Infectious Disease Flashcards by Heather White

What streptococcal-related disease presents as pharyngitis associated with a sandpaper rash, sore throat, fever, and a strawberry tongue appearance?

Scarlet Fever

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In moderate to severe impetigo, what is the treatment?

What bugs cause impetigo?

Oral antibiotics: Cephalexin or dicloxacillin

Staph. aureus and strep. pyogenes

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An India ink stain showing cysts should make you think of what diagnosis?

Cryptococcosis

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What immunoglobulin crosses the placenta?

IgG

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What immunoglobulin is responsible for early immunity?

IgM

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What are the most common fungal causes of purulent pericarditis?

Candida and Histoplasma species

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Bird or bat droppings should make you think of what diagnosis?

Histoplasmosis

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What animal is most likely to transmit rabies in the United States?

Bats

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Rabies is transmitted via saliva into bite wounds or mucus membranes. The virus then replicates. Does a bite on the head/neck have a shorter or longer incubation period compared to a bite on the extremities?

Shorter incubation period

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What are some symptoms of rabies infection?

What is the treatment?

Hydrophobia (fear of water, maifesting as throat spasms and making it difficult to swallow water)
Agitation
Muscle spasms
Hallucinations, ataxia, and seizures

Supportive care (often fatal), immune globulin if indicated

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What are the indications for rabies postexposure prophylaxis immune globulin?

Not previously vaccinated, immune globulin should be given around the wound site as soon as possible

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Describe the rash of Herpes Zoster?

Papulovesicular rash with unilateral, dermatomal distribution that does not cross the midline

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If performed, a Tzanck smear will show what kind of cells in Herpes Zoster infections?

Multinucleated giant cells

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Describe the presentation of Shigellosis?

Pateint presents with fever, bloody and mucoid diarrhea, and seizures (more common in children)

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What are some complications associated with shigella toxin?

Bacteremia and sepsis
Reactive arthritis
Hemolytic uremic syndrome
Seizure (m/c in children)

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A 16-year-old presents with an exudative sore throat and general malaise. Physical exam reveals posterior chain lymphadenopathy and splenomegaly. What diagnosis do you suspect?

Infectious mononucleosis

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How is infectious mononucleosis diagnosed?

Heterophile antibody test (Mono spot is more likely to be positive after second week of illness)

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How long after infection with mononucleosis should a patient refrain from contact sports?

At least 3-4 weeks

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Rice-water stool should make you think of what diagnosis?

What is the treatment?

Vibrio Cholera

Doxycycline or Ciprofloxacin; Azithromycin for pregnant patients

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A patient was camping a few days ago and now has a rash that began on his writs and ankles. What diagnosis should you be thinking of?

Rocky Mountain Spotted Fever

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What is the most common cause of food-borne gastroenteritis in the U.S.?

Campylobacter jejuni

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What are the most likely sources of a campylobactor jejuni infection?

Chicken
Water
Milk

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Which antibiotic is most likely to cause C. diff?

Clindamycin

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What are the two important pieces of patient education for anyone diagnosed with mononucleosis?

No contact sports (risk of splenic rupture) and no kissing (highly contagious)

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What is the minimum amount of time needed for a tick to transfer Lyme disease to a human?

24 hours

What type of mosquitos carry malaria?

Female anopheles

What is the most common cause of croup?

Parainfluenza virus

What is the treatment for Pneumocystis jirovecii pneumonia (PJP)?

Bactrim (TMP-SMX)

A gram-positive organism in clusters should make you think of what diagnosis?

Staphylococcus

What is the treatment for a tetanus infection?

Penicillin G, immune globulin, and supportive care (especially respiratory support)

Which herpes virus causes Epstein-Barr?

Human Herpesvirus 4

What might happen if you infuse vancomycin too quickly?

Red man syndrome (red rash of face, neck, and upper body)

A stuck-on grey membrane in the pharynx should make you think of what diagnosis?

Diptheria

What organism causes taxoplasmosis?

Toxoplasma gondii

The scotch tape test is used to diagnose what disease?

