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M3 > IDS TF > Flashcards

IDS TF Flashcards

1
Q

Pathologic changes in the GI in typhoid fever that was the basis of its definition in the early 1800s

A

Enlarged Peyer’s patches and mesenteric lymph nodes

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2
Q

Etiologic agents of typhoid fever

A

Salmonella typhi

Salmonella paratypho serotypes A, B and C

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3
Q

Most common means of transmission of Salmonella

A

fecal contamination by ill or asymptomatic chronic carriers

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4
Q

True about typhoid fever

a. it can’t be sexually transmitted between male partners
b. previous H. pylori infection is a risk factor
c. more common in rural areas
d. more common among adults

A

B

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5
Q

Drugs not effective against MDR S. typhi

A

CAT
chloramphenicol
ampicillin
trimethoprim

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6
Q

Most common clinical manifestation of typhoid fever

A

fever

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7
Q

Most common GI manifestation of typhoid fever

A

anorexia

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8
Q

Incubation period of typhoid fever

A

10-14 days

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9
Q

characteristics of fever in typhoid fever

A

prolonged, up to 4 weeks

T 38.8degC to 40.5degC

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10
Q

Which one is to cause milder disease?

a. S. typhi
b. S. paratyphi A

A

B

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11
Q

Among these initial symptoms, which is most common?

a. chills
b. cough
c. sweating
d. headache

A

D

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12
Q

True of rose spots EXCEPT

a. it’s appears in 30% of patients
b. faint, salmon colored
c. non-blanching
d. maculopapular rash
e. appears at the end of the 1st week

A

C; blanching

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13
Q

Second most common clinical manifestation of typhoid fever

A

anorexia

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14
Q

when does relative bradycardia occur in typhoid fever?

A

At the peak of high fever

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15
Q

When does GI bleeding and instestinal perforation occur?

A

third and fourth week of illness

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16
Q

intestinal perforation occurs in what percentage of patients?

A

1-3%

17
Q

Gi bleeding result from what pathologic changes in the initial site of Salmonella infiltration?

A

HUN
hyperplasia
ulceration
necrosis

18
Q

Neuropsychiatric symptom in typhoid fever that involves picking at bed clothes or imaginary objects

A

coma vigil

muttering delirium

19
Q

what percentage of typhoid fever patients will have mild relapse within 2-3 weeks of fever resolution, in association with the same strain type and susceptibility profile?

A

10%

20
Q

For how long will S. typhi be found in the feces of 10% of untreated patients

A

3 months

21
Q

Give 4 rare complications of typhoid fever

A 
DIC
hematophagocytic syndrome
pancreatitis
hepatic and splenic abscesses
granulomas
endocarditis
pericarditis
myocarditis
orchitis
hepatitis
pyelonephritis
hemolytic uremic syndrome
severe pneumonia
arthritis
osteomyelitis
endophthalmitis
parotitis
22
Q

The following can happen in typhoid fever EXCEPT

a. leukopenia
b. leukocytosis
c. neutropenia
d. AOTA
e. NOTA

A

E

23
Q

Serologic test for typhoid that detect febrile agglutinins

A

Widal test

24
Q

Most sensitive test for typhoid fever

A

antigen and nucleic acid ampilification tests

25
Q

Most effective against S. typhi

a. Ampicillin
b. TMP SMX
c. Fluoroquinolones
d. NOTA

A

C

success 98% carriage/relapse 2%

26
Q

antibiotics acceptable for Treatment for decreased ciprofloxacin susceptibility S. typhi strains

A

CAHC
ceftriaxone
azithromycin
high dose ciprofloxacin

27
Q

Preferred Treatment for Decreased Cirpofoxacin susceptiibility DCS S. typhi strain

A

10-14 day course of high dose ciprofolaxcin

28
Q

Use of this antibiotic for DCS strains decrease rates of treatment failure and leads to shorter durations of hospitalization than fluoroquinolones

A

Oral azithromycin

29
Q

MDR enteric fever
DCS
Fluoroqinolone-resistant strains

treatment of choice?

A

CCC

Ceftriaxone
Cefotaxime
Cefixime

30
Q

True of Typhoid fever treatment

a. uncomplicated enteric fever is treated in hospital setting
b. patients with persistent vomiting diarrhea and or abdominal distension should be hospitalized and given supportive tx and antibiotics
c. Therapy for at least 7 days, or at least 5 days after fever resolution
d. it is unsafe to use glucocorticoids in severe enteric fever

A

B

a. outpatient, antipyretics
c. 10 days, 5 days
d. severe enteric fever remains one of the few indications for glucocorticoid tx

31
Q

Treatment for chronic carriage

A 
4-6 weeks of
oral amoxicillin
TMP-SMX
ciprofloxacin
norfloxacin

M3 (66 decks)

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