Infectious Disease

Question 1

When should an emergently placed central catheter be removed?

Answer 1

Within 48 hours

Question 2

What test should you order to check for acute and disseminated histoplasma infection?

Answer 2

Histo urine Antigen

Question 3

Treatment for hot tub folliculitis

Answer 3

No antibiotics unless persistent infection, severe, or immunocompromised.

Question 4

What is the immune control phase of chronic Hep B?

Answer 4

1. DNA <2000
2. negative Hep B e antigen
3. normal LFTs

Question 5

If someone had Hep B, what is a consideration prior to starting immunosuppression?

Answer 5

Need to start antiviral before to prevent reactivation.

Question 6

What treatment is useful to prevent active Hep B in post exposure prophylaxis in susceptible person or in liver transplant where the host already had Hep B previously?

Answer 6

Hepatitis B immune globulin

Question 7

Patient with history of Hep B now inactive is preparing to receive liver transplant. How do you prevent the new liver from getting infected?

Answer 7

Hep B immune globulin

Question 8

What are 4 Ixodes infections?

Answer 8

Lyme, Anaplasmosis, Babesiosis, Powassan virus

Question 9

Which of the Ixodes infections are most likely to have meningoencephalitis?

A. Lyme
B. Babesiosis
C. Powassan virus
D. Anaplasmosis

Answer 9

C. Powassan virus

Question 10

What is the carrier for Japanese encephalitis?

Answer 10

Culex mosquito

Question 11

What is the presentation of Japanese encephalitis?

Answer 11

fever, Headache, encephalitis followed by focal neuro abnormalities (palsies, paralysis, Parkinsonian symptoms). May see aseptic meningitis.

will see IgM in CSF and later in serum

Question 12

What is the carrier for scrub typhus?

Answer 12

Chigger (orientia tsutsugamushi bacterium)

Question 13

What is the definition of disseminated Herpes Zoster?

Answer 13

any dermatomal involvement if immunocompromised. If immunocompetent, has to have at least 2 dermatomes or cross the midline.

Question 14

what is the difference in precautions needed between disseminated and focal Herpes zoster?

Answer 14

contact + airborne (can involve respiratory tract if disseminated) vs just contact

Question 15

What is the most common cause of fever in a returning traveler from South America?

Answer 15

Dengue

Question 16

What kind of fever is present in Dengue infection?

Answer 16

Abrupt onset of high fever with saddleback pattern (will go away then come back after a few days)

Question 17

What are distinguishing symptoms in Dengue fever?

Answer 17

Back pain (break bone fever), Retro-orbital pain, positive tourniquet test

Question 18

What disease do you think of with a positive tourniquet test? What does that mean?

Answer 18

1. Dengue
2. Petechiae develop distal to the BP cuff after it is deflated

Question 19

How is Chikungunya different from Dengue?

Answer 19

severe joint pain especially in the hands and feet, relapsing arthritis.

Can otherwise present similar to dengue, usually however this infection is asymptomatic.

Question 20

What symptoms are characteristic of Leptospirosis?

Answer 20

Conjunctival erythema, low back and calf pain. (may vary from just a fever to multisystem failure)

Question 21

What area of the world should you think of with typhoid fever?

Answer 21

South or Southeast Asia

(slow fever, longer lasting, GI sxs common, may have delayed rash over chest and abdomen)

Question 22

Why is vancomycin used in meningitis empiric coverage?

Answer 22

Double coverage due to high rates of ceftriaxone-resistant pneumococcus