ID Flashcards
White curd like vaginal discharge should make you think of what diagnosis?
vaginal candida infection
owl eye inclusion bodies should make you think of what diagnosis?
Cytomegalovirus
if you have a patient with positive blood cultures for candida what is the first line drug?
amphotericin B
what is the treatment for pertussis?
erythromycin x 7 days
a leukemia patient has a CT of the liver which shows punched out lesions. Dx?
hepatosplenic candida
what disease dose Rickettsia rickettsii cause?
rocky mountain spotted fever
an india ink stain showing cysts should make you think of what?
Cryptococcosis
an HIV pt presents with a nonproductive cough and a chest x ray showing diffuse interstitial infiltrates. Dx?
pneumocystis jiroveci pneumonia (PCJ)
honey and babies should make you think of what?
botulism
what type of organism causes botulism?
gram + rod, clostridium botulinum
what is the treatment for botulism?
antitoxin
a patient presents to the ER with acute progressive weakness, diploplia and a very dry mouth. what organism may be causing this?
clostridium botulinum
rice water stool
cholera
is diphtheria gram + or -?
gram positive
a stuck on grey membrane in the pharynx should make you think of what diagnosis?
diphtheria
what are the four steps in treating diphtheria?
antitoxin, penicillin, remove membrane, report the case to the CDC
what is the clinical name for whopping cough?
pertussis
what type of organism is tetanus?
a gram + rod, clostridium tetani
a pt ate out last night and today has cramping and bloody diarrhea. most likely organism?
salmonella
diarrhea with blood and mucus should make you think of what?
shigella
what is the best test to dx malaria?
peripheral blood smear
what organism has been linked to reactive arthritis?
shigella, also remember that reactive arthritis has a positive HLA-B27
what is the tx for shigella?
bactrim or fluoroquinolones
what organism causes lyme disease?
borrelia burgdorferi
what is the minimum amount of time needed for a tick to transfer lyme disease to a human?
24 hours
what is the drug of choice to treat lyme disease in kids or pregnant women
amoxicillin
what is the drug of choice to treat C. difficile?
metronidizole (flagyl)
A patient was in the woods yesterday and today presents with erythema migrans. What is the most likely diagnosis?
lyme disease
what drug is used to tx or prophylax malaria?
chloroquine
A patient was camping a few days ago and now has a rash that began on his wrists and ankles. What is the most likely diagnosis?
rocky mountain spotted fever
what is the drug of choice for treating rocky mountain spotted fever?
doxycycline
what is the drug of choice for the treatment of syphilis?
penicillin
is staph gram + or -?
gram positive
A patient being treated with penicillin for a syphilis infection develops fever, chills, muscle pain and headaches. Do you stop treatment?
No this is Jarisch-Herxheimer reaction. The patient must be closely monitored, but it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction.
what organism is believed to be the main culprit in creating peptic ulcers?
Helicobacter pylori
A painless, clean base chancre should make you think of what dx?
primary syphilis
is pseudomonas gram positive or negative?
gram negative
A patient complains of a rash on his palms and soles. He has a fever and chills. In conversation he mentions a strange painless chancre he had a few weeks ago. What is the most likely diagnosis?
secondary syphilis. this is the most contagious stage
what is the treatment for cholera?
fluids
what is the current drug of choice for Cytomegalovirus?
ganciclovir
what herpesvirus causes Epstein-Barr?
Herpes 4
A sixteen year old girl presents with an exudative sore throat and general malaise. On physical exam you observe some posterior chain lymphadenopathy and mild splenomegaly. What is the most likely diagnosis?
Epstein-barr virus
what are the two important pieces of patient education for anyone diagnosed with mononucleosis?
no contact sports due to risk of spleen rupture, no kissing (highly contagious)
what is the first symptom of a rabies infection
pain and anesthesia at the site of bite
how do you definitively diagnose rabies?
pathology of the brain of the animal that performed the bite using fluorescent antibody stain
a patient is bitten by rabier infected raccoon. on what days do you give human diploid cells?
0, 3, 7, 14, 28
a diaper rash with satellite lesions should make you think of what diagnosis?
candida
Name three serious reactions a patient may have with the use of vancomycin?
nephrotoxicity, ototoxicity and SJS
what tests are done to screen for HIV?
