EM Infectious Disease

Question 1

Classic triad of meningitis

Answer 1

fever, nuchal rigidity, change in mental status

Petechial rash is associated with N. Meningitidis

Question 2

Encephalitis Etiology

Answer 2

Most commonly caused by viral infections
HSV-1 and HSV-2 are rapidly progressing and life threatening
Also West Nile Virus, CMV, Mumps, EBV

Question 3

Encephalitis Treatment

Answer 3

Acyclovir 10mg/kg IV q 8 h (empiric treatment for HSV as it is the most deadly)

Question 4

Characteristic (but NOT specific) cutaneous lesions of endocarditits

Answer 4

Conjunctival and palatal petechiae
Subungual (splinter) hemorrhages
Osler nodes = tender, erythematous nodules with opaque centers which appear on pulp of fingers/toes
Janeway lesions = Nontender red or maroon macules or nodules on the palms and soles
eye exam may show Roth spots (pale oval areas surrounded by hemorrhage) near optic disc

Question 5

Botulism signs and symptoms

Answer 5

acute onset of bilateral cranial neuropathies associated with symmetric descending weakness

Also: Absence of fever, responsive, normal or slow heart rate and normal BP, no sensory deficits with the exception of blurred vision

Question 6

Smallpox: Clinical features

Answer 6

Incubation period: 12 days (7-17 days)
Non-specific prodrome (2-4 days) of fever, mylagias
Rash most prominent on face and extremities (including palms and soles) in contrast to truncal distribution of varicella
Rash scabs over in 1-2 weeks
Variola rash has a synchronous onset (in contrast to the rash of varicella which arises in crops