Infectious Disease Flashcards
Conditions warranting empiric antibiotics in vertebral osteomyelitis
Severe sepsis, progressive neurologic deficit, spinal instability, epidural abscess
MKSAP 20
These conditions indicate a potentially serious infection requiring immediate antibiotic treatment.
Most common cause of recurrent viral meningitis
HSV-2
MKSAP 20
Herpes Simplex Virus type 2 is frequently associated with recurrent episodes of viral meningitis.
Intra-erythrocyte ring or tetrad inclusions
Babesia infection
MKSAP 20
Babesia is a protozoan parasite that infects red blood cells and can cause malaria-like symptoms.
Treatment for spinal epidural abscess with neurologic symptoms
Drainage and antibiotics
MKSAP 20
Immediate intervention is crucial to prevent permanent neurological damage.
Antibiotic treatment of early localized Lyme disease
Doxycycline, amoxicillin, or cefuroxime axetil
MKSAP 20
These antibiotics are effective for early-stage Lyme disease treatment.
Testing beyond urinalysis for women with uncomplicated UTI
None
MKSAP 20
Urinalysis is typically sufficient for diagnosing uncomplicated urinary tract infections.
Preferred test to assess for TB infection in patients with previous BCG vaccination
IGRA
MKSAP 20
Interferon-gamma release assays are more reliable in BCG-vaccinated individuals.
GI infection that can mimic appendicitis
Yersinia enterocolitica
MKSAP 20
This bacterium can cause abdominal pain and symptoms similar to appendicitis.
Treatment of esophageal candidiasis
Oral fluconazole
MKSAP 20
Fluconazole is an antifungal medication used to treat candidiasis in the esophagus.
Initial treatment of M. tuberculosis infection
INH, rifampin, pyrazinamide, and ethambutol
MKSAP 20
This combination therapy is the standard initial treatment regimen for tuberculosis.
Treatment of progressive multifocal leukoencephalopathy
Management of the underlying immunocompromised state
MKSAP 20
Addressing the immunocompromised condition is critical for managing this viral infection.
Recommended therapy for MSSA endocarditis
Nafcillin, oxacillin, or cefazolin
MKSAP 20
These antibiotics are effective against Methicillin-sensitive Staphylococcus aureus (MSSA).
Management of prosthetic joint infection
Two-stage procedure with device removal and antibiotic course followed by new device implantation
MKSAP 20
This approach helps ensure complete eradication of infection.
Treatment for streptococcal toxic shock syndrome
Penicillin and clindamycin
MKSAP 20
This combination targets the bacteria and reduces toxin production.
Treatment for MSSA bacteremia
Penicillinase-resistant semisynthetic penicillin or first-generation cephalosporin
MKSAP 20
These antibiotics are chosen for their efficacy against MSSA.
Treatment for outpatient CAP in otherwise healthy patients
Amoxicillin, doxycycline, or a macrolide (if regional pneumococcal resistance <25%)
MKSAP 20
These antibiotics are recommended for community-acquired pneumonia in healthy individuals.
Characteristics of varicella rash
Centripetal distribution of macules, papules, vesicles at various stages of development
MKSAP 20
The varicella (chickenpox) rash has a distinctive progression and distribution.
Therapeutic drug class for invasive candidiasis without CNS or eye involvement
Echinocandins
MKSAP 20
This class of antifungals is preferred for treating serious candidiasis infections.
Best imaging test for evaluation of possible vertebral osteomyelitis
MRI with and without contrast
MKSAP 20
MRI is the most sensitive imaging modality for detecting vertebral infections.
Management for uncomplicated coagulase-negative Staphylococcus CLABSI
Remove catheter and repeat blood cultures
MKSAP 20
This approach is essential for diagnosing and treating central line-associated bloodstream infections.
Meningitis, cranial neuropathies, mental status changes, SIADH
TB meningitis
MKSAP 20
These symptoms are indicative of tuberculosis infection affecting the central nervous system.
