + travel + high fever

A

Legionella PNA

(Tx: fluoroquinolones or macrolides)

  • Contaminated water from cruise ships or hotels
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27
Q

Eggshell calcification on liver

A

Hydatid cyst

(Echinococcus granulosus; dog tapeworm)

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28
Q

Nosocomial UTI + endocarditis. Pathogen?

A

Enterococci

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29
Q

Colon carcinoma + endocarditis. Pathogen?

A

Strep bovis

(Strep gallolyticus)

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30
Q

Immunocompromised + endocarditis. Pathogen?

A

Candida

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31
Q

Post-dental infection + non-painful + yellow sulfur granules + sinus tracts. Dx/Tx?

A

Actinomyces

(Tx: Penicillin)

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32
Q

Pork + adult seizure

A

Neurocysticercosis

(Taenia solium)

  • Tx: Albendazole
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33
Q

Nocardia Tx

A

TMP-SMX

(Bactrim)

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34
Q

Ludwig Angina

A

Rapidly progressive submandibular cellulitis on the floor of the mouth 2/2 polymicrobial teeth root infection.

  • Usually infected mandibular molar
  • IV Abx prevents airway compromise (ampicillin-sulbactam or clindamycin)
35
Q

HIV pt w/ multiple ring-enhancing lesions, including basal ganglia

A

Toxoplasmosis

  • Tx: Sulfadiazine + Pyrimethamine
  • PPX: TMP-SMX
36
Q

Erysipelas

A

Upper dermis (superficial) skin infection, usually Group A Strep, that presents w/ warm tender erythematous rash w/ raised, sharply demarcated borders

37
Q

Stick from HBV patient. Tx?

A

HBV Ig + HBV Vaccination

38
Q

Unvaccinated rusty nail injury. Tx?

A

Tetanus vaccine

(+Tetanus Ig if symptomatic or never received vaccine)

39
Q

Valvular abnormality w/ Infective Endocarditis

A

Mitral Valve Prolapse

(MVP) w/ Mitral Regurgitation (MR)

40
Q

Porphyria Cutanea Tarda (PCT)

A

HCV-associated skin changes to sun exposure, with vesicles and bullae

41
Q

Only indication for meningococcal vaccination

A

High-risk

(asplenia, complement deficiency)

42
Q

Ehrlichiosis

A

Tick-borne bacterial infection from lone star tick (Amblyomma americanum) in Southeastern and South central US (e.g. Arkansas)

  • Reservoir is white tail deer
  • Leukopenia, Thrombocytopenia, Elevated LFTs & LDH
43
Q

Streptococcus mutans

A

Strep viridans group

(infective endocarditis from periodontal disease/dental work)

  • S mutans
  • S sanguinis
  • S mitis
  • S oralis
  • S sobrinus
44
Q

Immunocompromised w/ PNA Sx + beaded or branching rods + partially acid fast + aerobic

A

Nocardia

(most commonly pulmonary nocardiosis: nodular or cavitary lesions in upper lobes)

  • Tx: TMP-SMX
45
Q

HAP (Hospital-Acquired Pneumonia) Tx

A

Vancomycin + Pip

46
Q

TB-mimicking diseases

A
  • Histoplasmosis (Mississippi/Ohio River - Bird/Bat droppings; Mold in soil)
  • Blastomycosis (Wisconsin, Mississippi - Soil, rotting wood)
47
Q

Reticulated/lace-like rash + flu-like symptoms

A

Parvovirus B19

48
Q

Arthralgias + Painful fingertips/toes + hematuria/RBC casts + Rf+

A

Infective Endocarditis (

49
Q

HIV + Linear ulcers in the distal esophagus

A

CMV Esophagitis

50
Q

Intranuclear and intracytoplasmic inclusions

A

CMV

51
Q

CMV Tx

A

Ganciclovir

52
Q

Mycobacterium Avium presentation

A

HIV pt CD4<100 w/

  • Constitutional Sx (high fever, night sweats, fatigue, wt loss)
  • GI Sx (diarrhea, abd pain)
53
Q

HIV pt CD4<100 w/ Constitutional symptoms + Vascular cutaneous lesions + Liver/Bone/CNS involvement

A

Bacillary Angiomatosis (Bartonella)

  • Cat scratch
  • Head/Body Lice (Homelessness)
54
Q

CD4+ <50 + bloody diarrhea

A

CMV

(CMV Colitis)

  • Colonoscopy w/ biopsy
  • Ocular examination to r/o concurrent retinitis
55
Q

Immunocompromised pt w/ suspected bacterial meningitis Tx?