Pinworm (enterobiasis)

What organism is most commonly responsible for community-acquired pneumonia?

Strep pneumoniae

Bloody stool with cysts and trophozoites should make you think of what diagnosis?

Amebiasis

Under what age should a child not receive the flu vaccination?

6 months

Beefy red raised diaper rash with satellite lesions should make you think of what organism?

Candida

Post-exposure prophylaxis for meningoccocal meningitis is recommended for close contacts of patients with confirmed neisseria meningitidis. What is the treatment of choice?

Rifampin for 2 days For pregnant women, ceftriaxone for one dose is preferred

What organism is commonly the problem in a question where a hiker/camper has diarrhea?

Giardia lamblia

What drug do you use to treat pinworm?

Albendazole

Is neisseria gram (+) or gram (-)?

Gram negative

What is the drug of choice for syphilis?

Penicillin G

What is the most common prophylactic antibiotic used preoperatively?

Cefazolin (Ancef)

Is staph gram (+) or gram (-)?

Gram positive

What is the treatment for botulism?

Antitoxin

What causes mumps? | What is the most common complication of mumps?

Mumps is caused by the mumps virus, which is a paramyxovirus, an enveloped, single-stranded, negative-sense RNA virus | Orchitis

How do you definitively diagnose rabies?

Brain biopsy of the animal with fluorescent antibody staining

Why can't you give fluoroquinalones to kids?

They can cause issues with cartilage development

What is the most common complication following a shingles infection?

Post-herpetic neuralgia

What is the most common infection transmitted by rabbits?

Tularemia

What is the name of the PO antiviral with activity against influenza?

Oseltamivir; most effective within 48 hours of symptom onset

A patient presents to the ER with acute progressive descending weakness, diplopia, and a very dry mouth. What organism might be causing this?

Clostridium botulinum

A gram-positive organism in chains should make you think of what diagnosis?

Streptococcus

What are the first-line antibiotics to treat MRSA?

TMP-SMX, clindamycin, and doxycycline

Any reference to dark field microscopy should make you think of what organism?

Treponema pallidum

Owl-eye inclusion bodies should make you think of what diagnosis?

Cytomegalovirus (CMV)

Diarrhea with blood and mucus should make you think of what diagnosis?

Shigella

A pregnant woman and cat litter should make you think of what diagnosis?

Toxoplasmosis

What is the treatment for pertussis?

Azithromycin for 5 days

What is the treatment of shigella?

Hydration and ciprofloxacin

What is the causative organism of hot tub folliculitis?

Pseudomonas aeruginosa

What is the drug of choice for the treatment of Lyme disease?

Doxycycline

What disease is caused by Rickettsia rickettsii?

Rocky Mountain Spotted Fever

What is the drug of choice for urethritis caused by Neisseria?

Ceftriaxone 500 mg IM

What is the drug of choice to treat Lyme disease in pregnant women?

Amoxicillin

What is the most common cause of encephalitis in the U.S.?

HSV-1

What is a common lab finding in Rocky Mountain Spotted Fever?

Thrombocytopenia which can progress to DIC in severe cases - this is because the disease ffects the vascular endothelium

In a healthy, asymptomatic patient, what is the most sensitive test for tuberculosis?

Administration of purified protein derivative (PPD)

What is the screening test for syphalis?

Fluorescent treponemal antibody absorption (FTA-ABS)

What is the most common radiographic finding in tuberculosis?

Hilar lymphadenopathy

What is the first line treatment for pertussis?

Oral macrolide, either azithromycin, erythromycin or clarithromycin

In what phase of pertussis do you have the characteristic paroxysmal cough and inspriratory stridor?

Paroxysmal phase (weeks 2-6)

Though all infants are recommended to receive pertussis vaccination with a DTaP, what form of vaccination is recommended for adults?

Tdap, and the CDC recommends a booster every 10 years

What should be the treatment of choice in an individual with a severe penicillin allergy with strep?

Macrolides - clindamycin, asithromycin, or clarithromycin