III. Bacterial Infections

Question 1

A condition transmitted by airborn respiratory droplets with the following S/Sx: nasal pharyngeal, laryngeal, cutaneous infections, bull-neck appearance, leather like adherent membrane produced by an exotoxin. Bleeding of membranes may cause further spread causing paralysis of the palate and the pharynx

Answer 1

Diphtheria/Corynebacterium diphtheria (Tx: Pen G for 14 days or Erythromycin for 14days)

Question 2

A condition transmitted via aerosol drops producing explosive outburst in series of 5-10 coughs in one expiration ending in high pitched whoop and conjunctival or petechal hemorrhages on the upper body/

Answer 2

Whooping cough/Bordetella pertussis (Tx: Erythromycin for 14 days)

Question 3

Culture used for pertussis infection

Answer 3

Bordet Gengou agar plate

Question 4

Complications of pertussis infection

Answer 4

H-S-O-A-P: hemorrhage, seizures, otitis media, atelectasis, apnea, activation of latent TB, pneumonia

Question 5

A condition transmitted via droplets causing abrupt onset of fever, chills, headache, vomiting, rapid worsening of symtpoms within hours, initial morbiliform rash becoming petechial then purpuric within hours,

Answer 5

Meningococcemia/N. meningitidis (Tx: Pen G 250-400,000 U in 5-7 days, Ceftriaxone or Cefotaxime)

Question 6

A condition assoc with meningococcemia characterized by diffuse adrenal hemorrhage, DIC, coma, and death

Answer 6

Waterhouse-Friderichsen syndrome

Question 7

CSF finding in TB meningitis

Answer 7

Lymphocytic predominance, high protein, low glucose

Question 8

Prophylaxis for Meningococcemia

Answer 8

Rifampicin, Ceftriaxone IM single dose, Ciprofloxacin single dose

Question 9

An infection transmitted through ingestion of contaminated food and water from human feces characterized by prolonged high grade fever greater than 7 days, myalgia, abdominal pain, diarrhea/constipation, maculopapular rose spots on the lower chest or abdomen with a propensity for the ileum causing ileitis

Answer 9

Enteric Fever from S. typhi (Tx. 1. Uncomp: Chloramphenicol for 14d/Amoxicillin for 14d 2. Complicated: Ceftriaxone for 10-14d)

Question 10

Infection transmitted via feco-oral route causing watery voluminous diarrhea initially evolving into frequent small volume blood mucoid stools causing significant dehydration

Answer 10

Shigellosis or Dysentery/ Shigella dysenteriae; flexneri, biydii, sonnei (Tx: Cefixime for 5 days, Ceftriaxone for 5 days, Zinc for 14 days)

Question 11

Shiga-toxin, a potent protein synthesis inhibiting exotoxin in the colon which causes HUS is produced by what serotype of shigella?

Answer 11

S. dysenteriae serotype 1

Question 12

An infection transmitted via feco-oral route, found in roots of plants, undercooked shrimps, crabs, raw clams, oysters and mussels causing acute onset of profuse painless, watery diarrhea with rice water consistency and fishy odor, vomiting, washerwoman’s hands, no abdominal cramps or fever noted.

Answer 12

Vibrio Cholera (El tor 01 and 0139), Tx: Tetracycline for 3 days (not for less than 9 yrs old) or Doxycycline single dose

Question 13

Acquired via traumatic injury characterized by trismus, risus sardonicus, opisthotonus, boardlike rigidity, seizures

Answer 13

Tetanus/Clostridium tetani (Tx: TIG IM single dose

Question 14

Manifests within 3-12 days after birth as progressive difficulty in feeding with associated hunger and crying, paralysis or diminished movement, stiffness to touch, spasms

Answer 14

Neonatal tetanus (vignette: poor suck, born at home, (+) spasms)

Question 15

A condition caused by Treponema pallidum transmitted via sexual contact, transplacental transfer, blood transfusion, direct contact with infected tissues

Answer 15

Syphilis (Tx: Benzathine Penicillin G 50,000 U/kg IM)

Question 16

Chancre (clean painless ulcer with raised borders), regional lymphadenitis, heals spontaneously in 4-6 weeks

Answer 16

Primary Syphilis

Question 17

Manifests 2-10 weeks after the chancre heals, nonpruritic maculopapular rash on the palms and soles

Answer 17

Secondary Syphilis

Question 18

Gummatous lesions (granulomas of the skin and muskuloskeletal system)

Answer 18

Tertiary syphilis

Question 19

Congenital Syphilis: frontal bossing

Answer 19

olympian brow

Question 20

Congenital Syphilis: unilateral or bilateral thickening of the sternoclavicular portion of the clavicle

Answer 20

Higoumenaki’s sign

Question 21

Congenital Syphilis: Anterior bowing of the midportion of the tibia

Answer 21

Saber shins

Question 22

Congenital Syphilis: barrel shaped upper central incisors

Answer 22

Hutchinson teeth

Question 23

Congenital Syphilis: abnormal 1st lower molar

Answer 23

mulberry molar

Question 24

Congenital Syphilis: linear scars on mouth, anus, genitals

Answer 24

Rhagades

Question 25

Congenital Syphilis: painless knee joint swelling with sterile synovial fluid

Answer 25

Clutton joint

Question 26

An infection acquired via exposure to rat contaminated water or soil manifested as abrupt onset of chills, fever, severe myalgia, conjunctival suffusion, vomiting and headache

Answer 26

Leptospirosis/Leptospira interrogans (Tx: Pen G 6-8M U for 1 week)

Question 27

Stage of leptospirosis: Abrupt onset of fever, chills, sever headache, malaise, nausea, vomiting, myalgia, conjunctival suffusion with photophobia and orbital pain, hepatosplenomegaly, truncal red maculopapular rash

Answer 27

Anicteric leptospirosis, Septicemic phase

Question 28

Stage of leptospirosis: Brief asymptomatic interludde with recurrence of fever, now biphasic in character with aseptic meningitis

Answer 28

Anicteric leptospirosis, Immune phase

Question 29

Stage of leptospirosis: hemorrhage and cardiovascular collapse, RUQ pain, hepatomegaly, increased liver enzymes, hyperbilirubinemia, azotemia, oliguria then anuria

Answer 29

Icteric/Weil’s syndrome