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AMC MCQ flashcards > Infection > Flashcards

Infection Flashcards

1
Q

meningitis most common pathogen and empirical treatment? (for different age groups)

A
  • 0-2 months (Group B streptococcus, E.Coli) : benzylpenicillin + cefotaxime
  • >2months (N. Meningitidis, HiB, S pneumoniae) : ceftriaxone or cefotaxime, vancomycin if Gram positive
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2
Q

meningitis prophylaxis?

A

children, pregnant : Ceftriaxone

other adults : ciprofoxacin or rifampin

(rifampin contraindicated in severe liver disease, alcoholism)

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3
Q

a child with itching scalp, patchy loss of hair, scaling.

Dx and Tx?

A

Dx : Tinea capitis

Tx : PO antifungals (griseofulvin or terbinafine)

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4
Q

spontaneous baterial peritonitis

Dx, most common pathogen and Tx ?

A

ascitic fluid PMN > 250uL,

confirmed by culture

most commonly E.coli and other gut bacterial

initial Tx cefotaxime 2g IV 8 hourly

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5
Q

measles

how many days of school exclusion?

A

4 days from the onset of the rash

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6
Q

Tetanus vaccine schedule

A
  • DTPa 5 doses : 2, 4, 6 and 18 months, and 4 yrs old.
  • dTPa (reduced antigen) booster :
    • at 11-13 yrs
    • > 50 yrs old if last dose was more than 10 yrs ago
    • >65 yrs old if last dose was more than 10 yrs ago
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7
Q

an adult never been vaccinated against tetanus in the past. what to give?

A
  • dT 3 doses with 4 weeks intervals (1st dose should be dTPa. all three can be dTPa)
  • booster (dT or dTPa at 10 and 20 yrs after the primary doses)
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8
Q

18 months

high fever for 3 days

fever suddley subsides and maculopapular rash on trunk

no rash on face or limb

Dx?

A

roseola infantum

caused by HHV-6 or 7

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9
Q

severe endometritis?

what pathogens to cover?

which Abx?

what if she has a history of anaphylaxis to penicillin?

A

gonorrhea, chlamydia

ceftriaxone, azithromycin + metronidazole.

gentamicin, azithromycin + metronidazole

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10
Q

adult community acquired pneumonia.

empirical Abx?

A

Is it mild, moderate,severe?

  • Confusion : new onset
  • O pO2 <60mm or O2 sat <90
  • RR >30
  • BP sys <90 or diast < 60

none: mild, 1 : moderate, 2 or more: severe

mild :

  • amoxicillin 1g PO 8 hourly,
  • review in 48 hours.
  • (if cannot review in 48 hours, consider using doxycycline instead)
  • imporved –> 5 days,
  • slow improvement, 7 days.

moderate : admission

  • benzylpenicillin + doxycycline OR clarithromycin

Severe : ICU

  • benzylpenicillin +gentamicine + clarithromycin
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11
Q

the most common cause of gastroenteritis in adults and older children in australia?

in young children?

A

adults and older children : norovirus

youger children : rotavirus

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12
Q

thumb sign on lateral neck xray

Dx

m/c pathogen

Tx

A
  • epiglotittis
  • Past : H influenzae type B (not anymore due to the vaccine)
  • Current : Group A beta hemolytic streptoccocus
  • don’t delay airway protection because od Xray
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13
Q
A
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14
Q

cellulitis Abx?

A

IV flucoloxacillin

difloxacillin

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15
Q

hepatic hydatid cyst

which pathogen?

hosts?

how to eradicate?

human treatment?

A
  • pathogen : echinococcus
  • main host : dogs. intermediate host : sheep. accodental host : humans
  • eradication? :vaccination of lambs, deworming of dogs
  • Percutaneous drainage with albendazole therapy
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16
Q

exposure to measles.

Management?