Treatment of anaplasmosis
Doxycycline
MKSAP 20
Doxycycline is the first-line treatment for infections caused by Anaplasma species.
Prophylaxis for CMV infection
Valganciclovir
MKSAP 20
This antiviral medication is used for preventing cytomegalovirus infections, especially in immunocompromised patients.
Neurologic manifestations of Lyme disease
Meningitis, facial palsy, radiculopathy
MKSAP 20
Lyme disease can lead to various neurological complications if untreated.
Initial treatment for disseminated histoplasmosis
Liposomal amphotericin B
MKSAP 20
This antifungal is used for severe cases of histoplasmosis to control the infection.
Treatment for enterohemorrhagic E. coli
Supportive care
MKSAP 20
Test to determine cause of osteomyelitis in diabetic foot infection
Bone biopsy
MKSAP 20
Vaccination assessment following animal bite
Rabies and tetanus
MKSAP 20
Indications for travelers’ diarrhea prophylaxis
IBD or immunocompromise
MKSAP 20
Treatment of asymptomatic catheter-associated bacteriuria
None
MKSAP 20
Positive antigen/antibody but negative differentiation immunoassay and HIV RNA
False-positive HIV test
MKSAP 20
Diagnostic test for early Zika virus infection
Reverse transcriptase PCR on serum and urine
MKSAP 20
Timeframe to begin prophylactic antibiotics for Lyme disease
Within 72 hours if tick attached ≥36 hours
MKSAP 20
Intravenous antibiotic treatment for severe cat bite
Piperacillin-tazobactam, ampicillin-sulbactam, imipenem, or meropenem
MKSAP 20
Elective surgeries requiring preop nasal screening for S. aureus
Cardiothoracic and orthopedic
MKSAP 20
Infection control for hospitalized TB patients
Airborne isolation
MKSAP 20
Lab testing for genital warts
None
MKSAP 20
Treatment for purulent skin infection with systemic signs of infection
Incision and drainage, then trimethoprim-sulfamethoxazole or doxycycline
MKSAP 20
Causes of epididymitis in younger sexually active men
Gonorrhea and chlamydia
MKSAP 20
“Unmasking” of a previous infection after initiating HIV treatment
Immune reconstitution inflammatory syndrome
MKSAP 20
Treatment for mild babesiosis
Atovaquone plus azithromycin
MKSAP 20
CD4 count associated with increased risk for pneumocystis pneumonia
<200/µL
MKSAP 20
Mosquito-borne febrile disease with severe muscle pain
Dengue fever
MKSAP 20
Pneumococcal vaccination in unvaccinated patients with HIV
20-valent PCV alone or 15-valent PCV followed by 23-valent PPSV
MKSAP 20
Most common causes of chronic meningitis
TB and fungi
MKSAP 20
Manifestations of Lyme carditis
AV nodal block
MKSAP 20
Treatment of symptomatic cyclospora infection
Trimethoprim-sulfamethoxazole
MKSAP 20
Prophylactic treatment for smallpox exposure
Vaccinia immunization
MKSAP 20
Recommended CD4 count to initiate ART for HIV infection
Any CD4 count
MKSAP 20
Most significant risk factor for C. difficile colitis
Antibiotic therapy
MKSAP 20
Induction therapy for cryptococcal meningitis
Lipid formulation of amphotericin B plus flucytosine
MKSAP 20
Symptoms associated with leptospirosis after freshwater exposure contaminated with rodent urine
Meningitis, uveitis, rash, red conjunctivae, lymphadenopathy, hepatosplenomegaly
MKSAP 20
CDC criteria for pulmonary TB that is no longer contagious
Treated for 2 weeks, clinical improvement, 3 negative sputum smears collected 8 hours apart
MKSAP 20
Recommended treatment for uncomplicated urogenital gonococcal infection if chlamydia infection ruled out
Ceftriaxone 500 mg IM once
MKSAP 20
