ID 6

Question 1

Treatment for Hospital Acquired Meningitis?

Answer 1

Cefepime/Ceftazidime/Meropenem. Work against Gram negative Organism and have good CNS penetration.

Question 2

Common Aids- Related Lymphomas?

Answer 2

Diffuse large B cell lymphoma

Non-Hodgkin Lymphoma

Burkitt Lymphoma

Question 3

Pt is an organ transplant patient that had 1 rejection episode. He develops fever, malaise, leukopenia and hepatitis. Donor and Recipient were both positive for CMV ( +CMV IgG). What is the likely organism?

Answer 3

CMV.

Question 4

1. Contact with infected animals (Rabbits). Pts present with Ulceroglandular disease with a single Erythematous papular skin ulcer, Central Eschar and Tender local Lymphadenopathy.
   Dx?
2. Bites and Scratches from Domestic Pets (Cats.) Pt have localized cellulitis and regional lymphadenopathy.
   Dx?
3. Travel to Texas with Rat exposure.
   Presents with Fever and Regional Lymphadenitis (Swollen/Painful!!! Nodules)
   Dx?

Answer 4

1. Francisella Tularensis (Tularemia)
2. Pasteurella Multocida. Amoxicillin/Clavulanate
3. Yersinia Pestis ( Bubonic Plague- Bubo)

Question 5

Which medication is important to give in addition to abx in patients with suspected Acute Bacterial Meningitis caused my Strept Pneumoniae ?

Answer 5

Dexamethasone. If CSF or Blood Cultures show NONpenumoccoal organism than you can stop steroid.

Question 6

Recommended Prophylatic treatment for people EXPOSED to Neisseria Meningititis ?

Answer 6

Rifampin, Ciprofloxacin or Ceftriaxone.

Rif, Cip

Question 7

1. Common nocosomial infections in Transplant patients within the first month of surgery?
2. When does CMV occur?
3. When does PCP occur?

Answer 7

1. VRE, MRSA, Candida and Pseudomonas (colonizes hospital equipment (Mechanical Ventilation.)
2. 1-6 months ( Place on Valganciclovir ppx)
3. 3-4 months ( place on Bactrim PPx) -Buy Month 3

Question 8

Pt returned from a Rafting Trip in Central Africa 3 months ago. Presents with Dysuria, Urinary Frequency, Bladder outlet Obstruction and Hematuria.

Dx?
Rx?

Answer 8

Chronic Schistosomiasis

Praziquantel

Question 9

Give symptom of each stage:

1. Early localized Lyme disease
2. Early disseminated Lyme disease
3. Late Lyme Disease

Answer 9

1. Erythema migrans
2. CN palsy and/or Meningitis
3. Arthritis

Question 10

Pt with DM and multiple Admissions for Ketoacidosis presents with Purulent Nasal Discharge, Congestion and Right Sided Peri-orbital Swelling and Tenderness.

Dx?
Test?
Rx?

Answer 10

Mucormycosis

Biopsy

Surgical Debridement + IV Ampicilin

Question 11

Presents in Asplenic Patients, Age > 50 or Immunocompromised. After travel to Endemic area and Can Occur after Receiving a Blood Transfusion.

Dx?
Test?
Rx?

Answer 11

Babesiosis

Peripheral Smear

Azithromycin + Atovaquone

Question 12

Seen in patients who Garden/Landscape. Pt present with reddish nodules that later ulcerates and other nodules with ulcerations appear in area.

Dx?
Test?
Rx?

Answer 12

Sporotrichosis

Culture

Itraconazole

Question 14

1. Most common cause of epidemic viral encephalitis in the United States and occurs between June and October and may present with acute flaccid paralysis or parkinsonism?
2. A treatable form of encephalitis and may present without vesicular rash?
3. Most common cause of sporadic encephalitis in the United States, presenting with fever, seizures, altered mental status, and focal neurologic deficits?

Answer 14

1. HSV
2. VZV
3. West Nile Virus