ELISA and then if the positive diagnosis is confirmed with a western blot test
what is the drug of choice for the lyme disease?
doxycycline
what does trismus mean?
lock jaw, often secondary to tetanus
how do you treat amebiasis?
metronidazole (flagyl)
how do you treat pneumocystis jiroveci pneumonia (PCJ) formerly known as pneumocystis pneumonia (PCP)
bactrim
what is the treatment for tetanus infection
penicillin, immune globulin and supportive care (especially respiratory support)
how do hookworm larvae enter the body?
they penetrate the skin usually through the soles of the feet
how do you treat hookworm?
azoles
what type of mosquitoes carry malaria?
anopheles
how do you treat white oral plaques that can be scraped off?
most likely candida. tx with nystatin or oral fluconazole 1 mg are first line choices
A CT scan shows ring enhancing lesions in an HIV pt. what is the most likely diagnosis?
toxoplasmosis
what is the drug of choice for toxoplasmosis?
bactrim
what organism causes toxoplasmosis?
toxoplasma gondii
What drug do you use to treat pinworm?
you treat everyone in the house with albendazole. two weeks later you treat them again
the scotch tape test is used to diagnose what disease?
pinworm
is neisseria gram + or gram -?
gram negative
syphilis is caused by what organism?
treponema pallidum
a gram positive organism in chains makes you think of what diagnosis?
strep
a gram negative diplococci makes you think of what diagnosis?
neisseria
what is the most common prophylactic antibiotic used preoperatively?
cefazolin (Ancef)
what oral antibiotic can be used for pseudomonas?
ciprofloxacin
what is the suffix used for most fluoroquinolones?
oxacin
why aren’t fluoroquinolones used more frequently?
they have a lot of side effects
a pt presents with a ruptured achilles tendon. he states that he was recently in the hospital for a “blood infection and on a ton of antibiotics.” What antibiotic class may he have been on?
fluoroquinolones
why can’t you give fluoroquiniolones to kids?
they can cause cartilage development preoblems
what class of antibiotics should you start with for community acquired pneumonia
macrolides
list three macrolides.
erythromycin, azithromycin, clarithromycin
what antibiotic class is the class of choice for chlamydia?
tetracycline (doxy) or macrolides (azithro)
what class of antibiotics is sometimes prescribed specifically for its effects on increasing GI motility?
macrolides
which medication is worse to give to a pediatric patient, tetracycline or an aminoglycoside?
tetracycline (they cause teeth discoloration too)
pizza pie retinopathy should make you think of what dx?
cytomegalovirus
a patient presents complaining of metallic taste in her mouth and dark brown urine. what antibiotic might she be on?
metronidazole (flagyl)
what antibiotic is most likely to cause Clostridium difficile?
clindamycin
what is the current drug of choice for treating MRSA?
vancomycin
you place a patient on rifampin. what side effect should you warn her about?
orange-red discoloration of body fluids
what might happen if you infuse vancomycin too fast?
red man syndrome
name one oral medication that can be used for MRSA.
linezolid (zyvox) and bactrim
what organism is most commonly responsible for community acquired pneumonia?
strep pneumonia
what organism is the most common cause of an uncomplicated urinary tract infection?
E. coli
gummas or granulomatous nodules should make you think of what diagnosis?
tertiary syphilis
blood stool with cysts and trophozoites should make you think of what diagnosis?
amebiasis
community acquired carditis is most often by one of the HACEK organisms. List the HACEK organisms.
Haemophilus, actinobacillus, cardiobacterium, eikenella, kingella
what are the three medications often combines as a first line treatment for H. pylori?
omeprazole, clarithromycin and amoxicillin (PPI + 2 antibiotics)
what is the prophylactic antibiotic most commonly given before a dental procedure if one is necessary?
amoxicillin 2 gram po 1 hours before procedure.
A pregnant woman and cat litter should make you think of what diagnosis?
toxoplasmosis
what is the drug of choice to treat urethritis caused by neisseria?
ceftriaxone (rocephin)
is klebsiella gram + or gram -?
gram negative
a gram positive organism in clusters should make you think of what diagnosis?
staph
what is the best test for diagnosing rocky mountain spotted fever?
indirect immunofluorescent antibodies
a gram negative coccobaccili found in the sputum of patient with pneumonia should make you think of what diagnosis?
H. flu
what medication is used as prophylaxis for meningococcal meningitis?
rifampin
a child presents with an erythematous sandpaper rash
scarlet fever
Rheumatic fever most commonly affects which valve?
the mitral valve
Any reference to dark field microscopy should make you think of what organism?
Treponema pallidum
A COPD patient has apical cavities and calcified nodes on his chest x-ray. You also discover he has a pet bat and a few birds. What is the most likely diagnosis?
Histoplasmosis
