ID

Question 1

Flu vaccine

Answer 1

The vaccine is not a live virus and cannot cause the flu
Influenza vaccines that are administered with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine).

Question 2

most common causative organism in acute otitis media in children of all ages.

Answer 2

Strep pneumo

Question 3

scabies

Answer 3

Finding of burrows on exam is diagnostic; patients and household should be treated with 5% permethrin cream. Remember ‘fingerwebs’ is associated with scabies.

Question 4

most common organism responsible for cases of traveler’s diarrhea

Answer 4

E.coli - most common when traveling to areas with limited sanitation and poor water purification systems. Patients may experience abdominal cramping and watery diarrhea, usually lasting up to 5 days. Fluid replacement is the most important aspect of therapy. Antibiotics can also be given in severe cases, usually a fluoroquinolone.

Salmonella is the second most common cause of traveler’s diarrhea. It is associated with consumption of contaminated or undercooked meat and poultry products. It causes inflammatory diarrhea.

Question 5

common cause of diarrhea when traveling to Southeast Asia.

Answer 5

Campylobacter jejuni - Azithromycin is the preferred agent in this case.

Question 6

Reading TB tests
1 - no known risk factors 
2 - Health care worker
3- children < 4 y/o
4 - HIV or hx of organ transplant

Answer 6

1 - positive test at 15 mm of induration.
2 - 10 mm or more of induration
3 - 10 mm or more of induration
4 - 5 mm of induration or more.

Question 7

Lymphogranuloma venereum (LGV)

• caused by
• group at risk for
• results in
• rx

Answer 7

• a serotype of C. trachomatis
• men having sex with men
• small painless genital lesion followed by unilateral inguinal lymphadenopathy a couple weeks later, with or without anal discharge.
• doxycycline

Question 8

Enterobiasis

• sx
• dx

Answer 8

(AKA: pinworms) is often asymptomatic, but perianal itching is a common symptom.

There are 3 simple techniques that may be used to make the diagnosis: 1) Touch the perianal skin with transparent tape to collect pinworm eggs around the anus first thing in the morning. This method should be repeated on 3 consecutive mornings right after the infected person wakes up, and before the individual does any washing. If a person is infected, the eggs on the tape will be visible under a microscope; 2) Look for the presence of worms in the perianal reqion 2-3 hours after the infected person is asleep; or 3) Analyze samples taken from under the infected individual’s fingernails under a microscope looking for pinworm eggs.

Question 9

most common cause of dysuria in adult males

• due to organisms x2

Answer 9

Urethritis

• It is usually caused by gonococcal or chlamydial infections.

Question 10

Whooping cough

• caused by
• 3 phases
• Rx:

Answer 10

• “whooping cough” caused by Bordetella pertussis. It is highly contageous, and can be very severes in infants.

1. Catarrhal phase: one to two weeks of vague symptoms. Patients may have a low grade fever, malaise, and mild cough. This is when the patient is most infectious.
2. Paroxysmal phase: intense episodes of coughing, followed by a rapid inspiratory “whoop” and posttussive vomiting or syncope.
3. Convalecent phase: final phase of pertussis, in which symptoms begin to resolve, but the patient can still have a lingering cough for weeks to months

• azithromycin or clarithromycin, given within the first 3 weeks of illness.