Test for possible tuberculous monoarthritis with unrevealing synovial fluid analysis
Synovial biopsy
MKSAP 20
Treatment of uncomplicated brucellosis
Extended doxycycline plus rifampin or gentamicin
MKSAP 20
Chlamydia screening and diagnostic test in men
Urine NAAT
MKSAP 20
Fungal infection of cutaneous and lymphocutaneous tissue associated with plant exposure
Sporotrichosis
MKSAP 20
Test of sputum following positive AFB smear
NAAT
MKSAP 20
Medications that are associated with aseptic meningitis
NSAIDs, antimicrobial agents, intravenous immune globulin
MKSAP 20
Gonorrhea screening and diagnostic test in women
Genital swab NAAT
MKSAP 20
Major risk factors for invasive aspergillosis
Neutropenia, HSCT, solid organ transplant, hematologic malignancy
MKSAP 20
Adjunctive therapy for severe CAP in the ICU
Glucocorticoids
MKSAP 20
PrEP for HIV
Tenofovir plus emtricitabine or cabotegravir alone
MKSAP 20
Lyme disease testing for patient with erythema migrans and tick exposure
None
MKSAP 20
Symptoms of infection after salt water exposure leading to cellulitis with hemorrhage bullae
Vibrio vulnificus, Vibrio parahaemolyticus infection
MKSAP 20
Characteristic chest radiograph finding of inhalational anthrax
Widened mediastinum
MKSAP 20
Treatment for MRSA toxic shock syndrome
Vancomycin plus clindamycin
MKSAP 20
Cause of hemorrhagic colitis after consuming contaminated beef
Enterohemorrhagic E. coli
MKSAP 20
Risk factors for nongonococcal gram-negative joint infections
Injection drug use, advanced age, traumatic wounds, immunocompromised state
MKSAP 20
Mycobacterium species associated with hospital-acquired prosthetic valve endocarditis
Mycobacterium chimaera
MKSAP 20
HIV postexposure treatment
Tenofovir, plus either emtricitabine or lamivudine, plus either dolutegravir or bictegravir (three-drug regimen)
MKSAP 20
Treatment for group A Streptococcus necrotizing fasciitis
Surgical debridement, penicillin and clindamycin
MKSAP 20
Empiric treatment for TB meningitis
4-drug anti-TB regimen of rifampin, isoniazid, pyrazinamide, and ethambutol plus dexamethasone
MKSAP 20
Pyelonephritis indications for imaging
Fever lasting >72 hours, persistent bacteremia
MKSAP 20
Treatment duration for uncomplicated CAP with rapid clinical improvement
5 days
MKSAP 20
Preferred HIV ART regimen for most patients
Three-drug regimen from two different classes, preferably including an integrase inhibitor
MKSAP 20
Sensitive assay for acute and disseminated histoplasmosis
Histoplasma urinary antigen
MKSAP 20
Positive tuberculin skin test in patient with no TB risk factors
≥15 mm
MKSAP 20
Ground-glass attenuation surrounding nodule on lung CT
“Halo sign” associated with invasive aspergillosis
MKSAP 20
Initial management of CAUTI
Remove catheter and obtain new urinalysis and urine culture
MKSAP 20
Treatment for severe C. difficile colitis
Oral fidaxomicin (preferred) or oral vancomycin
MKSAP 20
Painless violaceous skin nodules in AIDS patient
Kaposi sarcoma
MKSAP 20
Diagnostic test for suspected genital herpes simplex infection
NAAT
MKSAP 20
Causes of CAP with exposure to pregnant animals
Coxiella burnetii infection (Q fever), Brucella species
MKSAP 20
Indications for asymptomatic bacteriuria screening
Pregnancy or planned invasive urologic procedure with mucosal bleeding
MKSAP 20
Empiric antibiotics for bacterial meningitis, age >50 years
Ampicillin plus ceftriaxone plus vancomycin
MKSAP 20
Cause of PTLD
EBV infection
MKSAP 20
Empiric antibiotic therapy for health care–associated meningitis
