Infectious Disease Flashcards
What is the most common endemic fungal infection in the United States?
What is it most common associated exposure?
Histoplasmosis
Bird or Bat Feces
A 46-year-old man presents to the urgent care with 4 days of diarrhea and abdominal cramps. He states he started to feel fatigued and had a low-grade fever when he got back from his Costa Rica trip. He then noticed abdominal cramping and explosive watery diarrhea that has now turned into bloody diarrhea. He reports around eight episodes of diarrhea per day. Vital signs today include HR of 92 bpm, BP of 132/81 mm Hg, RR of 16/min, oxygen saturation of 98% on room air, and T of 100.4°F. Upon physical exam, inspection and percussion of the abdomen is unremarkable. Auscultation reveals hyperactive bowel sounds. Mild tenderness to deep palpation of all four quadrants is elicited. A stool culture is obtained and is positive for Shigella. What is the best next step in the management of this patient’s condition?
Oral Hydration and Ciprofloxacin
A 23-year-old prison inmate was brought in from the detention clinic with a 3-day history of crampy abdominal pain and diarrhea. The patient reports the stools were small in volume and bloody. On examination, his abdomen is tender, he has decreased skin turgor, and the temperature was found to be 101.5°F (38.6°C). Stool microscopy reveals numerous RBCs and WBCs. A stool culture was ordered. What is the most likely diagnosis?
Shigella
A 7-year-old boy presents to the clinic with his parents for fever and sore throat that started suddenly yesterday. He also reports pain with swallowing, fatigue, and nausea but no cough, joint aches, myalgias, or abdominal pain. His medical history includes seasonal allergies to tree pollen, and he takes OTC cetirizine daily but no other medications. He is allergic to penicillin (rash). His vital signs today include T of 101.1°F, BP of 105/75 mm Hg, RR of 18/min, HR of 104 bpm, and oxygen saturation of 100% on room air. His physical exam reveals tender anterior cervical lymphadenopathy, and tonsils are red and edematous with exudates present on the pharynx and tonsils. Skin is warm, without rashes or lesions, and abdomen is soft, nontender, and without organomegaly. Sinuses are nontender, and tympanic membranes are pearly gray with no erythema bilaterally. Due to the most likely diagnosis and allergy to penicillins, what do you prescribe?
A Cephalasporin for Pharyngitis
What lymph nodes are most likely to be swollen in pharyngitis?
Anterior Cervical
What is the preferred antibiotic for treating Lyme Disease?
What are the contraindications to this antibiotic?
Doxycicline
One 200 mg dose is recommended for prophylaxis if the tick was embedded for > 36 hours and being given within 72 hours of exposure
Kids and pregnant women, Amoxicillin should be given instead
Which bacterium causes the tick-borne illness Rocky Mountain spotted fever?
Rickettsia rickettsii
A 40-year-old man with a history of HIV presents to the clinic with fever, cough, chest pain, and shortness of breath for 6 days. He was on antiretroviral therapy but stopped treatment 6 months ago. His recent travel includes a trip to Arizona 3 weeks ago, and he has no known sick contacts. Vital signs include a heart rate of 84 bpm, blood pressure of 114/78 mm Hg, respiratory rate of 26/minute, oxygen saturation of 94% on room air, and temperature of 100.4°F. Physical examination reveals regular rate and rhythm, mild respiratory distress, no stridor, rales and dullness to percussion over the right lung field, and soft, nontender abdomen. Point-of-care CD4 test results are 210 cells/mm3. What is the most likely diagnosis?
Coccidioidomycosis is a fungal infection caused by the dimorphic fungi species Coccidioides immitis and Coccidioides posadasii and is also known as valley fever. The fungi are found in soil and are endemic to arid regions of the western United States, including California, Arizona, New Mexico, Utah, and Nevada.
What medication is administered when a patient’s CD4 count is < 100 cells/mm3 to prevent toxoplasmosis?
Bactrim