A

Cefepime + Vancomycin + Ampicillin

56
Q

Grey mucous patches

A

Syphilis

57
Q

Epitrochlear LAD

A

Syphilis

(Pathognomonic)

58
Q

Multiple violaceous papules in HIV patient

A

Kaposi Sarcoma

(HHV-8)

59
Q

Most common cause of community-acquired bacterial meningitis

A

Strep pneumo

60
Q

Hypopigmented well-demarcated numb skin lesion

A

Leprosy

(respiratory droplet or armadillo)

  • Dx: Full thickness biopsy
  • Tx: Dapsone + Rifampin; +Clofazimine if multibacillary
61
Q

Excessive vomiting immediately after eating reheated rice

A

Bacillus cereus enterotoxin

62
Q

School teacher with acute onset symmetric arthralgias

A

Parvovirus B19

  • Dx: Anti-parvovirus B19 IgM Antibodies
63
Q

Pregnant or lactating woman w/ erythema migrans. Tx?

A

Amoxicillin

(Doxycycline is teratogenic!)

64
Q

Child <8yo w/ erythema migrans. Tx?

A

Amoxicillin

(Doxycycline is contraindicated in children due to adverse effects on bone development)

65
Q

Immigrant with RUQ pain + low-grade fevers

A

Amebic Liver Abscess

(Entamoeba histolytica)

  • Tx: Oral MNZ
  • Echinococcus (hydatid cysts) not associated with fevers
66
Q

Echinococcus Tx

A

Percutaneous aspiration/drainage + albendazole

67
Q

Heterophile antibody test

A

Monospot test (EBV)

68
Q

Common coinfections w/ G/C

A
  • HIV
  • HBV
  • Syphilis (Treponema pallidum)
69
Q

Central & Midwest US (Ohio & Mississippi River Valleys)

A

Histoplasmosis

(bird or bat droppings)

70
Q

Wisconsin

A

Blastomycosis

71
Q

Southwest

A

Coccidioidomycosis

72
Q

Northeast

A

Ixodes Tick

73
Q

Central/South America or Caribbean + flulike illness + symmetric polyarthralgias + macular rash + cervical LAD

A

Chikungunya Fever

(Aedes mosquito viral illness)

  • Self-limited (7-10d)
  • Dx: Serologic testing
74
Q

Tx of disseminated histoplasmosis

A

IV Amphotericin B + 1 year of oral itraconazole

75
Q

Tx of Febrile Neutropenia

A

Empiric anti-pseudomonal broad spectrum abx:

  • Cefepime
  • Meropenem
  • Piperacillin-Tazobactam (Pip/Tazo; Zosyn)
76
Q

Thrush, think

A

HIV or immunocompromised

(opportunistic infections)

77
Q

LP w/ high opening pressure, low WBCs, low glucose, elevated protein

A

Cryptococcal meningoencephalitis

(fungal)

  • Tx: IV Amphotericin B + Fluconazole
  • Defer treating newly discovered HIV to after antifungal Tx
78
Q

Sabouraud agar

A

Fungi

(“Sab’s a fun guy!”)

79
Q

Elderly diabetic patient with ear canal infection

A

Malignant Otitis Externa

(Pseudomonas)

  • Granulation tissue in ear canal on exam
80
Q

Acute testicular pain during viral illness

A

Mumps orchitis

81
Q

CSF profile in GBS (Guillain-Barre Syndrome)

A
  • Elevated proteins
  • Normal WBC, RBC, glucose

(albuminocytologic dissociation)

82
Q

Empiric antibiotics are NOT recommended for _______ in children

A

Bloody diarrhea

  • Because they increase the risk for hemolytic uremic syndrome (HUS) if the causative pathogen is high-risk STEC (E coli O157:H7).
83
Q

MCC of viral conjunctivitis (pink eye)

A

Adenovirus

  • Common in small children and caregivers in late summer, early fall
  • Self-limited
  • Warm or cool compresses for symptomatic relief