Vancomycin plus either cefepime, ceftazidime, or meropenem
MKSAP 20
Preferred antibiotic therapy for MRSA bacteremia
Vancomycin or daptomycin
MKSAP 20
Treatment duration for VAP
≤7 days
MKSAP 20
Initial imaging for all new diabetic foot infections
Plain radiography
MKSAP 20
First-line treatment for invasive aspergillosis
Voriconazole
MKSAP 20
Impact of continuing SSI prophylactic antibiotics postoperatively
None
MKSAP 20
Painful ear canal vesicles and Bell palsy
Herpes zoster oticus (Ramsay Hunt)
MKSAP 20
Management of ART during pregnancy
Continue ART
MKSAP 20
Most common cause of febrile illness in returning travelers
Malaria
MKSAP 20
Postexposure treatment for bioterrorism-related anthrax
Ciprofloxacin, levofloxacin, or doxycycline plus vaccination
MKSAP 20
Initial treatment of primary genital herpes simplex infection
Acyclovir, valacyclovir, or famciclovir
MKSAP 20
Antibiotic therapy for ampicillin-sensitive enterococcal endocarditis
Ampicillin plus gentamicin or ampicillin plus ceftriaxone
MKSAP 20
Hepatitis A prophylaxis given within 1-2 weeks of travel
Single-dose hepatitis A vaccine
MKSAP 20
Recommended for travelers to endemic areas.
Prevention of fungal infection after HSCT
Posaconazole
MKSAP 20
Used to prevent invasive fungal infections in immunocompromised patients.
The “4 Ds” of botulism
Diplopia, dysarthria, dysphonia, dysphagia
MKSAP 20
Key clinical features of botulism.
Specialized viral testing after HIV diagnosis
Genotype viral resistance
MKSAP 20
Important for determining appropriate antiretroviral therapy.
Most common agent causing prosthetic joint infection
Staphylococci
MKSAP 20
Particularly Staphylococcus aureus and Staphylococcus epidermidis.
Clinical syndromes of coccidioidomycosis
Acute or chronic pulmonary infection, cutaneous infection, meningitis, osteoarticular infection
MKSAP 20
Caused by Coccidioides species.
High-risk features for invasive Salmonella infection
Age ≥50 years with significant joint disease or valvular, endovascular, or cardiac disease; immunocompromise; age ≥65 years
MKSAP 20
These factors increase susceptibility to severe infections.
Malaria infections associated with potentially high levels of parasitemia
P. falciparum and P. knowlesi
MKSAP 20
Both can cause severe malaria and high parasite loads.
Treatment of severe travelers’ diarrhea in SE Asia
Azithromycin
MKSAP 20
Recommended for bacterial causes of diarrhea.
Duration of IV acyclovir therapy for HSV encephalitis
14-21 days
MKSAP 20
Essential for effective treatment of this serious condition.
Major complication of Zika virus infection in women
Fetal malformation
MKSAP 20
Associated with congenital Zika syndrome.
Common source of Campylobacter infection
Undercooked poultry
MKSAP 20
A leading cause of bacterial gastroenteritis worldwide.
Recommended diagnostic studies for causative organism in outpatients with CAP
None
MKSAP 20
Clinical diagnosis is often sufficient in outpatients.
Positive tuberculin skin test in HIV-positive patient
≥5 mm
MKSAP 20
Indicates significant exposure or infection risk.
GI illness from reptiles and amphibians
Nontyphoidal salmonella
MKSAP 20
Commonly transmitted through contact with reptiles.
Risk factors for diabetic foot ulcer–related osteomyelitis
Exposed bone, diameter >2 cm, nonhealing
MKSAP 20
Indicators of possible osteomyelitis in diabetic patients.
CD4 count associated with increased risk for MAC infection
<50/µL
MKSAP 20
Mycobacterium avium complex infections are a concern in advanced HIV.
