Infectious Disease Flashcards
Which of the following is the most common site of Pott’s disease in adults?
a. Upper cervical vertebra
b. Upper thoracic vertebra
c. Lower thoracic vertebra
d. Lower lumbar vertebra
c. Lower thoracic vertebra
Skeletal TB: 10%
• Most commonly affects weight-bearing joints: spine (40%) >hips (13%) > knees (10%)
• related to reactivation of hematogenous foci or to spread from adjacent paravertebral LN
• Paravertebral abscess:
– Upper spine tracks to the chest as mass
– Lower spine reaches inguinal ligaments or present as psoas abscess
• Most common site:
– Children: Upper thoracic
– Adults: Lower thoracic and upper lumbar
• Treatment: chemotherapy
A 26/M consulted you for a 1-month history of unexplained weight loss and night sweats. Physical examination showed palpable cervical lymphadenopathies. Chest X-ray was unremarkable. Biopsy of the lymph node revealed granuloma formation with Langhans giant cells. The patient was started on anti-TB medications. What is the most proper diagnosis for this patient?
a. Presumptive TB
b. Clinically diagnosed TB
c. Bacteriologically confirmed TB
d. Disseminated TB
a. Presumptive TB
Presumptive PTB
• cough of 2 weeks
• Unexplained cough of any duration with close contact with a known active TB case or high risk population
• weight loss, fever, hemoptysis
• Chest xray suggestive of PTB
Presumptive extrapulmonary: pleural or pericardial effusions, ascites, LAD, gibbus neck stiffness, tuberculin hypersensitivity
Bacteriologically Confirmed PTB
POSITIVE BY:
• Direct Smear Microscopy w/ at least one specimen
• Culture
• Xpert MTB/ Rif
DSSM: confirms diagnosis of TB
If negative DSSM but symtpoms and xray suggest presence of TB –> Xpert MTB/Rif, TB culture
Clinically Confirmed PTB
• 2 negative sputum specimen for AFB or MTB BUT with radiologic abnormalities consistent with TB
• No response to empiric antibiotics, and who has been decided to have TB requiring full course of tx
What is the principal vector of dengue virus?
a. Anopheles spp.
b. Aedes spp.
c. Culex spp.
d. Mansonia spp.
Aedes
Stools that contain blood or mucus indicate what pathology?
a. Ulceration of the large bowel
b. Malabsorption
c. Shiga-toxin-producing enterohemorrhagic Escherichia coli
d. Cholera
Ulceration of the Large Bowel
Which of the following is TRUE in the resuscitation of patients with sepsis?
a. Resuscitation with IV colloids at 30 mL/kg should begin within the first 3 hours
b. Vasopressin is the first-choice vasopressor
c. Dobutamine should be used with the intent of reducing vasopressin dose
d. In patients with elevated serum lactate, resuscitation should be guided towards normalizing these levels
d. In patients with elevated serum lactate, resuscitation should be guided towards normalizing these levels
A 35/M was referred for anemia. He had a history of malaria when he was young, for which treatment with an unrecalled antimalarial drug caused severe anemia. His brother also has a mild form of anemia, which none of his parents have. What medication was most likely given to this patient?
a. Chloroquine
b. Mefloquine
c. Primaquine
d. Atovaquone
Primaquine
Which of the following is a manifestation of severe falciparum malaria?
a. Single episode of generalized seizure in the last 24 hours
b. Hemoglobin 68 g/L
c. Plasma glucose 76 mg/dL
d. Serum bicarbonate level 12 mmol/L
d. Serum bicarbonate level 12 mmol/L
58/M with no known comorbidities is brought to the ER for decline in sensorium. He has a 3-day history of undocumented fever, generalized weakness and decreased appetite. Physical examination shows BP 70/50, HR 128, RR 22. He grimaces to pain and does not follow commands. He remains hypotensive after fluid resuscitation. Which of the following antibiotic regimen is most appropriate to start in this case?
a. Ceftriaxone 2 g IV + Azithromycin 500 mg IV
b. Ampicillin-sulbactam 1.5 g IV q6h + Levofloxacin 750 mg IV
c. Piperacillin-tazobactam 4.5 g IV q6h + Levofloxacin 750 mg IV
d. Piperacillin-tazobactam 4.5 g IV q6h + Vancomycin 25 to 30 mg/kg loading dose
d. Piperacillin-tazobactam 4.5 g IV q6h + Vancomycin 25 to 30 mg/kg loading dose
What is the cornerstone of management and control of schistosomiasis?
a. Elimination of intermediate host snails
b. Use of personal protective equipment
c. Improvement of water quality and sanitation facilities
d. Praziquantel treatment of infected people and mass-drug administration programs
d. Praziquantel treatment of infected people and mass-drug administration programs
A 22/M consulted due to a dog bite 5 days ago. On the day of consult, his pet dog who bit him escaped. He previously received 3 doses of preexposure rabies vaccination. What is the next best step in management?
a. Observe
b. Rabies immune globulin (RIG) only
c. Booster vaccine only
d. RIG and booster vaccine
c. Booster vaccine only
Which of the following is TRUE in SARS-CoV infection?
a. Virus may have emerged from bats in the Middle East
b. Humans are infected thru direct or indirect contact with infected dromedary camels
c. Upper respiratory symptoms are very prominent
d. Watery diarrhea may occur
d. Watery diarrhea may occur
A 26/M was diagnosed with HIV 8 months ago. He is compliant with his antiretroviral treatment. His latest CD4+ T lymphocyte count is 750/µL and is currently asymptomatic. What is the patient’s Centers for Disease Control (CDC) infection stage?
a. Stage 0
b. Stage 1
c. Stage 2
d. Stage 3
Stage 2
Which of the following types of exposure confers the highest risk of HIV transmission?
a. Human bite
b. Needle-sharing during injection drug use
c. Receptive anal intercourse
d. Receptive penile-vaginal intercourse
Receptive anal intercourse
A 45/F came in for a follow-up visit. She had a 3-month history of intermittent fever and fatigue. She has no recent travel or exposure to known infections. She has not been taking any medications. Physical exam remains unremarkable throughout her multiple visits. Results of the serum lab tests are within normal limits. Chest X-ray and ultrasound are likewise normal. Which is the most appropriate next step in management?
a. Repeat history and physical examination
b. Cryoglobulin and fundoscopy
c. FDG-PET
d. Chest and abdominal CT
b. Cryoglobulin and fundoscopy
