Infectious Disease questions Flashcards
(24 cards)
Which of the following is the most accurate test for infectious disease? A-protein levels B-culture C-IgM levels D-Gram stain
B-culture
Which of the following anabiotic's will cover MRSA? A-nafcillin B-cefozollin C-piperacillin-tazobactam D-ceftaroline E-azithromycin
D- ceftaroline (only cephalosporin that will)
Which of the following is most likely to be effective for Morganella or Citrobacter? A-tedizolid B-dalbavancin C-ertapenem D-oritavancin E-erythromycin
C- ertapenem
All the others are for gram +
What is the best broad-spectrum coverage for anaerobic G.I. bacteria? A-aztreobam B-piperacillin/tazobactam C-oxacillin D-cefipime E-doxy F-vanc
B-piperacillin-tazobactam. Only one listed that covers anaerobes. The penems will as well
What is the best anabiotic for E. coli bacteremia?
A- vancomycin
B- linolezid
C- quinolones/aminoglycosides/penems/aztreonam
D-doxy
E-oxacillin
C
What is the best way to confirm meningitis with a false negative culture? A-gram stain B-glucose level C-latex agglutination test D-protein level
C. Latex agglutination tests wont change after a few doses of abx
What is the next step in managing a patient with meningeal signs and focal neuro deficits? A-ceftriaxone, vanc and steroids B-head CT C-ceftriaxone D-neuro consult E- steroids
A- just treat in a clear-cut case
What is the most accurate test of herpes encephalitis? A-brain biopsy B -PCR of CSF C-MRI D-tzank prep E-serology
B. PCR is most accurate. Serology is useless.
What is the next step in a patient on acyclovir for encephalitis with rising creatinine levels? A-stop acyclovir B-reduce dose and hydrate C-switch to orals D-switch to foscarnet
B- orals are insufficient and foscarnet is more renally toxic
What is the most sensitive finding for otitis media? A-redness B-immobility C-bulging D-decreased light reflex E-decreased hearing
B- mobility essentially excludes OM
What is the most accurate diagnostic test for febrile sinusitis A-sinus biopsy or aspirate B-CT scan C- x-ray D- culture of the discharge E-transillumination
A
What is the next most appropriate step in a patient who presents with febrilesinusitis A-linezolid B-ct scan C- xray D-amoxicillin/clav and a decongestant E-erythromycin and a decongestant
D- treat empirically in a clear cut case.
Which is most accurate in determining diarrhea etiology? A-recent history B-frequency of bowel movements C-blood in stool D-stool odor E-recent interstate travel
C- blood must mean invasive pathogen
Which best correlates with increased mortality likelihood in hepatitis? A- bilirubin B- PT C- ALT D-AST E- alk phos
B- increased prothrombin time suggests fulminant liver failure
Which will become abnormal first after hep B infection? A- bilirubin B-e antigen C- surface antigen D- core IgM antibody E-ALT
C
Which of the following most strongly correlates with viral replication? A-bilirubin B-e antigen C-surface antigen D-core IgM antibody E-ALT
B (same as DNA polymerase)
which shows a patient is no longer infective? A-normal bilirubin B-no e antigen C no surface antigen D- no core IgM E-normal ALT
C- as long as there is surface antigen, there is replication
Which suggests need for treatment for chronic disease? A bilirubin B e antigen C surface antigen D core igM antibody E ALT
B: e antigen is strongest indicator of viral replication
Which most strongly suggests transmission to an unborn child? A bilirubin B e antigen C surface antigen D core IgM E ALT
B
What is the next step with new vesicular lesions? A oral acyclovir B topical acyclovir C tzanck prep D serology E PCR
A: treat a clear cut case
What is the most sensitive CSF test for neurosyphilis? A VDRL B RPR C FTA D stain E dark field
C: only FTA confirms “not neurosyphilis”
What is the next step with dysuria and many white blood cells in urine? A nitrofurantoin x3 B nitrofurantoin x7 C urine cx D us of urinary tract E ct of urinary tract
A: treat obvious uti. Only need longer tx if anatomic abnormality
What is the difference in treatment between prostatitis and cystitis? A causitive organism B duration of therapy C use of urinalysis D oral med efficacy E iv med efficacy
B- prostatitis takes longer
What is the next step after diagnosing c. Septicum endocarditis? A colonoscopy B TEE C CT ABD D repeat blood cx E surgical valve replacement
A: like S. Bovis, has GI association