Most cost-effective, specific initial imaging test for osteomyelitis if symptoms present for at least 14 days
Plain radiography
MKSAP 20
First-line imaging modality for suspected osteomyelitis.
CSF WBC >1000/µL, neutrophil predominance, glucose <40 mg/dL, protein 100-500 mg/dL
Bacterial meningitis
MKSAP 20
Classic findings in the cerebrospinal fluid analysis.
Management of infected human bites to the hand
Antibiotics plus surgical evaluation
MKSAP 20
Essential to prevent complications from bite wounds.
Neuraminidase inhibitor treatments for influenza
Oseltamivir (oral), zanamivir (inhaled), peramivir (IV)
MKSAP 20
Effective antiviral options for treating influenza.
Noninfectious encephalitis associated with ovarian teratoma in young women
Anti-NMDAR encephalitis
MKSAP 20
A serious autoimmune condition.
Foundation of infection prevention
Hand hygiene
MKSAP 20
Critical in reducing transmission of infections.
MKSAP 20
Treatment of bacterial joint infection
Antimicrobial therapy and joint drainage
MKSAP 20
Necessary for effective management of joint infections.
Antibiotics for osteomyelitis and retained orthopedic hardware
An antistaphylococcal agent to which the organism is sensitive, plus rifampin (if sensitive)
MKSAP 20
Important for treating infections associated with orthopedic implants.
Antibiotic treatment for mild nonpurulent cellulitis
Clindamycin, penicillin, cephalexin, dicloxacillin
MKSAP 20
Indications to stop pneumocystis prophylaxis in HIV-treated patients
CD4 count ≥200/µL for ≥3 months
MKSAP 20
Diagnostic testing for SSI
Culture of drainage, purulent fluid, or infected tissue
MKSAP 20
Management of rhino-orbital-cerebral mucormycosis
Extensive surgical debridement and early antifungal therapy
MKSAP 20
Positive HIV antigen/antibody, negative differentiation immunoassay, positive RNA NAAT indicates
Acute HIV infection
MKSAP 20
Painless, indurated genital ulcer is characteristic of
Chancre of primary syphilis
MKSAP 20
Cause of swimming pool–related diarrhea
Cryptosporidium
MKSAP 20
Most common manifestation of secondary syphilis
Rash with involvement of palms and soles
MKSAP 20
Posttransplant fever in the middle to late posttransplant period, lymphadenopathy, extranodal mass indicates
PTLD
MKSAP 20
Synovial fluid leukocyte count in infectious arthritis is
> 50,000/µL
MKSAP 20
MKSAP 20
Recommended oral antibiotic treatment for uncomplicated pyelonephritis is
7 days ciprofloxacin or 5 days levofloxacin
MKSAP 20
Daptomycin outpatient therapy monitoring includes
Weekly creatinine and creatine kinase
MKSAP 20
Initial treatment of symptomatic amebiasis
Metronidazole or tinidazole
MKSAP 20
Prophylactic antibiotic indications in women with recurrent UTI are
≥3 UTIs in 12 months or ≥2 in 6 months
MKSAP 20
Gram-negative coccobacilli with “safety pin” shape is
Yersinia pestis
MKSAP 20
Musculoskeletal side effect of fluoroquinolone antibiotics is
Tendinitis and tendon rupture
MKSAP 20
Most common organism causing vertebral osteomyelitis is
S. aureus
MKSAP 20
Common organ-specific manifestations of CMV infection include
- Pneumonia
- Encephalitis
- Esophagitis
- Colitis
MKSAP 20
Treatment duration for uncomplicated non-S. aureus CLABSI is
7-14 days
MKSAP 20
HME peripheral blood smear finding is
Morulae
MKSAP 20
Hallmark finding in Rocky Mountain spotted fever is
Delayed macular rash around ankles and wrists followed by central spread, progressing to petechiae or purpura
MKSAP 20
Management of ART during immune reconstitution inflammatory syndrome is to
Continue ART
MKSAP 20
Evaluation of watery diarrhea of <3 days’ duration in healthy patients results in
None
MKSAP 20
ICU CAP treatment includes
3rd-generation cephalosporin or ampicillin-sulbactam plus a macrolide or respiratory fluoroquinolone
MKSAP 20
Daily protocol to prevent CLABSI includes
Assessment of ongoing need for central line
MKSAP 20
Strategy to determine need for CMV treatment after HSCT
NAAT monitoring for CMV viremia
MKSAP 20
NAAT stands for nucleic acid amplification testing, which is used for detecting viral infections.