1) Hx of vaccination (+)
2) vaccination history unsure
3) pregnant, immunecompromised, not sure of vaccination

A

1) Hx of vaccination (+) : reassure
2) vaccination history unsure : MMR vaccine now and 4 weeks later
3) pregnant, immunecompromised, not sure of vaccination : natural human immunoglobulin (NHIG)

17
Q

three strategies to reduce perinatal HIV transmission?

A
  1. use of zidobudine for the mom and baby
  2. elective C-sec
  3. no breastfeeding
18
Q

prophylactic antibiotics for HIV patients with low CD4 count?

what species to cover?

A

need to cover,

  • < 200: toxoplasmosis
  • < 100 : Pneumocystis jiroveci
  • < 50 : MAC

use

  • trimethoprim-sulfamethoxazole : for toxo and PCJ
  • azithromycin : for MAC
19
Q

diabetic foot ulcer anti?

A

mild infection : PO amoxicillin-clavulanate

deep or widespread infections, osteomyelitis : piperacillin-tazobactam, ticarcillin-clavulanate, meropenem, ertapenem, carbapenem,

moxi or ciprofloxacin + metronidazole

3rd cephalosporin + metronidazole

20
Q

a man travelled to Thailand recently

presented with

fever, joint pain, retro-orbital pain, rash all over body,

no LAP,

leukopenia, thrombocytopenia. elevated AST

A

dengue fever

21
Q

diffuse patchy infiltrates on x ray

suspected atypical pneumonia

What is the most common pathgen in each age group?

children < 2 yrs

school aged children

A

children < 2 yrs : viral pneumonia

school aged children : mycoplasma pneumoniae

22
Q

scabies Tx

A

permethrin 5% cream

23
Q

adult, recurrent sinusitis, failed with amoxacillin, trimethoprim/sulphamethoxazole.

Tx?

A

a fluoroquinolone 14-21 days

24
Q

roundworm infection Tx?

(Ascarid lumbricoid infection)

25
Q

the most common pathogen for hospiral-acquired pneumonia

A

S. aureus

P. aeruginosa

26
Q

child with suspected pneumonia.

Tx?

A

out patient : amoxacillin 3-5 days

inpatient, not severe : amoxacillin. (if unable to take orally, consider benzylpenicillin IV)

inpatient, sever (ICU) : ceftriaxone + azithromycin

27
Q

Malaria prophylaxis with… ?

in Thai/Myanmar/Cambodia

in Central America

in South America or Africa

A

Thai/Myanmar/Cambodia : doxycycline, atovaquone-proguanil

Central America : chloroquine (chloroquine worsens psoriasis)

South America or Africa : Mefloquine (mefloquine can cause panic attacks, paranoia)

28
Q

vaccines that contain egg proteins?

A

Influenza

yellow fever

Q fever

29
Q

typhoid or paratyphoid fevers (enteric fevers)

salmonella from India

Tx?

A

azithromycin or ceftriaxone

India

use ciprofloxacin only if stool culture or blood cultures confirm the sensitivity.

30
Q

Rheumatic fever

the revised Jones criteria

A
  • 2 Major
  • 1 major + 2 minor + recent confirmed GAS infection (anti streprolysyn Ab, rapid antigen test for strep A , throuat culture)

Major

  1. carditis
  2. polyarthritis
  3. chorea
  4. erythema marginatum
  5. subcutaneous nodules

Minor

Clinical

arthralgia

fever

laboratory

elevated ESR/CRP

1st degree AV block

31
Q

the most common pathogen for pneumonia in patients with cystic fibrosis

under 5 years old ?

10 years and older?

A
  • under 5 years old : S. aureus
  • 10 years and older : Pseudomonas aeruginosa
32
Q

sore throat.

when to give antibiotics?

A

streptococcal score

  • no cough
  • fever > 38
  • cervical LN
  • tonsillar exudates
  • age 3-14

0-1: supportive care

2-3 : culture, or RADT–> Abx if positive

>4 : treat with amoxicillin

AMC MCQ flashcards (21 decks)

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