Extrapulmonary Infections

Question 1

5 reasons to get CT before LP

Answer 1

Hx of CNS disease

New onset seizures within the last week

Papilledema

Focal neuro deficits

Altered mentation

Question 2

Most common cause of bacterial meningitis

Answer 2

Strep pneumoniae

Question 3

Top 5 causes of bacterial meninigitis

Answer 3

Strep pneumo

N. Meningitidis

Group B Strep

H influ

Listeria

Question 4

Serotype of strep that is not covered by the typical pneumonia vaccine

Answer 4

Serotype B

Question 5

Typical abx regimen for meninigitis

Answer 5

vanc and 3rd gen ceph

Question 6

Patients who get ampicillin for meninigitis

Answer 6

Pregnancy and patients > 50 years old

Covers Listeria

Question 7

Abx regimen for meningitis if immunocompromised

Answer 7

Vanc + (Cefepime or Meropenem) + ampicillin

Question 8

Abx regimen for meningitis if recent neurosurgery or penetrating trauma

Answer 8

Vanc + (Cefepime or meropenem or ceftazidime)

Question 9

How are steroids started in meningitis

Answer 9

Start dexamethasone empirically

Stop if confirmed to not be strep pneumo

Continue for 4 days if confirmed strep pneumo

Question 10

3 viral causes of aseptic meningitis in the summer/fall

Answer 10

Coxsackievirus

Echovirus

Poliovirus

Question 11

4 causes of viral encephalitis in the summer/fall

Answer 11

West Nile virus

Eastern equine encephalitis virus

Western equine encephalitis virus

St. Louis encephalitis virus

Question 12

2 causes of aseptic meningitis in the winter/spring

Answer 12

Mumps

Lymphocytic choriomenigitis virus

Question 13

2 causes of aseptic meningitis that can occur at any time of the year

Answer 13

HIV

HSV-2

Question 14

2 causes of viral encephalitis in the winter/spring

Answer 14

Mumps

Measles

Question 15

2 causes of viral encephalitis that can occur at any time of the year

Answer 15

HIV

HSV-1

Question 16

Location of brain abnormalities on imaging with HSV encephalitis

Answer 16

temporal lobe

Question 17

Treatment for HSV encephalitis

Answer 17

14-21 days of IV acyclovir

Question 18

Treatment for west nile virus encephalitis

Answer 18

supportive

Question 19

Patient with fever, ocular abnormalities, neuroinvasive disease in the summer/fall

Answer 19

West Nile encephalitis

Question 20

Dx in a patient with altered mentation, proximal to distal paralysis, no sensory issues, and pleiocytosis on CSF

Answer 20

West Nile Virus paralysis

Question 21

3 infectious reasons that CSF opening pressure is elevated.

Answer 21

Bacterial

TB

Fungal

Question 22

Glucose is low in CSF on what 2 infectious etiologies?

Answer 22

Bacterial

TB

Question 23

2 pathogen classes covered for any head and neck infection

Answer 23

GNR’s

Oral beta-lactamase producing anaerobes

Question 24

Ludwig’s angina

Answer 24

Infection of the submandibular space

Question 25

Lemierre's syndrome

Answer 25

septic embolic appearing as a clot in the jugular vein

Question 26

Bacteria responsible for Lemierre's syndrome

Answer 26

Fusobacterium necrophorium

Question 27

Do you anticoagulate a patient with an IJ blockage from Lemierre's syndrome

Answer 27

No

Question 28

3 options for regimen in typical head and neck infections

Answer 28

Augmentin Rocephin and flagyl Clindamycin and levoquin

Question 29

Duration of treatment for paravertebral space infection

Answer 29

2-3 weeks, longer if for osteo as well

Question 30

Score to show severity in necrotizing skin and soft tissue infections

Answer 30

Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC)

Question 31

LRINEC score with a 92% PPV and 96% NPV for necrotizing skin infection

Answer 31

6 or more

Question 32

Most common cause of staphylococcal toxic shock syndrome

Answer 32

Tampons or nasal packing

Question 33

Most common cause of streptococcal toxic shock syndrome

Answer 33

Trauma Postpartum Possible NSAIDs

Question 34

Does staph or strep toxic shock syndrome have the higher mortality

Answer 34

Strep

Question 35

Does staph or strep toxic shock syndrome get IVIG for treatment

Answer 35

Strep only

Question 36

Abx regimen for staph toxic shock syndrome

Answer 36

MRSA: Vanc + clindamycin MSSA: nafcillin + clindamycin

Question 37

Abx regimen for strep toxic shock syndrome

Answer 37

Pen G + clindamycin IVIG

Question 38

Bacteria that causes gas gangrene in trauma

Answer 38

Clostridium perfringes

Question 39

Bacteria that causes gas gangrene spontaneously

Answer 39

Clostridium septicum

Question 40

Treatment for gas gangrene from clostridium

Answer 40

Surgical debridement Pen G + clindamycin

Question 41

Patient with myasthenia gravis appearance and use of black tar heroin infected with what?

Answer 41

Clostridium botulinum

Question 42

2 differences in presentation of botulism to myasthenia gravis

Answer 42

Dilated pupils non-fluctuating muscle weakness

Question 43

Treatment for patients with botulinum toxin infection

Answer 43

Antitoxin (from CDC) Penicillin (first line) flagyl if pcn allergic

Question 44

Class of drugs to not give in C. botulinum infection

Answer 44

Aminoglycosides as it worsens paralysis

Question 45

2 reasons to do valve replacement in left sided endocarditis

Answer 45

1. Vegetation size > 10 mm 2. Location on the anterior leaflet of the mitral valve