Osteomyelitis imaging after negative radiography
MRI with and without contrast
MKSAP 20
MRI is preferred for better visualization of bone and soft tissue involvement.
Treatment of uncomplicated Salmonella infection in patients aged <50 years
Supportive care
MKSAP 20
Antibiotics are generally not recommended for uncomplicated cases.
Treatment for MSSA toxic shock syndrome
Nafcillin or cefazolin combined with clindamycin
MKSAP 20
Clindamycin is used for its ability to inhibit toxin production.
Symptoms of disseminated gonococcal infection
Tenosynovitis, migratory polyarthralgia, and vesiculopustular rash
MKSAP 20
These symptoms may indicate a systemic spread of Neisseria gonorrhoeae.
Chronic skin infection after contact with fish tanks, fish, shellfish
Mycobacterium marinum
MKSAP 20
This bacterium is associated with aquatic environments and can cause skin infections.
Most common reason for blood culture–negative endocarditis
Pre-culture antibiotic administration
MKSAP 20
Antibiotics can inhibit bacterial growth, leading to negative cultures.
Prophylactic antibiotic treatment for a complicated dog bite
Amoxicillin-clavulanate
MKSAP 20
This antibiotic combination covers both aerobic and anaerobic bacteria commonly found in dog bites.
Risk factors for vertebral osteomyelitis
Older age, immunocompromise, indwelling catheters, hemodialysis, injection drug use, previous spinal surgery, degenerative disease
MKSAP 20
These factors increase susceptibility to infections of the spine.
CSF test highly sensitive for cryptococcal meningitis
Cryptococcal antigen
MKSAP 20
This test detects the presence of cryptococcal polysaccharide in cerebrospinal fluid.
CD4 count associated with increased risk for toxoplasmosis
<100/µL
MKSAP 20
A low CD4 count indicates a weakened immune system, increasing susceptibility to opportunistic infections.
Treatment for symptomatic giardiasis
Metronidazole, tinidazole, or nitazoxanide
MKSAP 20
These medications are effective against Giardia lamblia.
Adjunctive bacterial meningitis treatment
Dexamethasone
MKSAP 20
Dexamethasone is used to reduce inflammation and complications associated with bacterial meningitis.
Diagnostic test for VZV encephalitis without vasculopathy
CSF PCR
MKSAP 20
Polymerase chain reaction (PCR) testing can detect varicella-zoster virus in the cerebrospinal fluid.
Neisseria serogroup not covered by the quadrivalent conjugate meningococcal vaccine
Serogroup B
MKSAP 20
The quadrivalent vaccine covers serogroups A, C, W, and Y but not B.
Treatment for symptomatic coccidioidomycosis
Fluconazole
MKSAP 20
Fluconazole is an antifungal medication effective against Coccidioides species.
Symptoms of typhoid fever
Fever, relative bradycardia, abdominal pain, ‘rose spot’ rash
MKSAP 20
These are classical signs of typhoid fever caused by Salmonella Typhi.
Rapid sensitive and specific test for C. difficile colitis
NAAT for C. difficile toxin genes
MKSAP 20
NAAT is used for its high sensitivity in detecting C. difficile infections.
Treatment of fulminant C. difficile colitis
Oral vancomycin, IV metronidazole; vancomycin enema if ileus is present
MKSAP 20
This treatment approach addresses severe cases of C. difficile colitis.