ID

Question 1

tx influenza

Answer 1

oseltamivir

Question 2

what type of bacteria is Neisseria meningitidis

Answer 2

Gram-negative diplococci

Question 3

what meningitis causing bacteria is a concern in older adults, immunocompromised individuals, and neonates

Answer 3

Listeria monocytogenes

Question 4

who should not undergo lumbar puncture

Answer 4

Patients with findings of increased intracranial pressure, ongoing anticoagulant therapy, or other bleeding disorders

Question 5

Lumbar puncture meningitis

Answer 5

elevated opening pressure
decreased glucose concentration, elevated protein level, and elevated white blood cell count with predominant neutrophils

Question 6

tx meningitis

Answer 6

vancomycin with the addition of ceftriaxone or cefotaxime

Question 7

tx meningitis in older adults and immunocompromised

Answer 7

Ampicillin should be added

Question 8

what should be added as adjunctive therapy to reduce inflammation and prevent neurologic complications, such as hearing loss, in meningitis

Answer 8

dexamethasone

Question 9

Patients with confirmed or suspected meningococcal meningitis should be placed on

Answer 9

droplet precautions

Question 10

appropriate chemophylaxis for close contacts of n. meningitidis

Answer 10

rifampin, ciprofloxacin, or ceftriaxone

Question 11

what type of bacteria is salmonella

Answer 11

motile gram-negative bacillus

Question 12

salmonella outbreaks are most commonly associated w

Answer 12

poultry
eggs
transmission from contact w reptiles and amphibians

Question 13

sx salmonella

Answer 13

abdominal cramping, diarrhea, nausea, and vomiting
not usually grossly bloody diarrhea

Question 14

definitive dx salmonella

Answer 14

stool cultures

Question 15

most important component of therapy for salmonella

Answer 15

replacement of fluids and electrolytes

Question 16

Which virus is associated with outbreaks of gastroenteritis on cruise ships?

Answer 16

Norovirus

Question 17

HIV vaccinations

Answer 17

Tetanus and diphtheria vaccination should be performed every 10 years
Hepatitis B vaccination in a three-part series should be given to all patients who are HIV positive who do not demonstrate immunity to hepatitis B
Hepatitis A (2 or 3 doses)
Influenza vaccination in the inactivated or recombinant form should be administered annually
three doses of human papillomavirus vaccination should be administered to those who are ≤ 26 years old
Meningococcal vaccine (A, C, W, and Y type) should be administered in a two-dose series and repeated every 5 years
Pneumococcal vaccination (one dose of either the 20-valent or 15-valent pneumococcal conjugate vaccine) should also be administered to adult patients between the ages of 19 and 64 who are HIV positive and have never been vaccinated with pneumococcal vaccine. If the 15-valent pneumococcal conjugate vaccine is administered, a dose of the 23-valent pneumococcal polysaccharide vaccine should be given, typically at least 1 year later.

Question 18

labs recs HIV

Answer 18

complete metabolic panel and complete blood count every 3 to 6 months
lipid panel and glycosylated hemoglobin are also recommended at least yearly
An annual Pap test with human papillomavirus testing should be performed as well as annual testing for syphilis, gonorrhea, chlamydia, and trichomoniasis in patients who are sexually active
baseline purified protein derivative test for tuberculosis should be performed for patients who are HIV positive, with annual testing of those whose initial test was negative and who continue to have ongoing risk factors

Question 19

cause of Lyme disease

Answer 19

Borrelia burgdorferi (gram-negative spirochete)

Question 20

how is Lyme disease spread

Answer 20

Ixodes (deer) ticks

Question 21

how long must tick in Lyme disease stick to transmit bacteria

Answer 21

24 to 48 hours

Question 22

when and where does Lyme disease commonly occur

Answer 22

It most commonly occurs during summer months and is typically concentrated in the northeast and north central United States

Question 23

what type of rash do people with Lyme disease present with

Answer 23

erythema migrans

Question 24

common sx Lyme disease

Answer 24

erythema migrans
flu-like sx
AV block
cranial nerve palsy
arthritis
encephalopathy
polyneuropathy

Question 25

during the time erythema migrans is present,

Answer 25

serologic testing is negative

Question 26

tx Lyme disease

Answer 26

doxycycline twice per day for 10–21 days
amoxicillin in pregnant patients, lactating patients, and children younger than 8 years of age
IV ceftriaxone if severe

Question 27

prophylactic tx Lyme disease

Answer 27

one-time dose of doxycycline within 72 hours of tick removal

Question 28

acute mononucleosis is caused by

Answer 28

Epstein-Barr virus

Question 29

mono is commonly known as

Answer 29

the kissing disease

Question 30

MC sx mono

Answer 30

low-grade fever, sore throat, and posterior lymphadenopathy

Question 31

dx mono

Answer 31

rapid mononuclear spot test, which detects the presence of heterophile antibodies and is very specific for Epstein-Barr virus

CBC will show leukocytosis

Question 32

tx mono

Answer 32

refrain from contact sports for 4 weeks due to the risk of splenic rupture

supportive

Question 33

Shigella species

Answer 33

nonmotile facultative anaerobe gram-negative rods that contain enterotoxins, such as Shiga toxin

Question 34

how do you get shigella

Answer 34

person to person contact
contaminated food and water
daycare centers
residential institutions

Question 35

Shigella predominantly infects the

Answer 35

colon

Question 36

sx shigella

Answer 36

frequent, small volume diarrhea with stools occurring 8–10 times per day. Fever, abdominal cramping, tenesmus, and bloody and mucoid diarrhea can also be present

Question 37

Stool microscopy shigella

Answer 37

leukocytes and red blood cells

Question 38

preferred testing shigella

Answer 38

Stool culture

Question 39

tx shigella

Answer 39

oral rehydration
fluoroquinolone antibiotic, azithromycin, or third-generation cephalosporin (such as cefixime or ceftriaxone)
azithromycin is first line for kids (they should not take fluoroquinolone)

Question 40

Which Shigella species is associated with the development of reactive arthritis?

Answer 40

Shigella flexneri.